Improving Depression Screening in the Adult Rural Primary Care Setting

Abstract

An estimated 16 million adults are diagnosed each year with depression with primary care providers most commonly making the diagnosis. Depression screening guidelines from the United States Preventive Services Task Force and the American Academy of Family Physicians are recommended for all adults in primary care. Both the literature and an informal needs assessment confirmed a low rate of depression screening in rural primary care. A quality improvement project was conducted in three federally-qualified health centers in rural North Carolina by implementing a depression screening process. Pre-implementation data for depression screening revealed a screening rate of 0-1.4% in the organization’s clinics over the previous three years. Following implementation of the quality improvement project, depression screening rates improved to an overall rate of 14%, with one clinic reaching a 60% screening rate. Collaboration with behavioral health professionals to implement a low-cost depression screening and treatment protocol improved screening rates to meet Healthy People 2020 and Triple Aim goals in primary care.