D.15 d. SUICIDE BEHAVIOR AND OVERDOSE REPORT -SBOR- FREQUENTLY ASKED QUESTIONS - ATTACHED.pdf

Suicide Behavior and Overdose Report (SBOR): Frequently Asked

Questions

Updated 7/13/2022

General:

• What is the SBOR?

• When should I enter a SBOR?

• Who can complete an SBOR?

Reporting Suicide Events

• What are the requirements for using the SBOR to report suicidal behaviors?

• Do suicidal self-directed violence behaviors need to be documented in SPAN?

• What CPT (procedure) code should I use for completing the SBOR?

• Do we still need to add ICD-10 diagnosis codes to an encounter since suicidal behaviors are being tracked through the SBOR?

• Can events that occurred while the Veteran was on active duty be reported in the

SBOR?

Reporting Overdoses & Severe Adverse Drug Events

• What are the requirements for using the SBOR to report overdose events?

• What is an overdose?

• What is an adverse drug event?

• Do all adverse drug events (overdose events) need to be reported in the SBOR?

• Does an SBOR need to be completed if a patient accidentally takes more of a drug than recommended or intended, but does not experience a moderate or severe adverse drug event?

• What are some possible signs and symptoms of a severe adverse drug event? A moderate adverse drug event?

• What should I do with the section, under overdose reporting, marked THIS

SECTION TO BE COMPLETED BY PATIENT’S TREATMENT PROVIDER?

• What is the Overdose Review Team?

• My facility has not yet designated an Overdose Review Team. Who should I notify about a reported overdose event?

• I am reporting an overdose event in which Naloxone was used on the patient.

Should I complete the SBOR or the Naloxone Use Note?

• What is the VA Adverse Drug Event Reporting System?

Note Template & Data Questions

• The date of the event being reported is unknown. How should the date be entered in the template?

• I need to enter more than one event for the patient. Can I enter multiple events within the same note?

D. 15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004

• I entered the event date incorrectly on the SBOR. How can I fix this?

• Can CPRS alerts be enabled to notify SPCs or other staff members of completed

SBOR notes?

• How can I pull aggregate data on the number of Veterans who have had a reported event?

• I have learned additional information about a previously reported event. How should

I report the new information?

General:

What is the SBOR?

The Suicide Behavior and Overdose Report (SBOR) template is a national note template designed to standardize and streamline the process of reporting any suicidal self-directed violence behavior or overdose event among VA patients.

When should I enter an SBOR?

The SBOR should be entered by clinical staff who learn of any suicidal self-directed violence behavior or overdose event within the last 12 months. In accordance with the most current memorandum, reporting overdose events through the SBOR, including accidental overdoses, is now required. Each event only needs to be documented once.

• Suicidal self-directed violence behaviors include:

o Preparatory behaviors for suicide (e.g., writing a suicide note, stockpiling meds, buying a gun) o Preparatory behaviors for self-directed violence, where intent for suicide is undetermined o Suicide attempts, with and without injury o Self-directed violence events, with and without injury, where intent for suicide is undetermined o Deaths by suicide o Deaths by self-directed violence, where intent for suicide is undetermined

• Overdose events include:

o Suicidal and accidental overdoses o Fatal and non-fatal overdoses

The CSRE (Comprehensive Suicide Risk Evaluation) allows for the documentation of certain suicidal self-directed violence behaviors that are reported within the context of a

CSRE. If the Veteran reports a suicide attempt during a suicide risk evaluation, you may report the patient’s most recent suicide attempt, most lethal suicide attempt, and/or most recent preparatory behavior in the CSRE instead of the SBOR. If you do report the details of a suicidal behavior within a CSRE template, you should NOT also complete an SBOR for the same event (and vice versa). Each event should only be reported once.

The Veteran’s most recent suicide attempt, most lethal suicide attempt, and most recent preparatory behavior for suicide can be reported in the CSRE. If the Veteran reports additional attempts or preparatory behaviors, those events should be reported separately in an SBOR (one SBOR per additional event).

Who can complete an SBOR?

