Operationalizing Depression Screening in Ambulatory Palliative Care: A Quality Improvement Project.

J Pain Symptom Manage

Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine (D.S., M.D.S., M.C.R.), New York, New York, USA.

Published: January 2023

Background: Depression is common in the palliative care setting and impacts outcomes. Operationalized screening is unusual in palliative care.

Local Problem: Lack of operationalized depression screening at two ambulatory palliative care sites.

Methods: A fellow-driven quality improvement initiative to implement operationalized depression screening using the patient health questionnaire-2 (PHQ-2). The primary measure was rate of EMR-documented depression screening. Secondary measures were clinician perspectives on the feasibility and acceptability of implementing the PHQ-2.

Intervention: The intervention is a clinic-wide implementation of PHQ-2 screening supported by note templates, brief clinician training, referral resources for clinicians, and opportunities for indirect psychiatric consultation.

Results: Operationalized depression screening rates increased from 2% to 38%. All clinicians felt incorporation of depression screening was useful and feasible.

Conclusions: Operationalized depression screening is feasible in ambulatory palliative care workflow, though optimization through having screening be completed prior to clinician visit might improve uptake.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790031PMC
http://dx.doi.org/10.1016/j.jpainsymman.2022.09.002DOI Listing

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