Introducing a Standardized Approach to the Diagnosis of Anxiety and Depression in a Women’s Health Clinic

The goal of this quality improvement project (QIP) is the implementation of the standardized psychiatric screenings, Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ9), into a women’s health clinic. The purpose of implementing these screenings is to improve the diagnosing and subsequent treatment plans for patients in a women’s health clinic. Women have a higher prevalence of anxiety-based disorders and depressive disorders, when compared to men, as a result of their physiology, and genetics (Sapra et al., 2020; Salk et al., 2017). The GAD-7 and PHQ9 screening tools were implemented in the offices of a private practice group in South Florida. This was accomplished through the existing electronic medical records system (EMR) in place at the clinic. Despite the fact these screenings were already available within the clinic’s EMR system, they were seldom utilized prior to the QIP. This was due to the difficulty in locating these forms within the electronic medical record system (EMR). To advance the utilization of the available GAD-7 and PHQ9 screening forms, they were added to multiple types of patient encounters including history and physicals, follow-up appointments, new patient visits, and general appointments. Data was collected about the implementation process from the medical assistants who gave patients the self-screenings to complete, and patient encounter data was collected from the physician in charge of the women’s health clinic. Data from the physician was collected weekly for a total of ten weeks, and data from the medical assistants was collected biweekly during the same ten-week period. Limitations encountered included a small sample size and a lack of generalizability. Results from the physician surveys indicated that access to the forms lead to utilization of the diagnostic tools and patients who scored higher than three on either the GAD-7 or PHQ9 resulted in a prescription for anxiety or depression, respectively.