Addressing Behavioral Health Concerns in Trauma: Using Lean Six Sigma to Implement a Depression Screening Protocol in a Level I Trauma Center. Issue 4 (October 2020)

• Record Type: Journal Article
• Authors: Moran, Mary E.; Sedorovich, Ashley; Kish, Jamie; Gothard, Andrew; George, Richard L.
• Is Part Of: Quality management in health care. Volume 29:Issue 4(2020)
• Publication Date: 2020-10
• Subjects: behavioral health screenings -- depression -- health care quality -- Lean Six Sigma -- trauma; Medical care -- Quality control -- Periodicals; Total quality management -- Periodicals; Health services administration -- Periodicals; 362.1068
• DOI: 10.1097/QMH.0000000000000266
• Languages: English
• ISSNs: 1063-8628

Abstract

Abstract : Background: Patients with physical injuries or chronic conditions may be impacted by mental health conditions, which significantly affect their participation and progress in treatment. The Patient Health Questionnaire-2 (PHQ-2) depression screening can identify patients who are at greatest risk for depression to provide better whole-person care. Objective: The quality improvement project objective was to identify and design a process that would result in the PHQ-2 depression screening for admitted trauma patients with a minimum 75% completion rate. Methods: Lean Six Sigma (LSS) process design methodology, DMADV (define, measure, analyze, design, and verify), drove process improvement. Medical records from before (December 2018 through February 2019) and after (March 2019 through May 2019) the intervention were evaluated using frequencies, percentages, χ 2, and multivariable logistic regression to determine the effectiveness of the intervention. Results: PHQ-2 document location was imperative to successful compliance, which increased from 60.74% (78 of 128) to 80.56% (87 of 108). Specifically, weekend compliance increased from 42.9% (18 of 42) to 82.8% (24 of 29). Conclusion: LSS DMADV methodology helped health care professionals design a process to facilitate compliance with the PHQ-2 depression screening protocol in trauma patients. Adherence with this screening can help increase the number of behavioral health consultations, which in turn improves the treatment of traumatic injury survivors.