A Curriculum in Measurement-Based Care: Screening and Monitoring of Depression in a Psychiatric Resident Clinic

Objective: The goal of this curriculum was to train residents in measurement-based care (MBC). Method: Third-year psychiatry residents were educated in MBC through didactic seminars and a quality:improvement (QI) initiative with the goal of implementing the Patient Health Questionnaire Depression Scale (PHQ-9) to screen and monitor patients for symptoms of depression. Results: Residents suggested strategies for integrating the PHQ-9 into the clinic. Over the first 6 months, residents showed an increase in rate of depression screening from 4% to 92% of patients. Also, they increased monthly monitoring of outpatients with a diagnosis of depression from 1% to 76%. Residents who used the PHQ-9 to monitor patients with depression were significantly more likely to use additional standardized assessments. Conclusions: Combining an educational intervention with QI strategies can significantly affect residents' use of standardized assessments in an outpatient setting. Using standardized measures allows residents to assess their own clinical effectiveness, an emerging priority in training.