Formal Safety Research Articles

Formal Safety Assessment (FSA) for ship collision in Musi River

Abstract Accident data from the Palembang Port Authority Of6ice Class II shows that the level of traf6ic accidents in the waters of the Musi River in Palembang is relatively high. Hazard identi6ication was conducted on the Musi River, resulting in 25 ship accidents caused by collisions and 4 ship accidents due to grounding. Subsequently, risk assessment was performed by analysing the collision frequency and its consequences on human casualties. The collision frequency was calculated using IWRAP, yielding results of 8.18 x 10-2, 9.74 x 10-3, and 8.18 x 10-4 for the head-on, overtaking, and crossing scenarios, respectively. An analysis of the consequences in terms of human casualties estimated an average of 11 victims. Six options were proposed as risk control options (RCOs): public awareness and regulation implementation, Automatic Identi6ication System (AIS) installation, crew education and training, standardization of safety equipment, utilization of pilotage services, and channel widening. Each RCO will be evaluated based on its cost and bene6its. The 6inal stage of the FSA involves recommendations aimed at selecting the best RCOs, considering the cost-bene6it analysis (CBA). The optimal choice to minimize ship collisions and human casualties in the waters of the Musi River is to conduct crew education and training. This option is the most cost-effective due to its lowest Gross Cost value. The bene6its gained amount to USD 890,273.02 with a 68% reduction in risk value.

Using Formal Models, Safety Shields and Certified Control to Validate AI-Based Train Systems

Using Formal Models, Safety Shields and Certified Control to Validate AI-Based Train Systems

A Formally Integrated Adaptive Speed Management for Proactive Traffic Safety

The emergence of connected autonomous vehicles (CAVs) represents a key development in the quest to enhance traffic safety. CAVs hold significant promise for improving traffic safety and have great potential to contribute to transportation sustainability. However, their safety depends on the accuracy of the programmed rules and algorithms that guide their decision-making process. This paper introduces an adaptive traffic management system that integrates a formal traffic safety rule defined by pre-established bounds for Traffic Conflict Techniques. This system enables dynamic speed adjustments for vehicles violating the traffic safety rule in order to prevent potential collisions. To evaluate the effectiveness of our approach, we study a traffic flow on the SR528 highway in Orlando, Florida, and analyze the behavior of each vehicle in traffic based on extracted traffic safety indicators such as time-to-collision and space headway. This analysis is performed by the traffic safety rule to identify violating vehicles, and the speed update is achieved through the integration of the computer algebra system Mathematica and a micro-simulation tool called SUMO. Our study aims to improve the safety and efficiency of the traffic flow by combining simulation, TCTs analysis, and semi-formal tools like Mathematica to aid in the decision-making process of vehicles during traffic events, particularly shockwaves. Preliminary results demonstrate the efficacy of our approach in mitigating the impact of shockwaves. After applying the speed update, we observe an increase in time-to-collision and space headway. This indicates improved safety and reduced likelihood of collisions. Our findings highlight the potential of adaptive traffic management systems to enhance transportation safety and efficiency.

External drivers of changes in wildland firefighter safety policies and practices

Background Firefighter safety is a top priority in wildland fire response and management. Existing explanations emphasise how land management agency initiatives to change organisational culture, usually inspired by fatality incidents, contribute to changes both in formal safety policies and informal safety practices. Aims This paper identifies external factors that lead to changes in wildland firefighter safety policies and practices. Methods This paper uses qualitative data from a long-term ethnographic research project. Data include detailed fieldnotes, semi-structured interviews, and agency documents, which were systematically coded and thematically analysed. Key results In addition to the triggering effects of fatality incidents and agency initiatives to change organisational culture, external factors also directly impact the development of firefighter safety policies and practices. These include sociodemographic, material, political, and social-environmental factors. Conclusions Identifying and understanding the influence of multi-scalar external factors on firefighter safety is essential to improving safety outcomes and reducing firefighters’ exposure to hazards. Implications Attention to and recognition of external factors is valuable for fire managers and practitioners, whose work is influenced and constrained by meso- and macro-level factors. The framework presented in this paper would be useful in understanding other important aspects of wildland fire management.

