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The intention of this requirement is to specify that each patient receives care in an environment that a reasonable person, similarly, situated as the patient, would consider to be safe. For example, hospital staff should follow current standards of practice for patient environmental safety, infection control, and security. The hospital must protect vulnerable patients, including newborns and children. Additionally, this standard is intended to provide protection for the patient’s emotional health and safety as well as his/her physical safety. Respect, dignity, and comfort would also be components of an emotionally safe environment. To provide care in a safe setting, hospitals should identify patients at risk for intentional harm to self or others, identify environmental safety risks for such patients, and provide education and training for staff and volunteers. Patients at risk of suicide (or other forms of self-harm), or who exhibit violent behaviors toward others, receive healthcare services in both inpatient and outpatient locations of hospitals. Therefore, non-psychiatric settings of all hospitals where patients with psychiatric conditions may be cared for should also identify patients at risk for intentional harm to self or others and mitigate environmental safety risks. Psychiatric patients requiring medical care in a non-psychiatric setting (medical inpatient units, ED, ICU, etc.) must be evaluated, monitored, and cared for appropriately when demonstrating suicidal ideation or potential harm to others. The care could include, but not be limited to, utilizing safety measures such: as 1 on 1 monitoring with continuous visual observation, removal of sharp objects from the room/area, or removal of equipment that can be used as a weapon.

Although all risks cannot be eliminated, hospitals should be able to show how they identify patients at risk of self-harm or harm to others as well as steps they are taking to minimize those risks in accordance with nationally recognized standards and guidelines.

The potential risks include, but are not limited to, those from ligatures, sharp objects, harmful substances, access to medications, breakable windows, accessible light fixtures, plastic bags (for suffocation), oxygen tubing, bell cords, etc.

Hospitals may find the recommendations and resources in the 2018 report, Recommended standard care for people with suicide risk: Making health care suicide safe, issued by the National Action Alliance for Suicide Prevention (Action Alliance), to be highly useful in developing the best practices for effective patient screening and assessment for those patients at risk for harm to themselves, as well as for improving the care of patients at risk of suicide. 1 The Action Alliance is the public-private partnership working to advance the National Strategy for Suicide Prevention and reduce the suicide rate 20 percent by 2025. Notably, the report advances two of the goals of the National Strategy for Suicide Prevention (National Strategy): (a) Promote suicide prevention as a core component of health care services; and (b) Promote and implement effective clinical and professional practices for assessing and treating those identified as being at risk for suicidal behaviors. (To download a copy of the National Strategy, please visit: www.actionallianceforsuicideprevention.org).

Stay tuned in to your journal for facts and fun about us! We can’t wait to see all of you at the Summit! More Summit information will be sent as it is finalized and made available. This is the event that you won’t want to miss!

The Kentucky Hospital Association (KHA) provided scholarships and invited Rick to teach the Healthcare Accreditation Certification Program (HACP-CMS) to two cohorts in November and December, 2023. CIHQ would like to thank KHA for the opportunity, and congratulations to each cohort! We appreciate the feedback received and would like to welcome each of them to HACP!

“Great educational course, Rick was great! Thank you to KHA for providing this and scholarships!”