Adapting and implementing Caring Contacts in a Department of Veterans Affairs emergency department: a pilot study protocol

Sara J Landes; JoAnn E Kirchner; John P Areno; Mark A Reger; Traci H Abraham; Jeffery A Pitcock; Mary J Bollinger; Katherine Anne Comtois

doi:10.1186/s40814-019-0503-9

Adapting and implementing Caring Contacts in a Department of Veterans Affairs emergency department: a pilot study protocol

Pilot Feasibility Stud. 2019 Oct 10:5:115. doi: 10.1186/s40814-019-0503-9. eCollection 2019.

Authors

Sara J Landes^{1

2

3}, JoAnn E Kirchner^{1

3}, John P Areno⁴, Mark A Reger^{4

5}, Traci H Abraham^{2

3

6}, Jeffery A Pitcock¹, Mary J Bollinger^{3

6}, Katherine Anne Comtois⁷

Affiliations

¹ 1QUERI for Team-Based Behavioral Healthcare, Central Arkansas Veterans Healthcare System, North Little Rock, AR USA.
² South Central Mental Illness Research Education and Clinical Center (MIRECC), Central Arkansas VA Health Care System, North Little Rock, AR USA.
³ 3Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR USA.
⁴ 4South Central VA Health Care Network, Ridgeland, MS USA.
⁵ 5VA Puget Sound Health Care System, Tacoma, WA USA.
⁶ 6Center for Mental Healthcare & Outcomes Research (CeMHOR), Central Arkansas Veterans Healthcare System, North Little Rock, AR USA.
⁷ 7University of Washington School of Medicine, Seattle, WA USA.

Abstract

Background: Suicide among veterans is a problem nationally, and suicide prevention remains a high priority for the Department of Veterans Affairs (VA). Focusing suicide prevention initiatives in the emergency department setting provides reach to veterans who may not be seen in mental health and targets a critical risk period, transitions in care following discharge. Caring Contacts is a simple and efficacious suicide prevention approach that could be used to target this risk period. The purpose of this study is to (1) adapt Caring Contacts for use in a VA emergency department, (2) conduct a pilot program at a single VA emergency department, and (3) create an implementation toolkit to facilitate spread of Caring Contacts to other VA facilities.

Methods: This project includes planning activities and a pilot at a VA emergency department. Planning activities will include determining available data sources, determining logistics for identifying and sending Caring Contacts, and creating an implementation toolkit. We will conduct qualitative interviews with emergency department staff and other key stakeholders to gather data on what is needed to adapt and implement Caring Contacts in a VA emergency department setting and possible barriers to and facilitators of implementation. An advisory board of key stakeholders in the facility will be created. Qualitative findings from interviews will be presented to the advisory board for discussion, and the board will use these data to inform decision making regarding implementation of the pilot. Once the pilot is underway, the advisory board will convene again to discuss ongoing progress and determine if any changes are needed to the implementation of the Caring Contacts intervention.

Discussion: Findings from the current project will inform future scale-up and spread of this innovation to other VA medical center emergency departments across the network and other networks. The current pilot will adapt Caring Contacts, create an implementation toolkit and implementation guide, evaluate the feasibility of gathering outcome measures, and provide information about what is needed to implement this evidence-based suicide prevention intervention in a VA emergency department.

Keywords: Caring Contacts; Emergency department; Implementation; Suicide prevention; Veterans.