Trial Outcomes & Findings for Maintaining Implementation Through Dynamic Adaptations (MIDAS) Suicide Prevention 2.0 Clinical Telehealth (NCT NCT06011759)

Results Overview

The quarterly SP2Clin metric data is reported and available on a VA national dashboard. The SP2Clin metric is calculated by the number of suicide prevention telehealth consults submitted among those with a suicide behavior event.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

4 participants

Primary outcome timeframe

Baseline to 12-months post-baseline

Results posted on

2025-12-29

Participant Flow

VA medical centers were recruited through Veterans Integrated Service Network (VISN) ICC calls and presentations to interested sites from November 2022 through May 2023. VISNs of interest were identified based on sites within that VISN having documented gaps in referring to the program.

13 sites within VISNs of interest were approached directly. Following introductory presentations, 4 sites agreed to participate in the intervention arm. Four non-enrolled control sites were matched to the intervention arm sites based on size and baseline referral rates.

Unit of analysis: VA Medical Centers

Participant milestones

Participant milestones
Measure	Intervention A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP. Academic Detailing (AD): The National Resource Center for Academic Detailing (NaRCAD) describes AD as "an innovative, one-on-one outreach education technique that helps clinicians provide evidence-based care to their patients. Using an accurate, up-to-date synthesis of the best clinical evidence in an engaging format, academic detailers ignite clinician behavior change, ultimately improving patient health. A successful AD visit is highly interactive, always a dialogue, and assesses a clinician's individual needs, beliefs, attitudes, issues, and concerns in order to promote better \[practice\]." LEAP: Learn. Engage. Act. Process (LEAP) program is a structured 6-month core curriculum plus 6 monthly collaborative sessions. The LEAP quality improvement program engages frontline teams in sustained incremental improvements of EBPs over a six-month period, allowing space for busy clinicians to learn and immediately apply fundamental QI skills. LEAP encompasses: 1) a structured, accessible curriculum based on the Institute for Healthcare Improvement's (IHI) Model for Improvement and Plan-Do-Study-Act cycles of change; 2) team-based, hands-on learning, and 3) coaching support and a QI network to enhance learning and accountability.	Control To examine the effect of engagement in quality improvement activity on referral to the SP2.0 program, we compared participating sites with similar non-participating sites. Four non-participating sites were selected as matched controls, one for each participating site. Control sites were matched to participating sites on number of suicide behavior events and prevalence of Suicide Prevention Telehealth Program consults submitted at baseline.
Overall Study STARTED	0 4	0 4
Overall Study COMPLETED	0 4	0 4
Overall Study NOT COMPLETED	0 0	0 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Maintaining Implementation Through Dynamic Adaptations (MIDAS) Suicide Prevention 2.0 Clinical Telehealth

Baseline characteristics by cohort

Baseline data not reported

PRIMARY outcome

Timeframe: Baseline to 12-months post-baseline

Population: Participants are not enrolled in this study. All enrollment and analysis were conducted at the VAMC level.

The quarterly SP2Clin metric data is reported and available on a VA national dashboard. The SP2Clin metric is calculated by the number of suicide prevention telehealth consults submitted among those with a suicide behavior event.

Outcome measures

Outcome measures
Measure	Intervention n=4 VA Medical Centers A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP. Academic Detailing (AD): The National Resource Center for Academic Detailing (NaRCAD) describes AD as "an innovative, one-on-one outreach education technique that helps clinicians provide evidence-based care to their patients. Using an accurate, up-to-date synthesis of the best clinical evidence in an engaging format, academic detailers ignite clinician behavior change, ultimately improving patient health. A successful AD visit is highly interactive, always a dialogue, and assesses a clinician's individual needs, beliefs, attitudes, issues, and concerns in order to promote better \[practice\]." LEAP: Learn. Engage. Act. Process (LEAP) program is a structured 6-month core curriculum plus 6 monthly collaborative sessions. The LEAP quality improvement program engages frontline teams in sustained incremental improvements of EBPs over a six-month period, allowing space for busy clinicians to learn and immediately apply fundamental QI skills. LEAP encompasses: 1) a structured, accessible curriculum based on the Institute for Healthcare Improvement's (IHI) Model for Improvement and Plan-Do-Study-Act cycles of change; 2) team-based, hands-on learning, and 3) coaching support and a QI network to enhance learning and accountability.	Control n=4 VA Medical Centers To examine the effect of engagement in quality improvement activity on referral to the SP2.0 program, we compared participating sites with similar non-participating sites. Four non-participating sites were selected as matched controls, one for each participating site. Control sites were matched to participating sites on number of suicide behavior events and prevalence of Suicide Prevention Telehealth Program consults submitted at baseline.
SP2Clin Metric	22.6 telehealth consults Standard Deviation 4.1	20.0 telehealth consults Standard Deviation 3.8

SECONDARY outcome

Timeframe: Baseline to 12-months post-baseline

Population: Participants are not enrolled in this study. All enrollment and analysis were conducted at the VAMC level.

