MEASUREMENT-BASED CARE FOR DEPRESSION

Measurement-based care (MBC) has not been widely adopted in behavioral health (BH), which is a requirement of a recently revised care, treatment, and services standard for accreditation in BH settings (The Joint Commission [TJC], 2017). The purpose of this quality improvement (QI) project was to develop, implement, and evaluate an MBC Depression Protocol using the Patient Health Questionnaire-9 (PHQ-9). This was implemented to monitor progress and assure compliance with regulatory requirements for safe, effective and measurable care for patients with major depressive disorder (MDD). In this study, a convenience sample of 44 BH personnel was educated and evaluated on a newly created “MBC of Depression Protocol at the St. Joseph Hospital of Orange.” Deidentified PHQ-9 scores of MDD patients were analyzed, and protocol adherence by outpatient BH personnel was measured. In-service knowledge and confidence scores improved by approximately 32% (n=44). Protocol adherence by the outpatient staff met the target of 3 (100%) PHQ-9 surveys per patient. The mean aggregate change in PHQ-9 scores over episodes of care was 56% (n = 20) indicating a significant response to treatment. MBC will lead to improved patient-centric care by quantifying the outcomes of care, treatment, and services provided to patients. PHQ-9 monitoring may function as a “lab” test for depression.