Deep Learning Methods to Mitigate Human-Factor-Related Accidents in Maritime Transport

Artificial intelligence aims to be the solution to multiple engineering problems by trying to emulate the human learning process. In this sense, maritime transport standards have clearly evolved, which are based on two principal pillars: the International Convention for the Safety of Life at Sea Convention (SOLAS) and the International Convention for the Prevention of Pollution from Ships (MARPOL). Based on a formal safety assessment research process, these pillars try to solve most of the maritime transport accidents, which, in their final steps, are associated with human factors. In this research, an original methodology employing a deep learning process for image recognition during mooring line operation, a dangerous process on ships, is developed. The main results indicate that the proposed method is an excellent tool for advising ship officers on watch and, consequently, provides a new way to prevent human factors onboard from causing accidents, which in the future must be considered in international standards.

Challenges in rescuing snakes to protect human lives and promote snake conservation in Tamil Nadu, India.

Human-snake conflicts are common worldwide, often resulting in snakebites. Snakebite envenoming causes over 125,000 deaths and 400,000 permanent disabilities worldwide every year. India alone accounts for an average of ~58,000 annual snakebite-induced deaths. As human developments rapidly expand into suburban and rural areas, snakes are being displaced and incidences of residents finding snakes within their dwellings are increasing. Most people have an innate fear of snakes, compounded by centuries of negative influence from culture and mythology manifesting in people often attempting to kill snakes. Snake rescuers are volunteers who remove and relocate snakes to safe areas. This is a risky job that poses potentially fatal implications if bitten. These volunteers mostly receive no financial compensation for their time or transportation costs, but they choose to do it for their love of snakes, conservation, and for the altruistic nature of helping others. Snake rescuers often receive no formal training and are unfunded resulting in removing snakes improperly without adequate safety equipment or the required skill set to safely complete the task. Therefore, it is critical to determine their challenges and requirements to promote the safe rescue of snakes while protecting human lives. In this study, we developed an online questionnaire and interviewed 152 snake rescuers in Tamil Nadu, India following written informed consent to determine their challenges and needs for rescuing snakes safely. The results demonstrate that most rescuers are males, and they conduct snake rescues for varying lengths of time. They mostly receive no formal training and are bitten by snakes. They spend their own money on the purchase of snake-handling equipment and on treatments if bitten or injured during a rescue. The rescuers highlighted the urgent need for formal training, safety equipment and standard protocols for rescuing snakes in Tamil Nadu. Overall, this study demonstrates that snake rescuing should be appropriately regulated by the authorities, in particular the Wildlife Division of State Forest Departments in India, and formal training along with necessary equipment, medical insurance and appropriate recognition should be provided to them to safely remove snakes from human dwellings and manage the safety of both snakes and humans. They can also act as educators to disseminate information about the preventive and first aid measures for snakebites as well as the ecological importance of snakes.

A national study of firearm exposure and safety training among rural youth

BackgroundData regarding rural youths’ experience with firearms, including safety training, is highly limited despite their frequent presence in homes. Our objective was to investigate rural adolescents’ use of firearms and whether they had received formal firearm training.MethodsA convenience sample of 2021 National FFA (formerly Future Farmers of America) Convention & Expo attendees were given an anonymous survey at the University of Iowa Stead Family Children’s Hospital injury prevention booth. The survey explored their use of rifles/shotguns and handguns and whether they had completed a certified firearm safety course. Descriptive and comparative analyses, including multivariable logistic regression analyses, were performed on compiled data.Results3206 adolescents ages 13–18 years participated with 45% reporting they lived on a farm or ranch. The vast majority of participants (85%) had fired a rifle/shotgun; 43% reported firing them > 100 times. Of those that had fired rifles/shotguns, 41% had done so before 9 years old. Most had also fired a handgun (69%), with 23% having fired handguns > 100 times. Of those that had fired handguns, 44% had done so before 11 years. Average age for first firing rifles/shotguns was 9.5 (SD 3.1) years, and 11.1 (SD 3.0) years for handguns. Males, non-Hispanic Whites, and those living on farms or in the country had significantly greater percentages who had fired a rifle/shotgun or a handgun. Significant differences were also seen by U.S. census region. Over half (64%) reported having gone hunting. Of those that had used a firearm, 67% had completed a firearm safety training course. Overall, 23% were/had been members of a school or club shooting team and of these, 87% had taken a safety course.ConclusionsMost FFA member participants had fired both rifles/shotguns and handguns, many at very young ages. Significant differences in firearm use were noted by demographic factors including the home setting (i.e., farms and ranches) and their U.S. census region. Nearly one-third of adolescent firearm users had not received formal safety training. Promoting firearm safety should include advising families on when it is developmentally appropriate to introduce youth to firearms and on the importance of firearm safety training.