An SBOR should be completed by the first clinical staff member who learns of the

Veteran’s suicidal self-directed violence behavior or overdose. For staff-specific guidance on completing an SBOR, see:

https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20

SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/SBOR%20Staff-

Specific%20Guidance.pdf

The Suicide Behavior and Overdose Report (SBOR) is primarily a reporting tool, not an assessment tool. As such, nurses, with the exception of LPNs, may complete the SBOR to report any suicidal self-directed violence behavior or overdose event. When reporting overdose events, there is a set of questions relating to assessment and treatment that should be completed by a member of the patient’s treatment team (LIP). When filling out the SBOR, these questions may be skipped (indicated by the text: “THIS SECTION TO BE

COMPLETED BY PATIENT’S TREATMENT PROVIDER”). This will generate a cover sheet reminder for the patient’s treatment team to review the completed note and answer these additional questions.

Reporting Suicidal Self-Directed Violence Behaviors:

What are the requirements for using the SBOR to report suicidal self-directed violence behaviors?

As mandated in VHA Memorandum 031816 – UPDATE TO SUICIDE BEHAVIOR REVIEW

AND REPORTING, the SBOR is required to be be used by clinical staff to record all suicidal self-directed violence behaviors (including preparatory, and events with unknown/possible suicidal intent) that occurred within 12 months of date of notification. For any events reported involving suicidal or undetermined intent, facility Suicide Prevention

Teams are responsible for reviewing completed SBOR templates.

Do suicidal self-directed violence behaviors need to be documented in SPAN?

Historically, Suicide Prevention Coordinators/teams had been required to enter suicidal behaviors into a separate data system called SPAN (Suicide Prevention Application

Network). The SBOR eliminates the need for double-entry, and entry of suicidal behaviors and deaths for VA patients into SPAN has been phased out. SPCs should no longer report suicide events or deaths of VA patients into SPAN.

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004 https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/SBOR%20Staff-Specific%20Guidance.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/SBOR%20Staff-Specific%20Guidance.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/SBOR%20Staff-Specific%20Guidance.pdf

The Suicide Behavior Summary Report is a tool to assist SPCs and leadership with aggregate data collection as related to fatal and non-fatal suicide events. This dashboard unifies information that is recorded in Suicide Behavior and Overdose Reports (SBOR), Comprehensive Suicide Risk Evaluations (CSREs) and the Suicide Prevention

Applications Network (SPAN), and helps to provide present and historical counts of suicide-related events.

SPAN should continue to be used by SPCs to document suicide deaths of non-VA-enrolled

Veterans.

What CPT (procedure) code should I use for completing the SBOR?

The SBOR is a communication tool and a way of documenting information. It is not in and of itself a service. A CPT code is selected based on the type of clinical care/service being provided by a clinician and is required for billing purposes when completing an encounter.

Generally, completion of the SBOR will be part of a scheduled appointment time and would not be coded separately from that scheduled service. If information was received about suicidal behavior outside of a scheduled appointment or outside of time spent providing clinical care to a Veteran e.g. receiving a report from a community hospital of suicidal behavior with no contact with the Veteran then the SBOR should be completed by selecting “historical” at the time a “new visit” is created in CPRS rather than completing an encounter. No CPT code is selected for historical visits.

Do we still need to add ICD-10 diagnosis codes to an encounter since suicidal self-directed behaviors are being tracked through the SBOR?

Yes. The SBOR does not automatically generate ICD-10 codes.

For additional guidance on ICD-10 coding for suicide-related behaviors, see:

https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20

SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Coding%20Guidance/ICD-

10_Coding_for_Suicide-Related_Behavior.pdf

Can events that occurred while the Veteran was on active duty be reported in the

SBOR?

Yes. If the Veteran’s suicidal self-directed violence behavior or overdose event occurred within the past 12 months, it must be reported in the SBOR, even if the event occurred while the Veteran was on active duty.

Reporting Overdoses and Severe Adverse Drug Events

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004 https://dvagov.sharepoint.com/sites/VHAOMHSPSPP/Landing_Pages/Suicide%20Behavior%20Summary%20Report%20Dashboard.aspx https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Coding%20Guidance/ICD-10_Coding_for_Suicide-Related_Behavior.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Coding%20Guidance/ICD-10_Coding_for_Suicide-Related_Behavior.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Coding%20Guidance/ICD-10_Coding_for_Suicide-Related_Behavior.pdf

What are the requirements for using the SBOR to report overdose events?

