Implementation of Universal Adolescent Depression Screening: Quality Improvement Outcomes

• Published in: Journal of pediatric health care 2021-05, Vol.35 (3), p.270-277
• Main Authors: Bose, Jeff, Zeno, Rosie, Warren, Barbara, Sinnott, Loraine T., Fitzgerald, Elizabeth A.
• Format: Article
• Language: English
• Subjects: adolescent depression; Nursing; outcomes; Patient Health Questionnaire-9 modified for Adolescents; primary care; quality improvement
• ISSN: 0891-5245; 1532-656X
• DOI: 10.1016/j.pedhc.2020.08.004

Despite the increasing incidence of adolescent depression, suicide and evidence-based recommendations for adolescent depression screening, 70% of teens report not discussing depression with their provider. The aim of this quality improvement project was to improve the identification and management of adolescent depression by implementing a practice-based, universal depression screening. The Patient Health Questionnaire-9 modified for Adolescents was implemented during annual wellness visits for adolescents aged 12–18 years over 3 months. Retrospective chart reviews were conducted to determine a change in the rates of depression screening, depression diagnoses, referrals to mental health, and pharmaceutical treatment of depression. Pre/postimplementation data were compared. Documented adolescent depression screening increased from 0% to 74.5%. Increased rates of diagnosed depression (12.1%), mental health referrals (8%), and pharmaceutical treatment of depression (4.9%) were clinically and statistically significant. Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression.