The Internal Medicine Visit Planner is the key to communicating between the provider and the Depression Care Program. Depression screening for all patients in Internal Medicine will be driven by the visit planner. Tracking of positive screens, assessments and follow-up plans of the provider will be tracked through the visit planner.
The Depression Screening Algorithm, provides an overview of the screening, assessment and follow-up process.
- Patients will be prompted for initial screening by the nurse at determined intervals. Patients are asked the PHQ-2 (first two questions of the PHQ-9), which assess depressed mood and anhedonia. A positive score indicates further assessment by the full PHQ-9.
- Patients who score 3 or greater on the PHQ-2 will be asked to take the PHQ-9 (or assisted by the nurse).
- Providers are responsible for reviewing results of all PHQ-2 screens on the front of the Visit Planner and completing the provider prompts.
- For patients screening positive for the PHQ-2 (3 or greater), the provider is responsible for reviewing the PHQ-9 (on the back of the visit planner) and entering the total score of the nine questions.
- For patients whose PHQ-9 score indicates moderate depression (score of 10 - 14) or severe depression (15 or greater), the provider should provide depression education and discuss treatment with the patient. A brief algorithm is provided to guide treatment and for the provider to complete prompts indicating their plan of treatment.
Depression Care Program
- Patients with severe depression (score of 15 or greater) will receive a follow-up call at 2 weeks from the Depression Care Program Assistant.
- Patients with moderate or severe depression will be tracked by the program, overseen by a licensed clinical social worker (LCSW).
Assessment Forms and Depression Prompts
Sample Visit Planner (FRONT) - showing Depression Screening prompts for Nurses and Providers
Sample Visit Planner (BACK) - PHQ-9 questionnaire, total score and provider prompts for moderate and severely depressed patients
For patients with active suicidality see Suicidality page for all forms and response outlines.