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Implementation of Universal Adolescent Depression Screening: Quality Improvement Outcomes.

Jeff Bose, Rosie Zeno, Barbara Warren

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |February 14, 2021
    PubMed
    Summary

    Implementing universal depression screening in pediatric primary care significantly increased early identification and management of adolescent depression. This quality improvement project successfully boosted screening rates and subsequent diagnoses and treatment.

    Keywords:
    Patient Health Questionnaire-9 modified for Adolescentsadolescent depressionoutcomesprimary carequality improvement

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    Area of Science:

    • Pediatric Primary Care
    • Adolescent Mental Health
    • Quality Improvement

    Background:

    • Adolescent depression incidence is rising, yet many teens do not discuss symptoms with providers.
    • Evidence-based guidelines recommend universal depression screening for adolescents.
    • Current screening and management practices for adolescent depression are often insufficient.

    Purpose of the Study:

    • To enhance the identification and management of adolescent depression.
    • To implement a practice-based, universal depression screening protocol.
    • To evaluate the impact of universal screening on depression diagnosis and treatment.

    Main Methods:

    • The Patient Health Questionnaire-9 modified for Adolescents (PHQ-A) was used for screening.
    • Screening was integrated into annual wellness visits for adolescents aged 12-18.
    • Retrospective chart reviews compared pre- and post-implementation data.

    Main Results:

    • Documented depression screening rates increased from 0% to 74.5%.
    • Clinically and statistically significant increases were observed in diagnosed depression (12.1%), mental health referrals (8%), and pharmaceutical treatment (4.9%).

    Conclusions:

    • Universal depression screening in pediatric primary care is effective for early diagnosis.
    • Implementing evidence-based screening improves adolescent depression management.
    • This quality improvement project demonstrates a successful model for pediatric mental health care.