Improving effective depression care in an outpatient psychiatric clinic.

IF 1.2 4区医学 Journal of the American Association of Nurse Practitioners Pub Date : 2024-03-01 DOI:10.1097/JXX.0000000000000975

Thomas Moore, Sharanna Johnson

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Abstract

Background: With more than 20 million adults experiencing a major depressive episode in 2020, depression is one of the most widespread and costly illnesses in the United States.

Local problem: An audit of medical records at an outpatient psychiatric clinic revealed that none of the patients (0/56) were receiving standardized depression screening at follow-up appointments.

Methods: An 8-week rapid cycle Plan-Do-Study-Act model for change was used to spearhead a quality improvement (QI) project for effective depression care. The QI project comprised ongoing data collection through chart audit every 3 days, which drove tests of change (TOC). Team engagement surveys were also assessed for change in team engagement scores.

Interventions: The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression, and an effective care log (ECL) measured effective depression care. Every 2 weeks, a TOC was implemented, which guided further iterative changes throughout the project.

Results: Effective depression care increased to 74% over the course of the project, surpassing the initial aim of 50%. Completion rates of the PHQ-9 (76%) and ECL (91%) increased. Team engagement (27.1) also increased over the course of the project.

Conclusions: This project improved effective depression care. The success was largely due to the iterative TOCs, ECL, and team engagement.

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改善精神科门诊有效的抑郁症护理。

背景：2020年，超过2000万成年人经历了严重的抑郁症发作，抑郁症是美国最普遍、最昂贵的疾病之一。当地问题：一项对精神病门诊病历的审计显示，没有一名患者（0/56）在随访时接受标准化的抑郁症筛查。方法：采用一个8周快速周期的计划-实践-学习-行动变革模型，率先开展一项有效的抑郁症护理质量改进（QI）项目。QI项目包括每3天通过图表审计进行的持续数据收集，这推动了变化测试（TOC）。团队参与度调查还评估了团队参与度得分的变化。干预措施：患者健康问卷-9（PHQ-9）用于评估抑郁症，有效护理日志（ECL）测量有效的抑郁症护理。每两周实施一次TOC，指导整个项目的进一步迭代更改。结果：在项目过程中，有效的抑郁症护理提高到74%，超过了最初50%的目标。PHQ-9（76%）和ECL（91%）的完成率增加。项目期间，团队参与度（27.1）也有所增加。结论：该项目改善了有效的抑郁症护理。成功很大程度上归功于迭代的TOC、ECL和团队参与。

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来源期刊

Journal of the American Association of Nurse Practitioners Nursing-General Nursing

自引率

16.70%

发文量

172

期刊介绍： The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners. Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.