Grantees enter data into ZS-MT Data Collection tool
Data Collection Guide
This Data Collection Guide is geared to assist in entering the quarterly data required by SAMHSA.
Resources
WICHE Suicide Prevention Toolkit for Primary Care with the American Indian Addendum
Quick Links
| Quarter 1 | October 1 - December 31 |
| Quarter 2 | January 1 - March 31 |
| Quarter 3 | April 1 - June 30 |
| Quarter 4 | July 1 - September 30 |
| Quarter 1 | January 24 |
| Quarter 2 | April 23 |
| Quarter 3 | July 24 |
| Quarter 4 | October 24 |
Grant Activities
This flowsheet describes the clinical flow that follows a Zero Suicide framework, and is broken down into grant activities by tier at each point. The flowsheet and included activities can be adapted to a variety of clinical, non-clinical, and lay settings.
Budget Example
The budget is the yearly plan for spending grant dollars. The Budget Example below was designed to assist grantees in developing their yearly budgets. They need to be itemized and justify all expenses.
Invoice Example
Invoice is the request for money on funds already spent and need to reflect the scope of work.
The following provides an overview of the Zero Suicide Evaluation plan over the course of the five-year grant.
Phase 1
Phase 2
Phase 3
Phase 4
Phase 5
View the “big picture” of Zero Suicide and the steps taken to fully implement the framework. Each step contains the necessary items to do for that theme. There may be some overlap between themes, but they all work together to make Zero Suicide function efficiently.
Make a Plan
Make a Plan
Form Clinical Implementation Team (CIT)
Form Community Advisory Board (CAB) (includes referral network)
Brainstorm on implementation:
-
what is currently being done
-
where activities can be added
-
what kind of timeline is needed
-
what resources you will need
current level of staff engagement
- Perform baseline data assessments with organization staff
- Organizational Self-Assessment, Workforce Readiness Assessment, etc. Decide how to best get results
- Incentivize as necessary
Create a work plan, data collection plan, patient tracking plan
Map the plan and process of change for the clinic workflow
Train
Train
Analyze surveys for training needs
Communicate with a trainer on protocol/toolkit training
Identify additional training for evidence-based practices CIT wishes to implement
Facilitate training of staff:
- workforce development
- (recognition and action, e.g., QPR)
- (Lethal Means Counseling)
- (Safety Planning)
- formal ZS training
- (whole protocol/toolkit – screen, assess, treat/transfer, follow up in the clinical workflow)
Extend training to community partners (as needed and appropriate)
Track all training, meetings, etc. for trending over time
Put it into Action
Put it into Action
Implement Zero Suicide full
Risk Assessment (for patients indicating suicide risk)
Treat and/or Transfer
- (all) Lethal Means Counseling
- (all) Safety Planning
- (as available) in-house intervention, e.g., DBT or CBT
- (as needed and appropriate) referral, transfer to additional resources or definitive care
-
Follow Up (non-punitive caring contacts, phone calls, house visits) within 48 - 72 hours, at 3 months, at 6 months
-
Re-Engage (repeat screening for high-risk patients on return visits)
Track at-risk patients’ matriculation and status
Track quantitative data on screenings, assessments, referrals, follow ups
Track qualitative data for staff, providers, patients, and community
Collaborate with Community
Collaborate with Community
Utilize the CAB to foster data-sharing, reports back on patient status, and partnership in creating safe transfers for patients at risk of suicide (“Warm Handoffs”) in order to create a closed-loop system
Hold and attend regular CAB meetings
Share outcome data from lead clinical site CIT with staff and CAB
Create postvention plans (immediate, short-term, long-term) with CAB
Continue to build your CAB and referral network
Continue to build community awareness and buy-in to Zero Suicide using CAB and media tools
Work with the CAB on sentinel event review and process improvement
Report Data
Report Data
Perform baseline data
Repeat baseline data annually
Repeat processual data every six months
Report quarterly numbers to State:
- Number screened
- Number and percent assessed
- Number and percent referred
- Number and percent completed referrals
Number reached for follow-up- Sentinel events (suicide attempts and deaths)
Utilize State Sentinel Event Review Team, if necessary
CIT/CAB make program improvement recommendations for implementation
General questions on the Zero Suicide Project?
For grant questions, contact Madeline Boehm, Zero Suicide Grant Manager
For evaluation questions, contact Kate Chapin, Zero Suicide Project Evaluator
