Vermont Emergency Department Suicide Prevention Quality Improvement Initiative

Data

Suicide is a serious public health issue, with more than 49,000 lives lost nationally in 2022.
In Vermont, 125 individuals died by suicide in 2023. Data show that 65% of those who died had visited a healthcare provider within a year of their death, and 35% had visited an ED within a year of death.
According to Vermont’s Youth Risk Behavior Survey:
- One in seven high school students made a plan about how they would attempt suicide.
- One in five seriously thought about killing themselves.
Vermont survey data indicate that most ED staff lack prior suicide prevention training, underscoring the need for comprehensive education and resources.
50% of assessed elements across Vermont EDs show significant opportunities for improvement in suicide care best practices.

overview

The Vermont Suicide Prevention in the Emergency Department (ED) Quality Improvement (QI) Initiative is a pioneering effort to strengthen suicide care within Vermont’s emergency departments. With nearly universal voluntary participation from hospitals across the state since March 2022, Vermont is emerging as a national leader in advancing suicide prevention in ED settings. This initiative is dedicated to equipping emergency departments with the essential tools, training, and resources necessary to deliver evidence-based, suicide-safer care.

FUNDERS

Thank you to our generous funders for supporting this work: The Four Pines Fund and the Vermont Department of Health.

Our Goals

Improve the quality of care for patients presenting to Vermont EDs experiencing suicidality.
Implement evidence-based suicide-safer care pathways in Vermont EDs.
Provide training and resources to ED staff on best practices in suicide prevention.
Develop and sustain a statewide collaborative focused on suicide prevention in emergency care settings.
Reduce suicide deaths and suicide attempts by strengthening care pathways and interventions in ED settings.

KEY COMPONENTS OF THE INITIATIVE

1. Implementation of Suicide-Safer Care Pathways IN VERMONT EMERGENCY DEPARTMENTS

Adoption of the Essential Elements of a Suicide Care Pathway, ensuring systematic, evidence-based approaches to suicide prevention in emergency departments (EDs).

2. ED Staff Training & Capacity Building

Comprehensive Counseling on Access to Lethal Means (CALM) training to enhance suicide prevention efforts.
Access to on-demand technical assistance from local and national Subject Matter Experts, expert consultation, and annual mock surveys to support continuous quality improvement and readiness.

3. Quality Improvement (QI) Learning Collaborative

Quarterly QI learning collaborative meetings featuring peer-sharing, expert guidance, and applied learning.

4. Data-Driven Quality Improvement

Tracking key performance indicators (KPIs) aligned with the Essential Elements of Suicide-Safer Care to measure impact and progress.
Leveraging real-time data to drive continuous improvement in ED suicide prevention efforts.

IMPACT

93%-100% of Vermont hospitals participating

Over 400+ ED staff across 14 hospitals trained in Counseling on Access to Lethal Means (CALM)
100% of hospitals indicating improvements in their suicide care policies, procedures, or processes