Increasing Depression Screening in Rural Primary Care

Abstract

Purpose: The purpose of this quality improvement project was to increase depression screeningusing the nine-item Patient Health Questionnaire and same-day follow-up to at least 75% of eligible Marana Health Center primary care patients. Background: Depression can significantly impact the lives of individuals who suffer from it. It is known to cause increased difficulty with daily tasks, missed time off work, and poor adherence to medications for chronic conditions. By screening and treating depression in primary care, it can be addressed quickly, improving quality of life. At federally qualified health centers, depression screening and treatment are required for continued funding and awards. Methods: This project used the Model for Improvement and the Plan-Do-Study-Act cycle to guide preparation and implementation. Participants were recruited via e-mail to attend a live WebEx-based educational presentation on the treatment of depression in the primary care setting and the use of the Patient Health Questionnaire. Participants were asked to complete a pre-/post- survey that assessed their knowledge, confidence, beliefs, and intention to implement depression screening and follow-up into their practice. Results: Depression screening rates at Marana Health Center rose from 73% to 78% after implementation. Thirty-two staff members participated in the live education, and three completed the pre-/post-survey. The results showed a high level of knowledge and intent to utilize the Patient Health Questionnaire. It also showed increased belief in the importance of depression screening and treatment in the primary care setting. The perceived efficacy of the Patient Health Questionnaire and confidence in initiating treatment options remained mixed. Conclusions: Anticipated outcomes were achieved with a 4.9% increase in screening post- intervention. Additionally, providers expressed an increased perception of the importance of depression screening in primary care, increased intention to screen their patients, and continued confidence in their ability to administer the Patient Health Questionnaire in their practices.