WIP 110 - The Impact of Electronic Health Record Prompt on Assessing Firearm Access in Patients who Present to the Pediatric Emergency Department for Mental Health Concern

Poster Number: WIP 110
Publication Number: WIP 110.2579

Background: Firearms are a particularly lethal means utilized in youth suicide attempts. Counseling on safe firearm storage by healthcare providers has been shown to increase the adoption of safer firearm storage practices among patients. Yet, studies indicate that providers do not consistently address this topic with patients. Electronic health record (EHR) prompts that encourage providers to discuss firearm access and safe storage with patients presenting for a mental health concern may increase the number of providers who routinely counsel this high-risk group.

Objective: To determine if implementing an EHR prompt screening for firearm access and safe storage increases the frequency of provider documentation of firearm access in patients presenting to the pediatric emergency department (PED) for a mental health concern.

Design/Methods: This is a prospective cohort study of patients < 21 years of age presenting to the PED with a mental health concern at a large, urban, quaternary-care hospital from June 2021 to June 2023. Eligible patients were identified by meeting at least one of the following criteria: assigned a mental health-related chief complaint, enhanced or constant observation order, or psychiatry service consult order. The percentage of eligible patients with documentation of firearm access will be calculated before and after implementation of an EHR prompt in the mental health chief complaint note template. The prompt consists of binary questions asking if the patient has firearm access and if the firearm is stored locked and unloaded. The month of EHR prompt implementation, June 2022, will be considered a washout period. The proportion of patients with documentation of firearm access before and after the intervention will be compared using a t-test. Subgroup analyses will be performed to assess for associations in documentation of firearm access by age, sex, race/ethnicity, and insurance type. Deidentified data was collected and analysis will be completed by April 2024. This study was approved by the Albert Einstein College of Medicine IRB.