Implementing a Universal Depression Screening Toolkit to Improve Depression Detection and Documentation in Primary Care
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Authors
Steiner, Austin
Issue Date
2025-05-17
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Type
Manuscript
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Keywords
Major Depressive Disorder , PHQ-9 , Routine Depression Screening , Primary Care , Depression Treatment
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Abstract
An estimated two-thirds of all Major Depressive Disorder (MDD) in the United States is undiagnosed, and consequently, untreated. The location of this project, a primary care clinic within a midwestern healthcare system, has depression screening methods in place but are well below their target goal of screening 71.4% of patients. Additionally, new for fiscal year 2024, is Centers for Medicare and Medicaid (CMS) compliance code 134, which requires a follow-up plan documentation up to two days after the date of positive depression screening. The purpose of this quality improvement project is to increase rates of universal depression screening in adults in primary care with the use of a standardized PHQ-9 depression screening questionnaire and improve depression follow-up quality. This QI project used the Iowa based model to develop an evidence-based depression screening toolkit over a 12-week period.
This project involved a laminated educational hand-out for patients that was created using information on the PHQ process, its intent, and what its results mean related to depression treatment. A data collection sheet filled out by the nursing staff was used to track data on potential barriers to screening and selected treatments. A tool-kit was created for providers to help guide treatment plans once a positive screening is identified including several community resources, cost effective strategies, and clinical resources.
Over the 12-week implementation period, 30 patients were identified as having a positive PHQ screening. The rate of screening combined with proper documentation increased to 47.6% per month on average compared to 33.6% on in the 6 months prior.
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Publisher
Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University