Date of Publication

2024

Project Team

Margaret Aitken

Abstract

Purpose: Depression is among the most common mental health conditions in the US and negatively impacts quality of life, co-morbid chronic conditions, and healthcare costs. Screening for depression in the adult population with a validated tool is recommended by the USPSTF and associated with improved rates of treatment, but screening rates remain low in many primary care settings. This project aimed to increase depression screening with the Patient Health Questionnaire-2 for adults at a primary care office by 15% over a six-week period through the implementation of a standardized protocol. A secondary aim was to increase adherence to best practice guidelines through the protocol and education for medical assistants.

Methods: A review of practice policy, a pre-intervention survey of medical assistants and providers, and determination of baseline screening rates via chart review was performed. A standard protocol was developed and implemented at the site. Post-intervention screening rates and survey responses were collected.

Results: Depression screening rates did not significantly improve post-intervention (31% vs 34%). Screening rates varied widely among providers and by visit type. Screening rates did steadily improve during the planning phase of this project and the overall screening rate for the year was double the previous year’s rate (61% vs 30%).

Conclusions: The standardized protocol and educational session were not effective in immediately increasing screening rates or adherence to guidelines. Further quality improvement projects or research could investigate the impact of ongoing education and staff engagement on depression screening rates.

Keywords: Depression, screening, primary care, PHQ-2, quality improvement

Document Type

Dissertation/Thesis

Available for download on Friday, May 08, 2026

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