A PMHNP working in a busy, multipractitioner outpatient behavioral health clinic is asked to implement a routine suicide risk screening for all clients who present to the clinic. What is the first step the PMHNP should take to implement the change process?

Choice A reason: Selecting a screening tool is an important step in the implementation process, but it is not the first. Without understanding the clinic’s current capabilities, workflows, and barriers, choosing a tool may result in poor integration or resistance from staff. Choice B reason: Conducting a systemic needs assessment is the foundational first step in any change process. It allows the PMHNP to evaluate the clinic’s readiness, identify gaps in current practices, assess staff training needs, and determine logistical constraints. This ensures that the change is tailored to the organization’s specific context and increases the likelihood of successful implementation. Choice C reason: A chart review analysis can provide insight into past documentation and suicide risk patterns, but it is a retrospective tool. It does not address the broader organizational needs or readiness for change. Choice D reason: A root cause analysis is typically used to investigate adverse events or system failures. While it may be useful in understanding why suicide screening has not been previously implemented, it is not the appropriate first step in a proactive change process.