The Evaluation of a Depression Screening Protocol in a Pediatric Primary Care Office

Background: Adolescent depression is a disorder that has significant consequences to the individual, family and community. Depression is thought to affect up to 15% of adolescents yet only 1 in 5 are actually recognized and appropriately treated. Most adolescents visit their primary care provider but less than half of pediatric primary care providers screen for depression. Depression screening is the first step to recognition of depression. Purpose: To evaluate if a protocol using the PHQ-9 A as a depression screening tool within a primary care clinic made a difference by increasing the number of diagnosis of depression and/or the number of referrals to psychology or psychiatry. Method: This quality improvement project was instituted at four pediatric primary care sites. The four pediatric providers incorporated the use of the PHQ-9 A into their practices for adolescents age 11-17 coming in for a well visits. Data analysis was completed utilizing data from a three- month period prior to the protocol implementation and a three -month prospective period post implementation of the protocol. Results: The primary outcomes measured were diagnosis of depression and referrals to psychology and/or psychiatry. The depression diagnosis rate increased from 9% to 12% which could indicate a potential of 17 more adolescents were recognized as depressed with using the protocol. The rate of referral increased from 7.6 % to 11 % which can indicate that a potential of 19 more adolescents were referred appropriately to a mental health care provider with the use of the protocol. This Doctor of Nursing Practice quality improvement project was designed to evaluate the use of a depression screening protocol in a pediatric primary care office.A three-year embargo was granted for this item