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Multidisciplinary QI Initiative to Improve Women’s Service Line Depression Screening

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Jessica Makori, 3rd year Medical Student at University of Minnesota

Alex Snyder, Clinic Operations Manager of Maple Grove (North) OB/GYN

Jenny Johnson, Clinic Operations Manager of East Midwifery/OBGYN and Wyoming OB/GYN Clinics

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Coach: Jeanne Larson-Moore

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A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Background

JAMA (2024)

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Background

Patient Health Questionnaire 9 (PHQ-9) - a tool used for depression screening

https://www.socialworkportal.com/phq-9-questionnaire/

PHQ-2

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Background

PHQ-9 scores can help determine depression severity and management

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Aim

To improve depression screening (main driver) and follow up in the combined East Midwifery/OBGYN and North OBGYN clinics, with the goal of increasing the Leading Process Indicator (LPI) percentage average from 71% to 85% on a weekly basis by August 31st, 2023

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A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Current State Summary

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Current State Summary

PROBLEM – We are failing to screen 29% of perinatal patients for depression

Root Cause Analysis

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Tests

of Change

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Depression Screening Control Charts

There was one statistically significant change impacting performance in the East Region (5/7/2023).

There was one statistically significant change impacting performance in the North Region (7/9/2023).

Project Results

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A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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East and North ≥ 16% higher screening rate than the next best performing clinic

Next Steps

North is the highest in Women’s Ambulatory Care prior to project

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Lessons Learned

What went well?

What would you do differently next time?

  • Our teams were supportive of this project and were dedicated to make this project successful
  • Implement a change in the prenatal depression screening workflow at the same time
  • Involve providers in the follow up process

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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Thank You

  • Thank you, Christina Haupt and Amy Johnson for your leadership and support through our project!
  • Thank you, Jeanne Larson-Moore, for coaching us through this process and making sure we are successful!
  • Thank you for our North and East Clinics for your willingness and dedication to improve the depression screening process in our clinic.

A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services

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A collaboration among the University of Minnesota,

University of Minnesota Physicians and Fairview Health Services