The Politics of Social Policy Implementation: The Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) and Uneven Development in India

Since the onset of the twenty-first century, India has initiated various social welfare programs to provide social protection for the people who have been marginalized from the formal social safety net. Since 2005, legislation has granted a series of social rights to marginalized rural households. Among these rights-based welfare programs, the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) stands out as the flagship initiative of India’s new welfare system. It has targeted marginalized informal rural households, who have not enjoyed the fruits of the social safety net, by formally granting them the right to employment. It has also incorporated new governance ideas such as a demand-driven approach, decentralized implementation, and social audit to increase accountability and transparency. The MGNREGA has emerged as the largest social welfare scheme in terms of budget allocation and coverage, yielding positive outcomes such as increased beneficiary incomes, advancement of gender equality, and creation of assets in rural areas. Nonetheless, despite the expansion of the MGNREGA all over India, policy outcomes have been uneven between the states in terms of participation rates, the relationship between poverty level and participation, and cumulative average person-days per household. This prompts the question: why does the MGNREGA produce superior policy outcomes in certain states but not in others? By delving into the politics surrounding policy implementation at the local level, this paper argues that the degree of goal congruence between policy implementers shapes divergent policy outcomes.

Analysis of risk influential factors of marine pilots during the embarkation and disembarkation

Due to the complex geographical conditions within the port waters, it is necessary to take pilotage operations. The embarkation and disembarkation (E&D) of marine pilots is the riskiest phase of pilotage work, with accidents occurring frequently. In order to examine the key Risk Influential Factors (RIFs) of E&D accident of marine pilots, in this study, a novel complex network model of RIFs of marine pilots during the E&D process is proposed. Firstly, based on the E&D accident investigation report of marine pilots, the causal chain of E&D accidents is extracted, and the RIFs leading to E&D accidents are identified. Secondly, a complex network model of RIFs of marine pilots during the E&D is constructed based on the complex networks theory, and the network reliability is verified. Finally, by comprehensive use of topology characteristics analysis, robustness analysis and module analysis, the key RIFs of pilot E&D accidents are identified. The research results show that pilot and management factors have important impact on pilot safety, ‘insufficient pilot ladder strength' is the most critical RIF. It should be focused on RIFs with high connectivity between modules and within modules, and the risk evolution can be blocked through the control of those RIFs. Abbreviations: BNs: Bayesian Networks; CDM: Critical Decision Method; DEMATEL: Decision-making Trial and Evaluation Laboratory; E&D: Embarkation and Disembarkation; FSA: Formal Safety Assessment; RIFs: Risk Influential Factors; RPD: Recognition-Primed Decision; SHERPA: Systematic Human Error Reduction and Prediction Approach; SOLAS: International Convention for the Safety of Life at Sea; VTS: Vessel Traffic Services; TECHR: Technique for Early Consideration of Human Reliability.

Formal Safety Assessment of the Connection of the Sunda Strait and Java Sea Through the Implementation of IMO Routeing Measures

Formal Safety Assessment of the Connection of the Sunda Strait and Java Sea Through the Implementation of IMO Routeing Measures

Clinician Perspectives on Suicide Safety Planning and Its Implementation

Objective The safety planning intervention is an evidence-based practice shown to reduce suicide risk, but implementation of high-quality safety planning has proven challenging. We aimed to understand clinician perspectives on the safety planning intervention to inform future implementation efforts. Method This cross-sectional survey of clinicians who care for patients at risk of suicide in an academic medical center asked about comfort levels and fidelity to components of the safety planning intervention and assessed implementation barriers and facilitators. We used exploratory data analysis and regression analysis to explore clinician perspectives and assess the relationship between formal training and implementation. Results Ninety-two clinicians responded to the survey. Two-thirds of participants (64.9%) endorsed using all six core elements of the safety planning intervention. Participants who reported receiving formal training in safety planning were significantly more likely to report being comfortable completing a safety plan (p < .001); those with higher levels of comfort were significantly more likely to endorse using all of the core elements of the safety planning intervention (p < .001). Conclusions Training in the evidence-based safety planning intervention is associated with clinician comfort and awareness of the core elements of the intervention. Our results suggest that there are gaps in clinician training and that formal safety planning intervention training could have a positive effect on clinician comfort and treatment fidelity.

