Date of Publication


Project Team

Deborah Wachtel, DNP, MPH, APRN; Christopher Hebert, MD


Purpose: Detection and intervention of depression, substance use disorder, and social determinants of health (SDOH) in primary care improves quality of life, prevents complications, reduces health care costs and inequities, and leads to health promotion. This project aimed to increase behavioral health and SDOH screening rates in primary care through implementation of a screening process utilizing validated patient questionnaires.

Methods: A pre-intervention assessment was conducted with Providers A and B. A process was then developed for screening patients at annual exam visits, utilizing the Patient Health Questionnaire (PHQ)-2, the Single Alcohol and Substance Abuse Screening Questions, and a SDOH Questionnaire. The Plan-Do-Study-Act (PDSA) method was used for implementing the process. Effectiveness was measured through electronic health record (EHR) reports of patients screened.

Results: Screening rate data were collected via EHR reports. Pre-intervention, Provider A’s screening rates for total patients (N = 696) were 15%; 6 months following implementation, rates increased to 42%. Provider B’s pre-intervention rates for total patients (N = 755) were 35% and increased to 58%. Data via staff interviews were collected each biweekly PDSA cycle, identifying areas needing clarification and improvement. The process was finalized after three cycles.

Conclusions: Implementing a standardized process to screen patients for behavioral health and SDOH improved screening rates. The PDSA method allowed for an organized approach to implementation. Limitation of this intervention includes a small practice site. Further study at a larger practice would be recommended to determine impact on a larger scale.

Document Type


Included in

Nursing Commons