With publication of the most recent memorandum, any overdose events that occurred within the past 12 months must be reported with the SBOR. Overdose events that occurred within the past 12 months must be reported in the SBOR include:

• Accidental Overdoses

• Suicidal Overdoses

• Overdoses with Undetermined Intent

What is an overdose?

An overdose is defined as injury to the body (poisoning) that happens when a drug is taken in excessive amounts (CDC). An overdose can be fatal or nonfatal. An overdose can be accidental or intentional. An overdose can occur with prescription medication, over-the-counter medication, unprescribed substances, and foods/substances with toxic potential

(alcohol, ethylene glycol - antifreeze). Overdoses can also occur with multiple substances being used or ingested together.

Some overdoses may be classified as adverse drug events.

What is an adverse drug event?

An Adverse Drug Event (ADE) is an injury resulting from the use of a drug. This definition includes harm caused by the drug as a result of adverse drug reactions, drug-drug interactions, product quality problems, or drug overdoses (whether accidental or intentional).

Do all adverse drug events* (overdose events) need to be reported in the SBOR?

No. All accidental overdoses that result in a moderate* or severe* adverse drug event

(injury) need to be reported in the SBOR.

Accidental overdoses that result in a mild adverse drug event, or other types of adverse drug events (e.g., adverse drug reactions, drug-drug interactions, product quality problems) should still be reported to the VA ADERS POC, but are not required to be documented in the SBOR.

All intentional overdoses, or overdoses with undetermined intent for suicide, need to be reported in the SBOR, regardless of extent of injury.

*Adverse Drug Events (ADEs) Severity levels are:

(1) Mild ADE. A mild ADE is an event that requires no intervention or minimal therapeutic intervention such as discontinuation of drug(s).

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fopioids%2Fbasics%2Fterms.html&data=04%7C01%7C%7C9bf72a77161b468d73f108d95e7aec45%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637644704303661231%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=kKnDMAEJ%2FFZW69fFKl6hBjnwbAldbZWX4r5p4%2FVsG00%3D&reserved=0

(2) Moderate ADE. A moderate ADE is an event that requires active treatment of adverse reaction, or further testing or evaluation to assess extent of non-serious outcome.

(3) Serious ADE. A serious ADE occurs when a patient’s condition has one or more of the following outcomes (or requires medical intervention to prevent one of these outcomes):

death, a life-threatening experience, inpatient hospitalization (or a prolonged hospitalization), a persistent or significant disability, or a congenital anomaly or birth defect.

For more details, see Directive 1070, Adverse Drug Event Reporting and Monitoring:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8831

Does an SBOR need to be completed if a patient accidentally takes more of a drug than recommended or intended, but does not experience a moderate or severe adverse drug event?

No. An SBOR only needs to be completed in the following cases:

• Accidental overdose that results in a moderate or severe adverse drug event (injury)

• Any suicidal self-directed violence behavior, or behavior of undetermined intent

What are some possible signs and symptoms of severe adverse drug event? A moderate adverse drug event?

The severity of the event is not symptom** dependent, but it is a reflection of the care provided to the individual related to the overdose or suspected overdose. Depending on the prescribed medications (example: opioids) or unprescribed substance

(example: heroin, methamphetamine) that are involved, the care provided may include

(but is not limited to) obtaining labs, monitoring with an EKG or requiring EMS assistance, administration of naloxone for an opioid reversal, administering activated charcoal, or evaluation in an emergent/urgent care setting.

**Depending on the drug involved, possible signs and symptoms of a severe adverse drug event could include respiratory depression, seizures, loss of consciousness, hallucinations, or lack of response to stimuli. Signs and symptoms of a moderate adverse drug event could include sedation, slurred speech, muscle tremors/altered movement, visual disturbances, changes in mood or mental function, difficulty with urination, or distressing or intolerable headaches, fatigue, digestive disturbances, etc.