Collision between supply vessels and offshore installations case cargo handling and personal transferring operation

Abstract This paper presents a systematic methodology aiming at investigating human-error induced collisions between attendant vessels and offshore installations, with focus on three key risk categories: Cargo handling and personnel transferring (CH), loss of station keeping (SK) and ship handling and maneuvers (SH). Because of space limitation, the methodology will be applied here to the first category (CH) only. The Failure Mode, Effects and Criticality Analysis (FMECA) method was used to identify the hazards. Moreover, the Interpretive Structural Modeling (ISM) of Multi Criteria Decision Making (MCDM) was used for the same purpose and results of both methods were favorably compared. Moreover the Fault Tree Analysis (FTA) was used to evaluate the root causes of accidents down to the Underling Factors (UFs) benefiting from the revised guidelines for the IMO Formal Safety Assessment (FSA).

Are Welsh primary schools Sunproofed? Results of a national survey, part 2: sun protection practices in primary schools in Wales.

Skin cancer rates are on the rise globally. School sun safety programmes are recommended by the World Health Organization to reduce the risk of future skin cancer at the population level; however, these are encouraged but not mandated in Wales. To explore current sun protection practices and sun safety education in primary schools in Wales and whether these are linked to the existence of a formal sun safety policy. An online survey to all 1241 Welsh primary schools asking about sun safety practices, education and formal policies was undertaken. In total, 471 (38.0%) schools responded. A minority (22/469, 4.7%) of responding schools reported they had sufficient shade for most activities. In the spring and summer terms, almost two-thirds of schools encourage hat wearing (304/469, 64.8%) and sunscreen (296/468, 63.2%). Although nearly all schools reported that parents were encouraged to apply sunscreen to students before school (449/469, 95.7%), there was wide variation in other sunscreen application practices. Less than one-third of schools (129/445, 29.0%) reported that they include sun protection education in the curriculum in every year group, with 11.7% (52/445) including this in certain years only. Schools with a formal policy were more likely to report more comprehensive sun protection practices, including having sufficient shade [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.04-2.19; P = 0.03], having spare hats for pupils to wear (OR 1.59, 95% CI 1.07-2.37; P = 0.02), providing guidance for staff (OR 5.87, 95% CI 3.05-11.28; P < 0.001), encouraging them to model sun safe behaviours (OR 1.82, 95% CI 1.18-2.80; P = 0.007) and teaching sun protection education as part of the curriculum in every year group (OR 2.56, 95% CI 1.76-3.71; P < 0.001). With respect to sunscreen, the existence of a formal policy did not seem to affect a school's practice. Although in most cases, the existence of a formal policy suggests more comprehensive sun protection practices and education in schools, sun protection measures and education need improvement across the primary school sector in Wales to reverse rising skin cancer rates.

Perspectives on technology: urethral slings in a post-mesh world.

To detail the history of synthetic mid-urethral slings (SMUSs) and fascial slings, their efficacy, associated complications, and changes to practice that have occurred after the issuing of the 2011 US Food and Drug Administration (FDA) Safety Communication statement on transvaginal mesh (TVM), and to highlight the need for surgical registries and high-quality randomised controlled data to guide recommendations for continence procedures, in view of current concerns regarding mesh. A literature search was conducted in EMBASE, PubMed, and the Cochrane Database of systematic reviews to identify articles published from 2011 onward, following the FDA Safety Communication regarding TVM. Prior to the formal FDA Safety Communication in 2011, TVM was considered a safe option for the treatment of both pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The 2011 FDA safety communications and ensuing widely publicised litigation against TVM manufacturers have shifted both surgeon and patient acceptance of mesh products. Several efforts by medical and government bodies have been made to establish ways to monitor the surgical outcomes and safety of mesh products. The Australasian Pelvic Floor Procedure Registry is one such example. Although SMUSs have a long and established safety profile, perceptions of mesh products for SUI have also been negatively affected. The extent of this, however, has yet to be adequately measured through qualitative and quantitative data. The available data suggest it has been difficult for patients and consumers to distinguish between TVM morbidity for POP vs SUI. Furthermore, there remains a lack of high-quality randomised or real-world registry data to definitively exclude the SMUS from the SUI treatment algorithm. Since SMUSs are a viable option for SUI treatment, the concept of a 'post-mesh world' remains contentious. Controversies surrounding SMUSs have changed the treatment landscape of SUI. Against the background of significant litigious action following the FDA warnings against mesh use, there has been significant reduction in the uptake of synthetic mesh products. Although there are ample data related to surgical outcomes and safety for both autologous fascial and retropubic SMUSs in carefully selected patients, informed consent and surgical training will be of paramount importance as newer synthetic materials reach clinical maturity.

