Gap in Current Practice
In my current practice setting, I have noticed a gap in the consistent use of standardized depression screening tools for adult patients during initial psychiatric evaluations. While some providers use evidence-based tools like the PHQ-9, others rely solely on unstructured interviews, leading to variations in diagnostic accuracy and treatment planning.
Applying the PDSA Framework
Plan
.Objective: Increase the consistent use of the PHQ-9 depression screening tool during initial psychiatric evaluations to 100% within three months.
-
Actions:
-
Develop a standardized screening protocol.
-
Provide training sessions for all providers on the PHQ-9’s validity, reliability, and integration into workflow.
-
Update electronic health record (EHR) templates to include the PHQ-9 as a mandatory field for new evaluations.
-
Do
Implement the screening protocol in one clinic location for a one-month trial.
.Assign a nurse or medical assistant to administer the PHQ-9 before the provider enters the room.
.Collect data on screening completion rates.
-
Study
-
Analyse completion rates and compare them with baseline data.
-
Gather feedback from providers and support staff on workflow changes, time impact, and patient engagement.
-
Assess whether the standardized tool improved documentation and treatment planning consistency.
-
-
Act
-
If the trial shows improved compliance and positive provider feedback, expand the protocol to all clinic locations.
-
If barriers are identified (e.g., time constraints, resistance to change), revise workflow or provide additional training before full rollout. APA
-
Change Management and Leadership Strategies
-
Kotter’s 8-Step Change Model: Create a sense of urgency by presenting data on inconsistent screening and its impact on patient care. Build a coalition of supportive providers and involve them in planning to encourage buy-in.
-
Transformational Leadership: Inspire staff by emphasizing the patient safety and quality benefits of consistent evidence-based screening.
-
Shared Governance: Engage both clinical and administrative staff in decision-making, allowing them to voice concerns and propose workflow adjustments.
-
Ongoing Communication: Provide regular updates, celebrate quick wins (e.g., first week with 100% compliance), and share patient success stories to sustain motivation.