What should I do with the section, under overdose reporting, marked THIS SECTION

TO BE COMPLETED BY PATIENT’S TREATMENT PROVIDER?

This section contains additional questions relating to the patient’s risk factors for overdose, changes to the patient’s treatment plan, and referrals. This section is intended to be filled out by a member of the Veteran’s treatment team (LIP). If you are not a current member of https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.va.gov%2Fvhapublications%2FViewPublication.asp%3Fpub_ID%3D8831&data=04%7C01%7C%7C9bf72a77161b468d73f108d95e7aec45%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637644704303666209%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=8uU7j99IkdWjEUkSoVFD8Q%2BiCnI35IQvOZTDhZyAwYc%3D&reserved=0 the Veteran’s treatment team, you may skip this section when filling out the SBOR template. By skipping the section and submitting the SBOR, a cover sheet reminder will be generated, which will allow a member of the Veteran’s treatment team to complete these questions at a later point. If you are a member of the Veteran’s treatment team (LIP), you should click the box to expand the questions and complete them.

Note: This clinical reminder is only available at facilities that installed the UPDATE_2_0_23

VA-NALOXONE USE template and activated the associated cover sheet reminder. If this reminder is not active at your facility, talk to your health informatics staff about the process for turning on a new cover sheet reminder at your site.

What is the Overdose Review Team?

Local facilities are strongly encouraged to designate a team at their facility to regularly review reported overdose events. This team should have expertise in:

• pain management,

• addiction,

• pharmacology, and/or

• mental health.

A facility’s STORM or CARA review team may be appropriate to serve as the Overdose

Review Team, and/or may be a good point of contact in developing a new interdisciplinary review team at the facility.

At minimum, facilities are required to ensure a process is in place to review overdose events. Teams may consider discussing medication lethality, (e.g., advisable to prescribe less lethal alternative? Less lethal alternative available?), whether supply of medication should be modified, use of blister packs or other safety mechanisms, trends in certain medications being used to overdose.

STORM POC List:

https://vaww.portal2.va.gov/sites/PERC/STORM/Resource%20Library/STORM%20POCs.

xlsx

My facility has not yet designated an Overdose Review Team. Who should I notify about a reported overdose event?

If your facility has not yet designated an Overdose Review Team, you should at minimum ensure that the Veteran’s treatment team is notified of the event and that the facility has a process in place for reviewing overdose events. If the event should be reviewed by another team as well (e.g., Suicide Prevention Team for suicidal events, MHRRTP team for events that occurred in MH RRTP setting, VA ADERS POC for severe adverse drug events), please ensure that team is also notified.

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvaww.portal2.va.gov%2Fsites%2FPERC%2FSTORM%2FResource%2520Library%2FSTORM%2520POCs.xlsx&data=04%7C01%7C%7C9bf72a77161b468d73f108d95e7aec45%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637644704303671235%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=gUSD1Czq%2B9lvIcfeB3R02Uftj6XWIwxmEigSjHyrVZE%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvaww.portal2.va.gov%2Fsites%2FPERC%2FSTORM%2FResource%2520Library%2FSTORM%2520POCs.xlsx&data=04%7C01%7C%7C9bf72a77161b468d73f108d95e7aec45%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637644704303671235%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=gUSD1Czq%2B9lvIcfeB3R02Uftj6XWIwxmEigSjHyrVZE%3D&reserved=0

I am reporting an overdose event in which Naloxone was used on the patient.

Should I complete the SBOR or the Naloxone Use Note?

All of the elements of the Naloxone Use Note, for cases where naloxone was used on the patient, have been incorporated into the SBOR template. When reporting an overdose event in which naloxone was used on the patient, you should use the SBOR instead of the

Naloxone Use Note. When reporting an overdose event in which naloxone was used on someone other than the patient, continue to use the Naloxone Use Note.

The Naloxone Use Note is a national note template used to document and track outpatient naloxone use. For more details on this template:

https://vaww.va.gov/REMINDERS/docs/National_Naloxone_Use_Note.pptx

What is the VA Adverse Drug Event Reporting System?