Modernisation of Domestic Ro-Ro Passenger Ships Operating in the Philippines

This paper forms part of a wider study in the form of a Formal Safety Assessment of the domestic passenger ships operating in the Philippines, undertaken on behalf of the Philippines Government, and financed by the World Bank and the International Maritime Organisation. The paper focuses on design deficiencies of the domestic RoPax ships, primarily in damage stability. The process of ship selection for representation of the wider fleet risk assessment is explained, leading to one medium RoPax and one large RoPax, typical of some 500 of these ships, serving the open sea domestic trade in the Philippines. To this end, the selected designs have been subjected to a systematic process of damage stability and flooding risk analysis in order to identify design vulnerabilities, leading to risk estimation in the form of Potential Loss of Life. A number of risk control options have then been identified, enabling a thorough risk assessment and identification of cost effective RCOs, as well as impact assessment, using IMO risk acceptance criteria as basis. Despite the poor state of the domestic Ro-Ro passenger vessels operating in the Philippines, many of these aged, badly retrofitted, poorly maintained, and operated, it has been possible to identify cost-effective design solutions to raise the damage stability (and safety) standard of these ships to international standards of newly designed ships; it seems an unprecedented achievement, but evidently true. This presents the Philippine Government and the owners of these vessels with a unique opportunity to upgrade their domestic fleet of RoPax vessels and showcase these against the best in the world. Because of the similarity in the approach, the selection of risk control options and the overall analysis adopted, only one of the typical RoPax vessels selected is presented in this paper.

Digital sailmate: enhancing safety through low-cost stability monitoring in artisanal fishing

Despite overall mortality decreasing, offshore fishing remains one of the riskiest work-based activities worldwide. For example, fishing communities in East Africa have a 43-fold higher rate of drowning than the general population. A lack of safety culture and knowledge around vessel stability contributes to this issue. Formal safety measures can be difficult to enforce, especially in small scale and subsistence fishing activities dominated by small artisanal boats. Digital technologies hold potential to effectively improve fishing safety. A digital safety device based on commonly held and relatively low-cost consumer products such as smartphones can provide increasing information to fishers enabling more informed safety decisions to be taken during vessel use. This paper proposes the algorithms for a prototype device to monitor stability of fishing vessels, with focus on the capabilities of low-fidelity data in stability assessment. The findings of experimental results at model and full scale are presented. The research indicates that an inclining test can be carried out with minimal training or knowledge base to allow an adequate stability assessment of a vessel before departure on a fishing trip. This baseline measure can then be used to track stability whilst underway as vessel motion is recorded and processed continually updating the stability assessment.

Bayesian Network Analysis of Industrial Accident Risk for Fishers on Fishing Vessels Less Than 12 m in Length

The Marine Stewardship Council estimates that approximately 38 million people worldwide work in fisheries, and more than one-third of the global population is dependent on aquatic products for protein, highlighting the importance of sustainable fisheries. The FISH Safety Foundation reports that 300 fishers die every day. To achieve sustainable fisheries as a primary industry, the safety of human resources is of the utmost importance. The International Maritime Organization (IMO) and the International Labor Organization (ILO) have made efforts towards this goal, including the issuance of agreements and guidelines to reduce industrial accidents among fishing vessel workers. The criterion for applying these guidelines is usually a total ship length ≥12 m or ≥24 m. However, a vast majority of registered fishing vessels are &lt;12 m long, and the fishers of these vessels suffer substantially more industrial accidents. Thus, we conducted a quantitative analysis of 1093 industrial accidents affecting fishers on fishing vessels &lt;12 m in length, analyzed risk using a Bayesian network analysis (a method proposed by the Formal Safety Assessment of the IMO), and administered a questionnaire survey to a panel of experts in order to ascertain the risk for different types of industrial accidents and propose specific measures to reduce this risk.

