This quality improvement activity examined Safety Planning Intervention (SPI) over two 3-monthly periods for presentations from 13–17-year-olds with suicidal risk to a regional hospital Emergency Department (ED). We collected patient demography, presentation characteristics, presentation rate, and clinician use of SPI, including those under Emergency Examination Authorities (EEAs). An education workshop was offered between the audits, aimed to increase clinician (social work, psychology, nursing, and psychiatry) knowledge of SPIs. The annual ED presentation rate for suicide risk for 15–17-year-olds was 1,520 per 100,000 persons. More presentations were female, non-Indigenous persons, and fewer than half presented voluntarily. Most presentations were for suicide attempt followed by suicide threat. In the first audit clinicians initiated SPIs in fewer than 50% of cases and completed SPIs in 15%. Whereas in the second audit where SPIs were initiated by clinicians in 69% of cases and fully completed in 49%, less than half the presentations with EEAs received a completed SPI. Indigenous persons, although a lower proportion of presentations, were overrepresented for the population. Following the education workshop, there was an improvement in SPI completion, reflecting the benefits of education and training to clinical staff. Lastly, this study highlights the benefit of conducting audits as quality improvement activities for patient care.