A Pilot Study of the Feasibility of a Depression and Suicide Screening Quality Indicator


A Pilot Study of the Feasibility of a Depression and Suicide Screening Quality Indicator

Authors: Patricia DeMellopine (site Principal Investigator) and Mary Wong, Hsiao-Lan (Dee) Shih (site Sub Principal Investigators)

Study Aim: Will the Implementation of a fall risk tool with more patient specificity (Edmonson Psychiatric Fall Risk Assessment Tool) improve nurses’ fall risk assessment for the Behavioral Health inpatient population in 3 months?

Project Goal: The objective for this multi-site study with The National Database of Nursing Quality Indicators (NDNQI®) was to examine the feasibility of a depression and suicide screening quality indicator to determine the incidence of depression and suicide screening and the prevalence of patients with depression and processes for depression treatment in acute and ambulatory care settings. The Principal Investigator is Emily Cramer, PhD, University of Kansas Medical Center.

The specific aims were to:

  • Examine the interest among hospitals to participate in a depression and suicide screening quality indicator.
  • Examine the feasibility of electronic data extraction for screening measures across care settings.
  • Explore missing data patterns for hospital-collected data elements.
  • Identify the barriers hospitals encountered when collecting and reporting depression and suicide screening incidence.
  • Identify levels of organizational support and behavioral health resources for the screening and treatment of depression and suicide risk.

Background: Prevalence rates in the United States are high among adults (6-7%), adolescents (13%) and the older adults (16%). Depression has both primary and secondary impacts on patient health because it frequently occurs with other chronic diseases, and can impact patient adherence to treatment protocols. Depression has been prioritized as a measure for Ambulatory Care Settings by the ANA and AAACN. Reducing suicide has become a priority for many organizations. Evidence has shown that the most effective way to prevent suicide is to identify and treat depression. Measures to look at suicide and depression in healthcare are available but very limited in scope.

Methodology: Two Screening Measures were used: a) Incidence Measure using electronic data and b) Prevalence Measure using chart abstracted data. Prevalence study was conducted for one day across units (24 hour time for both inpatient and ambulatory). The goal was to obtain a target sample of 50 hospitals, a random sample of 800 NDNQI hospitals were invited to participate. El Camino Hospital participated with one inpatient unit (2C) and one ambulatory unit (MV ED).

Results: The primary goal was determining the availability of data elements and feasibility of data collection. The total study sample size was small and a comparison to similar hospitals and units was not possible with this pilot.

Conclusions: We appreciated the opportunity to participate in this multisite evaluation of the current state of available measures for depression and suicide screening and follow-up in healthcare. We were able to discover where our current status is with documentation comparing our inpatient and ambulatory process.