Staff Education to Enhance PHQ-9 Depression Screening in a Mental Health Clinic

Doctor of Nursing Practice Project Summary Lack of standardization in the implementation and documentation of the Patient Health Questionnaire-9 (PHQ-9) was noted in this outpatient mental health clinic, impeding reproducible depression screening and evidence-based monitoring. The purpose of this Doctor of Nursing Practice (DNP) project was to examine whether staff education, enhanced by clinical workflow aids, could foster uniform PHQ-9 documentation in applicable patient encounters. Strategies employed included a systematic staff education session, a quick reference guide, an electronic health record (EHR) guide, and provision of prompt guidance and support during adoption. A pre- and post-quality improvement assessment was conducted using anonymized audits of patient encounters. Post-implementation results demonstrated optimization in standardized PHQ-9 completion and proper documentation, increasing from a reference point of 56% to 86%. Follow-up planning for PHQ-9 recordkeeping increased from 60% to 88%, and the rate of employee education completion reached 95%. Competency assessment scores improved from 68% pre-education to 90% post-education. These findings indicate that staff education, merged with workflow and documentation support, can enhance the reproducibility of PHQ-9 screening and follow-up documentation. This project supports the use of systematic education and workflow alignment to reinforce standardized depression assessment, thereby promoting quality improvement in an outpatient mental health clinic.