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Background: Depression contributes to the suboptimal health outcomes among people with type 1 diabetes (T1D) . American Diabetes Association recommends depression screening in individuals with T1D. We aim to demonstrate the use of QI tools in expanding depression screening in the T1D Exchange Learning Collaborative (T1DX-LC)
Method: Six clinics in the T1DX-LC participated in expanding depression screening utilizing PHQ-2, PHQ-4, or PHQ-9. The clinics applied QI principles to design plan-do-study-act cycles to develop, improve, and adapt interventions. The interventions tested include use of a screener at visits, expanding screening to age 12, pulling weekly data to flag patients that should be screened, peer support group, standardizing screening workflow, use of EHR/health information technology, provider training, monthly meetings to discuss screening protocol, and streamlining referral process. The hospitals shared monthly aggregate data with the T1DX-LC
Result: Participating clinics were successful at implementing depression screening. Screening increased from a baseline of 59% to 72% over 17 months
Conclusion: Utilizing the PHQs for depression screening is feasible and QI principles are useful in expanding screening rates. Continued expansion of depression screening is necessary to improve emotional well-being and diabetes self-care management.
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Multicenter Quality Improvement Project: Increasing Depression Screening across Six Pediatric Endocrinology Centers in the U.S.
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