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Joint Commission: How to improve patient depression screening and treatment

Hospital Safety Insider, January 17, 2019

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A new study published in The Joint Commission Journal on Quality and Patient Safety showcases four ways to improve screening and treatment of patients for depression. Depression is the leading cause of disability and 16.2 million Americans experienced a major depressive episode in 2016.  The condition often goes untreated in certain demographics such as minorities, refugees, and immigrants.

The study, “Not Missing the Opportunity: Improving Depression Screening and Follow-Up in a Multicultural Community,” was conducted by Ann M. Schaeffer, DNP, CNM, and Diana Jolles, PhD, CNM, at the Harrisonburg Community Health Center (HCHC) in Virginia. Their goal was to improve their Screening, Brief Intervention, and Referral to Treatment (SBIRT) method for identifying and treating depression.

Evidence-based guidelines recommend facilities screen for depression diagnosis, treatment and follow-up. However, they explain that only seven states report depression screening and follow-up data and the condition is the fourth least-reported measure on the Medicaid Adult Core Set. 

 “The project demonstrated the feasibility of using rapid-cycle improvement to improve depression screening and follow-up within a multicultural community health center,” the authors noted. “This project also brought attention to a chronic condition with long-standing implications for individual and community health that too often go unidentified and therefore unaddressed.”

The study looked at the impact of four core interventions:

• Using written standardized screening tools in six languages
• Using the Option Grid™, a standardized tool to help clients who screen positive for depression to share what matters most to them
• Using a “right care” tracking log to help providers document follow-up phone calls and visits for at-risk patients
• Conducting team meetings and in-services to support capacity building

By the end of the study:

• The use of evidence-based care increased to 71.4 %
• Compliance with follow-up policies increased from 33.3% to 60%
• Screenings done in the patient’s preferred language increased to 85.2%
• Identifying at-risk patients using a patient health questionnaire increased 45.5%

Improving depression care can also be useful in suicide prevention—a major goal of The Joint Commission this year.

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