The Unity Center for Behavioral Health (UBH) Psychiatric Emergency Services (PES) opened in February of 2017 using Columbia Suicide Severity Rating Scale (C-SSRS) alone for suicide assessmeng. In April of 2017 the Joint Commission mandated the inclusion of risk and protective factors in the suicide assessment documentation. The aim of this project determine how or if this more robust assessment influences treatment planning and to reframe the work that has been done using a evidence based quality improvement methodology to inform next steps.