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How does your primary care clinics use the PHQ2/PHQ9 screening tools?

  • 1.  How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 20 days ago

    Our practice consists of 9 clinics in the greater metro area of Kansas City.  We have discovered some practice inconsistencies in the use of the PHQ2 and PHQ9 tool/s.  Please share how your practices use the tools, when they use them for example what appointment type, or if you do not use these screeners what screening tools do you use for mental health?

     Thank you in advance!



    ------------------------------
    Cie Cascone, MSN, RN
    Corporate Clinical Educator
    Spira Care, LLC
    2300 Main St.
    Kansas City, MO 64108
    816-395-2062 OFFICE
    816-365-3368 MOBILE
    Cie.Cascone@SpiraCare.com
    Pronouns: She, Her, Hers
    ------------------------------


  • 2.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 20 days ago

    Hello Cie,

    Our organization uses the PHQ-2/9 and requires it to be completed at least every 6 months, regardless of the reason for the visit, based on past medical history and a previous screening score. We use Epic, so the rules, alerts, and hard stops are all built in the background. It is set up so that staff cannot get out of the chart at all without either completing the questionnaire or overriding it for 1 of 4 reasons: Functionally unable to communicate, Patient refuses, Medically urgent appointment, or Other (with comments). We can also review the reasons why staff are not completing the questionnaire to ensure validity.

     

    Our clinical education team provides training on the PHQ along with tips for addressing the topic, especially if the patient is coming in for a sick visit.

    Feel free to reach out if you have any questions!

     

    Thank you,

     

    Sharon J.J. Peacock, MSN-Ed., RN, NPD-BC, AMB-BC

    Nursing Professional Development, Sentara Ambulatory Services Division

    Chair, AAACN Staff and Patient Education SIG

     

    Office: 434-654-4529    Email: SJPEACOC@sentara.com

    590 Peter Jefferson Parkway, Suite 323, Charlottesville, VA 22911

     

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  • 3.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 20 days ago

    Previously, we included PHQ2 in our standard rooming process for all adult pts and then asked the PHQ9 if pts answered yes to either question. Recently, though, we've decided to use PH9 exclusively (because the PHQ2 doesn't screen for suicidality) and it's asked according to the care gaps (every three months for those with a depressive dx and annually for those without a depressive dx). 

    There was pushback initially about having additional question, but since they're asking it less often, the average number of questions asked per day is about the same. Providing scripting and opportunities to practice was also very important for our staff. 



    ------------------------------
    Ashley Martin, MPH, RN, BSN
    Clinical Education Specialist
    Lower Lights Christian Health Center
    Columbus, OH
    ashley.martin@llchc.org
    ------------------------------

    Original Message


  • 4.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 20 days ago
    Cie,

    Great topic!

    Our organization has worked to improve Depression Screening processes for several years; here are our top strategies:
    • Capture at every opportunity - every visit
    • Use front office staff to assist with completion while waiting
    • Same-day clinics and urgent care locations (not all) screen adolescent populations
    PHQ-2 is used for all adults, if positive the PHQ-9 is completed
    PHQ-9: Some locations use strictly
    PHQ-A is used for adolescents

    Hope this helps!


    Thank you,

    Cindy

    Cindy Garrett, RN, MBA, BSN, AMB-BC
    VP Ambulatory Quality

    Dignity Health Medical Foundation

    Dignity HealthⓇ
    A member of CommonSpirit


    CA Region Ambulatory Quality
    CommonSpirit Health™

    530.919.5467 (mobile)

    Executive Assistant:  Lori Balcoff

    916.379.2902

    Lori.Balcoff@commonspirit.org


    Quality Assistant:  Courtney Cardenas

    Courtney.Cardenas@commonspirit.org


    DHMF CSPS Connections Page

    Caution: This email is both proprietary and confidential, and not intended for transmission to (or receipt by) any unauthorized person(s). If you believe that you have received this email in error, do not read any attachments. Instead, kindly reply to the sender stating that you have received the message in error. Then destroy it and any attachments. Thank you.



    Original Message


  • 5.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 19 days ago
    This is a great discussion.  What is your process if someone screens positive?
    Stephanie

    Stephanie G Witwer, Ph.D., RN, NEA-BC, FAAN
    Department of Nursing
    Emeritus Staff



    Original Message


  • 6.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 19 days ago

    We then go to the PHQ9 full assessment. Based on the patient's responses the medical provider may address the patient's needs or complete a warm hand-off with our Behavioral Health Consultant in each care center or both depending on the assessment and patient's needs. 