The VA Adverse Drug Event Reporting System (VA ADERS) is the VA’s national adverse drug event (ADE) reporting system for spontaneous ADE reporting. VA ADERS is accessible at all VA facilities. Facility users are able to submit reports to the centralized VA database on a standardized report template for drugs, biologic products, and vaccines/immunizations. Reports may be forwarded to the FDA MedWatch program and the FDA/CDC Vaccine Adverse Event Reporting System (VAERS). For more information on VA ADERS, visit https://vaww.cmop.med.va.gov/MedSafe_Portal/training.asp.

With regard to the SBOR, an adverse drug event (ADE) can be reported in VA ADERS to document what happened with the use of the medications. The unintended consequences surrounding the use of several medications were the emphasis for also reporting in VA

ADERS so that national tracking and trending could take place for events where an overdose occurred but was not the intention. This was first described as situations surrounding opioids and use of other sedating medications or interacting medications that may affect the patient’s mental state, consciousness, etc. That injury/harm to the patient is the intended “event” to report to the VA ADERS program. When reported in VA ADERS, the reporter may enter descriptive terms to indicate the details surrounding the event as well as any documentation of intended or unintended outcomes. Once the report is received, those specific details are matched to standardize terms that help in aggregating the events (e.g., accidental overdose and unintentional overdose could be queried and aggregated under the same term for an unintentional overdose and would be separate from intentional overdose and overdose (not otherwise described)). Likewise, intentional overdose that is documented may have descriptions that allow for aggregated reporting that is described by a similarly descriptive term.

Note Template and Data Questions

The date of the event being reported is unknown. How should the date be entered in the template?

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fvaww.va.gov%2FREMINDERS%2Fdocs%2FNational_Naloxone_Use_Note.pptx&data=04%7C01%7C%7Cabbda56bb61a42de5c2808d960a7f389%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637647096719095850%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=w%2BAJN79%2BORSdLO9kHrwsBGj44GvzPFoAL3KzdXBnhTM%3D&reserved=0 https://vaww.cmop.med.va.gov/MedSafe_Portal/tools.asp#VAADERS https://vaww.cmop.med.va.gov/MedSafe_Portal/training.asp

Event date should be entered in the format MM/DD/YYYY, even if the date is approximate.

Event date should be approximated whenever possible with a month/day/year. For example, if the Veteran states the event occurred ‘last month’ but was not able to provide a specific date, enter last month, year and estimate the day as the 1st of the month in this format: 06/01/2021.

I need to enter more than one event for the patient. Can I enter multiple events within the same note?

No. Only one event at a time can be reported within this template. If the patient reports multiple events that have not already been reported, please do the following:

1. Enter the first event in the SBOR template.

2. For the second event that needs to be reported, create a new historical visit.

3. Within that new historical visit, enter an SBOR note for the second event.

4. Repeat steps 2 and 3 for any additional events that need to be reported.

I entered the event date incorrectly on the SBOR. How can I fix this?

Some data (including, importantly, the date of the event) is stored as comments to a health factor. Follow the below instructions to edit the health factor comments to ensure data accuracy.

1. Click on the signed Note, then choose Encounter.

2. Choose Edit Note Encounter.

3. Click on health factor tab, click to highlight and select the health factor whose comments need to be updated.

a. For CSRE Most Recent Attempt date: VA-SUICIDE PRIOR ATTEMPT DATE

b. For CSRE Most Lethal Attempt date: VA-SUICIDE PRIOR ATTEMPT DATE

LETHAL

c. For CSRE Most Recent Preparatory behavior date: VA-PREP BEHAVIOR RECENT

DATE

d. For SBOR event date: VA-SBOR EVENT DATE

4. Update/Enter correct date in comment field.

5. Click OK.

For detailed instructions and screenshots, please see:

https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20

SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Add ing%20Health%20Factors%20in%20Encounter%20Form.pdf

Can CPRS alerts be enabled to notify SPCs or other staff members of completed

SBOR notes?

