Timely Depression, Suicide Screening, and Transition of Care Coordination in an Addiction Treatment Setting

Abstract

Background

People with substance use disorders (SUDs) experience higher rates of depression and suicide and lack primary care providers (PCP).

Local Problem

Twenty chart audits at the St. Lawrence Addiction Treatment Center (SLATC) showed 65% (n = 11) of SUD patients lacked a PCP. Standardized screening tools and timely appointments were lacking. The aim was to increase timely scheduled psychiatric appointments for SUD patients at discharge by 80% within 90 days.

Methods

A 90-day rapid cycle improvement project with plan-do-study-act was the process for improvement. Data were collected with four interventions from screening, checklist, patient, and team engagement concurrently. Run charts, spreadsheets, and aggregate data were interpreted for timely care. Interventions: Screening tools evaluated risks for depression and suicide. If patients screened positive, a decision aid was used for patient education. Discharge Care Coordination Checklist was used as a quality tool tracking all patients. The Project Briefing Tool and team engagement activities were used to improve participation.

Results

Screening tools were spread with 125 screenings showing 53 positives for depression and four positives for suicide. After using the decision aid, 24 (45.2%) chose depression medications, 29 (52.8%) chose complementary alternative medicine, and one patient chose neither. Of the 125 patients on the Discharge Care Coordination Checklist, 43.2% (n = 54) were scheduled with appointments, The Project Briefing Tool improved participation.

Conclusion

Standardized screening tools, CAM, and co-creation activities improved timeliness of care. A further study for the impact of mental health services for relapse prevention was recommended.

Funding

No funding