Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic
Abstract Background Depression adversely affects health outcomes in patients with childhood-onset systemic lupus erythematous (cSLE). By identifying patients with depressive symptoms, we can intervene early with referrals to mental health resources and improve outcomes. The aim of our quality improv...
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BMC
2025-01-01
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| Series: | Pediatric Rheumatology Online Journal |
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| Online Access: | https://doi.org/10.1186/s12969-024-01038-3 |
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| author | Emily Datyner Jodi Dingle Victoria Newsome Lisa H. Buckley Natasha Belsky Seungweon Park Manda Mitchell Brooke Fine Barron Patterson T. Brent Graham Alaina Davis |
| author_facet | Emily Datyner Jodi Dingle Victoria Newsome Lisa H. Buckley Natasha Belsky Seungweon Park Manda Mitchell Brooke Fine Barron Patterson T. Brent Graham Alaina Davis |
| author_sort | Emily Datyner |
| collection | DOAJ |
| description | Abstract Background Depression adversely affects health outcomes in patients with childhood-onset systemic lupus erythematous (cSLE). By identifying patients with depressive symptoms, we can intervene early with referrals to mental health resources and improve outcomes. The aim of our quality improvement project was to increase and maintain rates of standardized depression screening for youth with cSLE seen within our pediatric rheumatology clinic. Methods Patients with cSLE 12 years of age or older seen for routine follow-up at our pediatric rheumatology clinic from September 16, 2019, through December 30, 2022, were offered the Patient Health Questionnaire-9 modified for adolescents (PHQ-A) to screen for depressive symptoms. A multidisciplinary team developed a key driver diagram to plan potential interventions to improve rates of screening. Plan‒Do‒Study‒Act (PDSA) cycles were used to prepare, implement, and evaluate interventions. Notable interventions focused on accurately identifying eligible patients, facilitating bidirectional communication between staff, and integrating and automating screening within the electronic health record (EHR). Statistical process control (SPC) methods were used for data analysis. Results The percentage of eligible patient encounters where depression screening was completed increased from 0 to 81% and was maintained for more than 6 months. This represents special cause variation, as evidenced by data shifts on our statistical process control chart. Among the 592 patients who completed depression screens, 114 (17%) were positive for moderate to severe symptoms, and 59 (9%) were positive for suicidal ideation (SI). Conclusions A high rate of standardized depression screening for youth with cSLE was achieved and maintained via integration and automation within our EHR. Establishing a highly reliable screening system is a critical first step in improving mental health care for this vulnerable population of youth. |
| format | Article |
| id | doaj-art-9a594f192c51447e879446f5cc8cec7d |
| institution | Kabale University |
| issn | 1546-0096 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj-art-9a594f192c51447e879446f5cc8cec7d2025-01-05T12:11:15ZengBMCPediatric Rheumatology Online Journal1546-00962025-01-0123111010.1186/s12969-024-01038-3Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinicEmily Datyner0Jodi Dingle1Victoria Newsome2Lisa H. Buckley3Natasha Belsky4Seungweon Park5Manda Mitchell6Brooke Fine7Barron Patterson8T. Brent Graham9Alaina Davis10Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltDepartment of Pediatrics, Prisma HealthNorth Augusta PediatricsDepartment of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltVanderbilt University School of MedicineVanderbilt University School of MedicineDepartment of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltDepartment of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltDepartment of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltDepartment of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltDepartment of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children’s Hospital at VanderbiltAbstract Background Depression adversely affects health outcomes in patients with childhood-onset systemic lupus erythematous (cSLE). By identifying patients with depressive symptoms, we can intervene early with referrals to mental health resources and improve outcomes. The aim of our quality improvement project was to increase and maintain rates of standardized depression screening for youth with cSLE seen within our pediatric rheumatology clinic. Methods Patients with cSLE 12 years of age or older seen for routine follow-up at our pediatric rheumatology clinic from September 16, 2019, through December 30, 2022, were offered the Patient Health Questionnaire-9 modified for adolescents (PHQ-A) to screen for depressive symptoms. A multidisciplinary team developed a key driver diagram to plan potential interventions to improve rates of screening. Plan‒Do‒Study‒Act (PDSA) cycles were used to prepare, implement, and evaluate interventions. Notable interventions focused on accurately identifying eligible patients, facilitating bidirectional communication between staff, and integrating and automating screening within the electronic health record (EHR). Statistical process control (SPC) methods were used for data analysis. Results The percentage of eligible patient encounters where depression screening was completed increased from 0 to 81% and was maintained for more than 6 months. This represents special cause variation, as evidenced by data shifts on our statistical process control chart. Among the 592 patients who completed depression screens, 114 (17%) were positive for moderate to severe symptoms, and 59 (9%) were positive for suicidal ideation (SI). Conclusions A high rate of standardized depression screening for youth with cSLE was achieved and maintained via integration and automation within our EHR. Establishing a highly reliable screening system is a critical first step in improving mental health care for this vulnerable population of youth.https://doi.org/10.1186/s12969-024-01038-3Quality improvementChildhood onset systemic lupus erythematosusDepressionScreening |
| spellingShingle | Emily Datyner Jodi Dingle Victoria Newsome Lisa H. Buckley Natasha Belsky Seungweon Park Manda Mitchell Brooke Fine Barron Patterson T. Brent Graham Alaina Davis Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic Pediatric Rheumatology Online Journal Quality improvement Childhood onset systemic lupus erythematosus Depression Screening |
| title | Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic |
| title_full | Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic |
| title_fullStr | Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic |
| title_full_unstemmed | Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic |
| title_short | Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic |
| title_sort | increasing and maintaining rates of standardized depression screening in youth with childhood onset systemic lupus erythematosus in a pediatric rheumatology clinic |
| topic | Quality improvement Childhood onset systemic lupus erythematosus Depression Screening |
| url | https://doi.org/10.1186/s12969-024-01038-3 |
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