title: General practice critical incident reviews of patient suicides: benefits, barriers, costs, and family participation.
abstract: OBJECTIVE
  To explore the feasibility of holding critical incident reviews (CIRs) after patient suicides in general practice and their ability to change practice.
  
  
  METHODS
  Thirteen practices were invited to conduct a facilitated CIR on 18 current patient suicides. Next of kin views were sought. All staff attending a CIR were interviewed after the review.
  
  
  RESULTS
  Ten practices reviewed 12 deaths. Twenty six staff attended reviews; all were interviewed. Next of kin contributed to six reviews; only one criticised care. Changes following the reviews included steps to improve internal communication and bereavement support to set up internal CIRs and review prescribing policies. Communications between practices and other agencies were clarified.
  
  
  CONCLUSIONS
  Practices were willing to hold CIRs and appreciated the potential positive value but need reassurance that they will not be blamed for suicides, and that the cost in time and resources will be recognised.
authors.affiliation: University of Southampton, UK. E.A.King@soton.ac.uk
authors.forename: E
authors.initials: E
authors.lastname: King
authors.forename: K
authors.initials: K
authors.lastname: Kendall
authors.forename: R
authors.initials: R
authors.lastname: Wiles
authors.forename: H
authors.initials: H
authors.lastname: Rosenvinge
authors.forename: C
authors.initials: C
authors.lastname: Gould
authors.forename: A
authors.initials: A
authors.lastname: Kendrick
mesh_terms: D005190:Family; D005194:Family Practice / Q000458:organization & administration*; D006801:Humans; D010361:Patients; D018024:Peer Review, Health Care; D013405:Suicide