Operationalizing Depression Screening in Ambulatory Palliative Care: A Quality Improvement Project

Background. Depression is common in the palliative care setting and impacts outcomes. Operationalized screening is unusual in palliative care. Local Problem. Lack of operationalized depression screening at two ambulatory palliative care sites.Methods. A fellow-driven quality improvement initiative to implement operationalized depression screening using the patient health questionnaire-2 (PHQ-2). The primary measure was rate of EMR-documented depression screening. Secondary measures were clinician perspectives on the feasibility and acceptability of implementing the PHQ-2.Intervention. The intervention is a clinic-wide implementation of PHQ-2 screening supported by note templates, brief clini-cian training, referral resources for clinicians, and opportunities for indirect psychiatric consultation.Results. Operationalized depression screening rates increased from 2% to 38%. All clinicians felt incorporation of depres-sion screening was useful and feasible.Conclusions. Operationalized depression screening is feasible in ambulatory palliative care workflow, though optimization through having screening be completed prior to clinician visit might improve uptake. J Pain Symptom Manage 2023;65:e7 -e13.(c) 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.