    ------------------------------
    Cie Cascone, MSN, RN
    Corporate Clinical Educator
    Spira Care, LLC
    2300 Main St.
    Kansas City, MO 64108
    816-395-2062 OFFICE
    816-365-3368 MOBILE
    Cie.Cascone@SpiraCare.com
    Pronouns: She, Her, Hers
    ------------------------------

    Original Message


  • 7.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 19 days ago
    I am curious if anyone has a RN Care Coordination program for Behavioral Health.  My organization has one and referrals go to the RN CC and they work within our behavioral health integration model to develop a plan.  This type of work is reimbursed under the CoCM codes.
    Stephanie

    Stephanie G Witwer, Ph.D., RN, NEA-BC, FAAN
    Department of Nursing
    Emeritus Staff



    Original Message


  • 8.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 18 days ago
    At our organization the Medical Assistants are to screen for depression using the PHQ-2, if the score is 3 or above the e.h.r. automatically prompts further assessment using the PHQ-9. If the screen is positive, the provider will address. Depending on the severity the provider will manage and/or refer to Behavior Health.


    --
    Nancy Banuelos
    Chief Operations Officer

    Community Health Centers of the Central Coast (CHC)
    805-346-3900 work
    nancy.banuelos@chccc.org email
    www.communityhealthcenters.org

    2050 S. Blosser Rd -- Santa Maria, CA 93458-7310

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  • 9.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 19 days ago

    If a patient's screen is positive, especially for the 9th question, our process is to stay with the patient and have a co-worker verbally notify the provider. The provider is required to complete the Columbia Suicide Screening Tool, and there are additional suggestions based on the patient's response. The provider is not able to sign their note without completing the Columbia Suicide Screening Tool.

     

    Thank you,

     

    Sharon J.J. Peacock, MSN-Ed., RN, NPD-BC, AMB-BC

    Nursing Professional Development, Sentara Ambulatory Services Division

    Chair, AAACN Staff and Patient Education SIG

     

    Office: 434-654-4529    Email: SJPEACOC@sentara.com

    590 Peter Jefferson Parkway, Suite 323, Charlottesville, VA 22911

     

    Shape Description automatically generated with medium confidence

     

     

     




    Original Message


  • 10.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 19 days ago
    Sharon and all,


    Our processes are the same as Sharon shared regarding suicide screening.

    Additionally, here is the documentation piece the provider must complete for any positive screens:
    image.png
    A provider may determine that a screen is either negative or positive (even if the screen is positive). If the result is determined to be positive, the provider must select the Follow Up Plan as shown. 

    These discrete fields assist with data submission and coding purposes. 

    Hope this is helpful!


    Thank you,

    Cindy

    Cindy Garrett, RN, MBA, BSN, AMB-BC
    VP Ambulatory Quality

    Dignity Health Medical Foundation

    Dignity HealthⓇ
    A member of CommonSpirit


    CA Region Ambulatory Quality
    CommonSpirit Health™

    530.919.5467 (mobile)

    Executive Assistant:  Lori Balcoff

    916.379.2902

    Lori.Balcoff@commonspirit.org


    Quality Assistant:  Courtney Cardenas

    Courtney.Cardenas@commonspirit.org


    DHMF CSPS Connections Page

    Caution: This email is both proprietary and confidential, and not intended for transmission to (or receipt by) any unauthorized person(s). If you believe that you have received this email in error, do not read any attachments. Instead, kindly reply to the sender stating that you have received the message in error. Then destroy it and any attachments. Thank you.



    Original Message


  • 11.  RE: How does your primary care clinics use the PHQ2/PHQ9 screening tools?

    Posted 19 days ago

    We are fortunate to have Behavioral health in all 3 of our clinics. Providers can ask BH to come into the room or make an urgent referral to BH at time of service. For adults,  we ask PHQ-2 at every visit and ask the full PHQ-9 once per year. For pediatrics its always a PHQ-9 once per year unless they have a positive test then it's every visit for a year. We do ask the suicidal question as more than just suicide. We ask about self harm or wanting to harm others as well. Maybe this helps someone!



    ------------------------------
    Alicia Posey, LPN
    ------------------------------

    Original Message


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