Each facility will need to individually consult with their Health Informatics staff to assist with activating that programming. CACs will need to complete a group in VistA with the names

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004 https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Adding%20Health%20Factors%20in%20Encounter%20Form.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Adding%20Health%20Factors%20in%20Encounter%20Form.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Adding%20Health%20Factors%20in%20Encounter%20Form.pdf identified for the automatic alert – SPCs, Overdose review team, etc. Facilities will need to independently maintain that list of names (i.e., when staff leave and new staff come on board the SPC or other designated staff will need to notify the CACs so the list can be updated). The alert functions similar to alerts received when consults are received and will be visible in CPRS as an additional notification alert.

These alerts are NOT additional signature alerts. Like consults, once the provider reviews the alert, it will no longer be visible in the alert section of CPRS.

You can talk to your health informatics staff about the process for adding an alert to this element of the template. Sample VistA programming language for enabling this alert is included at the end of this FAQ.

Note: This type of alert may not be possible to enable at integrated facilities.

How can I pull aggregate data on the number of Veterans who have had a reported event?

The Suicide Behavior Summary Report is a tool to assist SPCs and leadership with aggregate data collection as related to fatal and non-fatal suicide events. This dashboard unifies information that is recorded in Suicide Behavior and Overdose Reports (SBOR), Comprehensive Suicide Risk Evaluations (CSREs) and the Suicide Prevention

Applications Network (SPAN), and provides present and historical counts of suicide-related events.

SPPRITE is available to access lists of patients who have had a recently reported event, for the purposes of follow-up and care management. SBOR data is also being displayed on the CRISTAL patient lookup tool.

I have learned additional information about a previously reported event. How should

I report the new information?

It is important to ensure that the information in the SBOR is accurate. To report new information (e.g., changing an ‘Unknown’ answer to ‘Yes’ or ‘No,’ or adding/removing a method used, etc.), the changes should be documented in the medical record as an addendum to the initial SBOR note. Additionally, the health factors must be updated to ensure accurate reporting. For instructions on adding or removing health factors from the

SBOR template, see:

https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20

SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Add ing%20Health%20Factors%20in%20Encounter%20Form.pdf

D.15 d) Suicide Behavior and Overdose Report (SBOR): Frequently Asked Questions - 36C26225R0004 https://dvagov.sharepoint.com/sites/VHAOMHSPSPP/Landing_Pages/Suicide%20Behavior%20Summary%20Report%20Dashboard.aspx https://dvagov.sharepoint.com/sites/VHAPERC/Reports/SitePages/SPPRITE_home.aspx https://dvagov.sharepoint.com/sites/VHAPERC/Reports/SitePages/CRISTAL_home.aspx https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Adding%20Health%20Factors%20in%20Encounter%20Form.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Adding%20Health%20Factors%20in%20Encounter%20Form.pdf https://dvagov.sharepoint.com/:b:/r/sites/VACOMentalHealth/Safety%20Planning%20%20SBR/Suicide%20Behavior%20and%20Overdose%20Reporting/Removing%20and%20Adding%20Health%20Factors%20in%20Encounter%20Form.pdf

Sample VistA programming language for enabling alerts:

Enter Post-Signature Code for Alert

Select TIU DOCUMENT DEFINITION NAME: SUICIDE BEHAVIOR AND OVERDOSE REPORT

TITLE

Std Title: SUICIDE PREVENTION NOTE

Select one of the following:

N N/A

I INDIVIDUAL USER

G MAILGROUP

T TEAM LIST (OE/RR with Queued Alert)

Choose RECIPIENTS to receive the alert (N/I/G/T) or '^' to exit: TEAM LIST (OE/R

R with Queued Alert)

Select OE/RR LIST NAME: TIU SUICIDE BEHAVIOR REPORT

1) N/A- No Conditional Alert is needed

2) PCP- Include patient's Primary Care Provider from PCMM as a recipient

3) AUTOPRT- Generate message to chart copy printer at encounter location

Choose an alert ROUTINE from the above listing: (1-3): 1

DEVICE NAME (Optional) for Paper Alert:

The Post-Signature code for 'SUICIDE BEHAVIOR AND OVERDOSE REPORT' will be set a s follows...

POST-SIGNATURE CODE: D EN^TIUPSCA("T.TIU SUICIDE BEHAVIOR REPORT","","")

Do you want to update Post-Signature Code into 'SUICIDE BEHAVIOR AND OVERDOSE RE

PORT'? NO// YES