Depression is one of those problems that is so big and so pervasive that tackling it seems impossible. This is why process improvement is so powerful: By setting one goal – improving depression screening rates – eleven U of U Health’s Community Clinics are making the impossible manageable.

1. © U N I V E R S I T Y O F U T A H H E A L T H ,
IMPROVING DEPRESSION SCREENING
RATES
EMILY CARLSON MHA, ELSPETH FUERTSCH MHA, CHANDA SUNDARA, JORDAN BALLAM MBA,
ANNIE MERVIS MSW, JULIE DAY MD
UNIVERSITY OF UTAH HEALTH CARE COMMUNITY CLINICS AND
DEPARTMENT OF FAMILY AND PREVENTATIVE MEDICINE CLINICS

2. © U N I V E R S I T Y O F U T A H H E A L T H ,

3. © U N I V E R S I T Y O F U T A H H E A L T H ,
WHY DEPRESSION SCREENING?
• High Prevalence
• High Cost
• Resources to Act on and Improve Outcomes

4. © U N I V E R S I T Y O F U T A H H E A L T H ,
DATA COLLECTION
• Denominator
– Age 12 and older
– Primary Care Provider
– Last 12 Months
• Numerator
– PHQ-2
– PHQ-9
– PHQ-A
– Geriatric Depression Scale
– mEval PROMIS
Depression Questions

5. © U N I V E R S I T Y O F U T A H H E A L T H ,
METHODS
• Pre-Visit Planning
• Staff Education
• Screening Administration
• Behavioral Health Intervention
• Institutionalize Depression Screening

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PRE-VISIT PLANNING
• Plan for the patient appointment
• Prioritize patient needs
• Determine what can be addressed

7. © U N I V E R S I T Y O F U T A H H E A L T H ,
STAFF EDUCATION
• Which?
– Tool
– Patient
• How?
– Administer
– Explain to patient
• What?
– Follow-up Actions

8. © U N I V E R S I T Y O F U T A H H E A L T H ,
SCREENING ADMINISTRATION
• mEval
– Prior to the Appointment
– In the waiting room
• During Patient Rooming
– Paper
– Verbal
• Epic Capture
• Non-English Screening Tools

9. © U N I V E R S I T Y O F U T A H H E A L T H ,
BEHAVIORAL HEALTH INTERVENTION
• Behavioral Health Providers
available at the clinic
– Crisis Assessment
– Brief Therapy
– Referral to Other Resources
– Warm Hand Off
– Positive mEval Response Workflow

10. © U N I V E R S I T Y O F U T A H H E A L T H ,
INSTITUTIONALIZE DEPRESSION SCREENING
• Healthy Planet Definition Updated
• Health Maintenance Topic Created

11. © U N I V E R S I T Y O F U T A H H E A L T H ,
40.8%
41.9%
44.2%
48.8%
51.8%
53.9% 54.5%
30%
35%
40%
45%
50%
55%
60%
AUG SEP OCT NOV DEC JAN FEB
DEPRESSION SCREENING RATES

12. © U N I V E R S I T Y O F U T A H H E A L T H ,
13.74%
5.24%
8.54%
11.39%
12.18%
12.21%
14.37%
16.66%
18.04%
19.93%
21.23%
21.98%
0% 5% 10% 15% 20% 25%
All Clinics Combined
GREENWOOD
SOUTH JORDAN
STANSBURY
SUGARHOUSE
PARKWAY
MADSEN
REDSTONE
REDWOOD
FARMINGTON
WESTRIDGE
CENTERVILLE
DEPRESSION SCREENING PERCENTAGE INCREASE
BY HEALTH CENTER

13. © U N I V E R S I T Y O F U T A H H E A L T H ,
NEXT STEPS
• Refine Pre-Visit Planning Process
• Track Patient Outcomes after a Positive
Depression Screen

14. © U N I V E R S I T Y O F U T A H H E A L T H ,
THANK YOU!
• Centerville Health Center, Primary Care
• Farmington Health Center, Primary Care
• Greenwood Health Center, Primary Care
• Madsen Health Center, Family Practice
• Parkway Health Center, Primary Care
• Redstone Health Center, Primary Care
• Redwood Health Center, Primary Care
• South Jordan Health Center, Primary Care
• Stansbury Health Center, Primary Care
• Sugarhouse Health Center, Primary Care
• Westridge Health Center, Primary Care

15. © U N I V E R S I T Y O F U T A H H E A L T H ,
To learn more, visit:
https://uofuhealth.utah.edu/accelerate/