Change in number of telehealth consults to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative.

Outcome measures

Outcome measures
Measure	Intervention n=4 VA Medical Centers A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP. Academic Detailing (AD): The National Resource Center for Academic Detailing (NaRCAD) describes AD as "an innovative, one-on-one outreach education technique that helps clinicians provide evidence-based care to their patients. Using an accurate, up-to-date synthesis of the best clinical evidence in an engaging format, academic detailers ignite clinician behavior change, ultimately improving patient health. A successful AD visit is highly interactive, always a dialogue, and assesses a clinician's individual needs, beliefs, attitudes, issues, and concerns in order to promote better \[practice\]." LEAP: Learn. Engage. Act. Process (LEAP) program is a structured 6-month core curriculum plus 6 monthly collaborative sessions. The LEAP quality improvement program engages frontline teams in sustained incremental improvements of EBPs over a six-month period, allowing space for busy clinicians to learn and immediately apply fundamental QI skills. LEAP encompasses: 1) a structured, accessible curriculum based on the Institute for Healthcare Improvement's (IHI) Model for Improvement and Plan-Do-Study-Act cycles of change; 2) team-based, hands-on learning, and 3) coaching support and a QI network to enhance learning and accountability.	Control n=4 VA Medical Centers To examine the effect of engagement in quality improvement activity on referral to the SP2.0 program, we compared participating sites with similar non-participating sites. Four non-participating sites were selected as matched controls, one for each participating site. Control sites were matched to participating sites on number of suicide behavior events and prevalence of Suicide Prevention Telehealth Program consults submitted at baseline.
Change in Number of Consults to SP 2.0 Clinic	289.0 telehealth consults Standard Deviation 171.3	256.0 telehealth consults Standard Deviation 191.2

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline to 12-months post-baseline

Population: This measure is only administered for those who participate in LEAP; this measure was not administered as no sites elected to participate in LEAP.

16-item measure of change in quality improvement skills application. Values 1 to 4 where higher values indicate more frequent use of quality improvement skills.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-first Academic Detailing session

Population: Participants were providers at participating sites who had received at least one AD session. AD satisfaction data was collected at the individual level; however, no demographic data was collected.

7-items measuring satisfaction with Academic Detailing. Each response option uses a Likert-type scale with values 1 to 5 where higher values indicate higher satisfaction.

Outcome measures

Outcome measures
Measure	Intervention n=9 Participants A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP. Academic Detailing (AD): The National Resource Center for Academic Detailing (NaRCAD) describes AD as "an innovative, one-on-one outreach education technique that helps clinicians provide evidence-based care to their patients. Using an accurate, up-to-date synthesis of the best clinical evidence in an engaging format, academic detailers ignite clinician behavior change, ultimately improving patient health. A successful AD visit is highly interactive, always a dialogue, and assesses a clinician's individual needs, beliefs, attitudes, issues, and concerns in order to promote better \[practice\]." LEAP: Learn. Engage. Act. Process (LEAP) program is a structured 6-month core curriculum plus 6 monthly collaborative sessions. The LEAP quality improvement program engages frontline teams in sustained incremental improvements of EBPs over a six-month period, allowing space for busy clinicians to learn and immediately apply fundamental QI skills. LEAP encompasses: 1) a structured, accessible curriculum based on the Institute for Healthcare Improvement's (IHI) Model for Improvement and Plan-Do-Study-Act cycles of change; 2) team-based, hands-on learning, and 3) coaching support and a QI network to enhance learning and accountability.	Control To examine the effect of engagement in quality improvement activity on referral to the SP2.0 program, we compared participating sites with similar non-participating sites. Four non-participating sites were selected as matched controls, one for each participating site. Control sites were matched to participating sites on number of suicide behavior events and prevalence of Suicide Prevention Telehealth Program consults submitted at baseline.
Provider Satisfaction With Academic Detailing	4.75 Units on a scale Standard Deviation 0.43	—

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline to 12-months post-baseline

Population: This measure is only administered for those who participate in LEAP; this measure was not administered as no sites elected to participate in LEAP.

6-item measure of satisfaction with LEAP. Values 1 to 5 where higher values indicate higher satisfaction.

Outcome measures

Outcome data not reported

Adverse Events

Intervention

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Control

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Paul Pfeiffer, MD, MS, Corresponding Principal Investigator

VA Ann Arbor Health Care System

Phone: N/A

Email: [email protected]

Results disclosure agreements

Principal investigator is a sponsor employee
Publication restrictions are in place