Perceptions of Human Factors and patient safety education in undergraduate healthcare curricula: a pharmacy perspective

Abstract Introduction A recent systematic review identified a lack of formal patient safety (PS) education in undergraduate healthcare curricula1. Gaps were also identified in relation to teaching of Human Factors (HF) in this context. Aim This qualitative study aimed to examine the perceptions of School of Pharmacy faculty at an Irish university relating to PS/HF in undergraduate healthcare education. Methods Qualitative semi-structured interviews were conducted with seven School of Pharmacy faculty at an Irish university. Findings from a recent systematic review were used to inform research and interview questions.[1] Sampling was purposive and included lecturers from the disciplines of clinical pharmacy and pharmaceutics. Interviews were conducted, either in person or virtually, then transcribed and anonymised. Reflexive thematic analysis (TA) was chosen as the method of analysis, [2] conducted by the first author with input from the wider research team. Within the reflexive piece of this work was the drive to be informed by the lived experience of participants. In alignment with the principles of reflexive TA, an iterative approach was taken to data collection and analysis.[2] This approach informed a sample size which facilitated in-depth exploration of the topic. Results Seven interviews were conducted, and six key themes were derived from the analysis. These are presented in Table 1 along with the identified subthemes. Conclusion This study demonstrates gaps relating to HF/PS teaching in undergraduate pharmacy education in the Irish context. Findings of this study indicate that much PS learning is implicit and occurs while students are on clinical placement. Lack of synergy between the academic and clinical settings was identified as a gap. Interprofessional education was identified as a platform which may help bridge this gap. In agreement with previously published literature, there is a need for robust competency frameworks to underpin safety content.[1] These findings will inform future initiatives to develop HF and PS competency in undergraduate healthcare education. A limitation of this research is that all data were collected at a single university. A strength is that this study captures the lived experience of PS education from the perspective of academic staff at an Irish school of pharmacy which in 2015 made the transition to a new MPharm programme.

Tingkatan Mutu dan Mitigasi Risiko pada Penanganan Udang Windu di PPI Selili Samarinda ke Pasar Barong Tongkok, Melak

East Kalimantan has a superior commodity: tiger shrimp (Penaeus monodon). Some of these commodities are marketed to several areas in Samarinda City and to areas outside Samarinda City, namely West Kutai Regency (Barong Tongkok Market). The distribution process uses a cold chain (cool box) system for 12 hours of travel. Long distribution times cause product quality to decrease. This study aims to assess tiger shrimp's quality and handling strategies using a cold chain system at PPI Selili Samarinda City. The quality level is determined using organoleptic testing at points 1 (PPI Selili) and 2 (Pasar Barong Tongkok). The formal safety assessment (FSA) method is used to identify risks in each handling activity, risk assessment associated with tiger shrimp deterioration, risk control, and recommendations to minimize quality degradation. Based on organoleptic tests, the quality of tiger shrimp is included in the category of safe for consumption. Product handling activities included unloading products from ships, moving them to terminals, washing, structuring, packaging in cool boxes, transportation by shipping services, shipping to Melak Pasar Barong Tongkok, unloading from shipping services, and product arrangement. The highest potential risk is handling shipments to Melak Pasar Barong Tongkok, which has 22 potential hazards. Risk mitigation can be applied through socialization and evaluation related to suitable fish handling methods (CPIB) and making operational schedules for cleaning in the product loading and unloading area before and after handling activities. Keywords: formal safety assessment, risk management, handling strategy, transportation, tiger shrimp

Evaluating the Prevalence of Four Recommended Practices for Suicide Prevention Following Hospital Discharge

The Joint Commission's National Patient Safety Goal (NPSG) for suicide prevention (NPSG.15.01.01) requires that accredited hospitals maintain policies/procedures for follow-up care at discharge for patients identified as at risk for suicide. The proportion of hospitals meeting these requirements through use of recommended discharge practices is unknown. This cross-sectional observational study explored the prevalence of suicide prevention activities among Joint Commission-accredited hospitals. A questionnaire was sent to 1,148 accredited hospitals. The authors calculated the percentage of hospitals reporting implementation of four recommended discharge practices for suicide prevention. Of 1,148 hospitals, 346 (30.1%) responded. The majority (n = 212 [61.3%]) of hospitals had implemented formal safety planning, but few of those (n = 41 [19.3%]) included all key components of safety planning. Approximately a third of hospitals provided a warm handoff to outpatient care (n = 128 [37.0%)] or made follow-up contact with patients (n = 105 [30.3%]), and approximately a quarter (n = 97 [28.0%]) developed a plan for lethal means safety. Very few (n = 14 [4.0%]) hospitals met full criteria for implementing recommended suicide prevention activities at time of discharge. The study revealed a significant gap in implementation of recommended practices related to prevention of suicide postdischarge. Additional research is needed to identify factors contributing to this implementation gap.