Improving Provider Knowledge, Skill, and Confidence With Ketamine-Assisted Therapy: A Quality Improvement Project

Background: Suicide is the 10th leading cause of death in the United States. Ketamine has been shown to have a robust and rapid effect on depression and has been shown to decrease suicidal ideation immediately after administering one treatment. Studies have found that combing ketamine with integrative therapy has longer-lasting and more desirable effects. Many clinics are offering intravenous and intramuscular ketamine administration without therapy which shows reduced outcomes for clients. Methods: A quality improvement project was completed to investigate the effectiveness of an educational training and ketamine-use toolkit for 21 clinic providers employed by a suburban outpatient clinic providing intravenous ketamine administration. The first project step was to identify the pre-existing procedure for intravenous ketamine administration. Second, a literature review of ketamine-assisted therapies was conducted. A brief educational training and toolkit were presented virtually to 21 clinic providers in November 2021. The toolkit included a provider's intentions worksheet, a provider's script for use with ketamine clients, and ketamine- specific informational documents for clinics providing ketamine treatments. Pre- and post- surveys were sent to 21 clinic providers, and a follow-up survey was sent to the clinic providers in January 2022. The post virtual training survey measured the change in clinic providers' knowledge and confidence in ketamine-assisted therapy. A clinic chart review was conducted to measure the number of provider referrals for ketamine treatment. Results: Twenty-one clinic providers attended the training. Sixteen completed the pre-survey, and six completed the post-survey. Surveys showed an increase in clinic providers' knowledge of ketamine-assisted therapy and increased providers' confidence in using ketamine-assisted therapies. The clinic chart review, which spanned from November 2021 to February 2022, demonstrated increased clinic provider referrals for ketamine-assisted therapies. Conclusions: Clinic providers' knowledge of and confidence in ketamine-assisted therapies increased following viewing the virtual educational training and toolkit on the provision of ketamine-assisted therapies. The number of provider referrals for ketamine-assisted treatment indicates increased provider confidence as to the effectiveness of ketamine-assisted therapies in treating acute mental health conditions. Due to the small sample size and limited project variability, replication of this project is needed to determine if similar outcomes occur in other outpatient behavioral health settings.