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Identifying Barriers Among Rooming Staff and Providers to Improve Depression Screening in Primary Care

Singh, Malvika
Whitcomb, Holly
Cangiano, Michelle
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Universal depression screening is recommended for all individuals aged 12 years and older, as the absence of screening is associated with adverse outcomes. Despite this recommendation, the rates of screening in primary care settings remain suboptimal. The global aim of this project was to increase the annual depression screening rates among individuals aged 18 and older at a primary care clinic in Vermont, aiming to achieve a target rate of 70% in accordance with the Vermont All-Payer Model. The primary aim was to identify barriers encountered by rooming staff and providers regarding the use of the existing depression screening protocol. The secondary aim was to improve depression screening rates by applying tailored interventions that addressed the identified barriers. To help identify the barriers faced, the awareness, frequency of use, and experience related to each phase of the screening protocol, as well as the perceived barriers, were evaluated through a survey. Identified barriers included workflow inefficiencies, challenges with documentation, and patient resistance. Two Plan-Do-Study-Act (PDSA) cycles were employed to introduce workflow modifications, provide enhanced education for rooming staff and providers, optimize pre-visit planning, and improve electronic health record (EHR) documentation practices. This quality improvement initiative demonstrated significant progress in completing depression screenings for patients during their annual visits. However, overall, there was no improvement in screenings completed across all visits. The data suggests that identified barriers and targeted interventions improved screening rates during annual visits but did not meet the project’s target goal of 70% for all visits. Future efforts should concentrate on screening for all types of visits, pre-visit planning, and telehealth visits.
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2025-01-01
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Research Projects
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