Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic.
| Title: | Increasing and maintaining rates of standardized depression screening in youth with childhood-onset systemic lupus erythematosus in a pediatric rheumatology clinic. |
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| Authors: | Datyner E; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA. emily.k.datyner@vumc.org.; Dingle J; Department of Pediatrics, Prisma Health, Columbia, SC, USA.; Newsome V; North Augusta Pediatrics, North Augusta, SC, USA.; Buckley LH; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA.; Belsky N; Vanderbilt University School of Medicine, Nashville, TN, USA.; Park S; Vanderbilt University School of Medicine, Nashville, TN, USA.; Mitchell M; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA.; Fine B; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA.; Patterson B; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA.; Graham TB; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA.; Davis A; Department of Pediatrics, Vanderbilt University Medical Center, Monroe Carell Junior Children's Hospital at Vanderbilt, 2141 Blakemore Avenue, Nashville, TN, 37232, USA. |
| Source: | Pediatric rheumatology online journal [Pediatr Rheumatol Online J] 2025 Jan 04; Vol. 23 (1), pp. 3. Date of Electronic Publication: 2025 Jan 04. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 101248897 Publication Model: Electronic Cited Medium: Internet ISSN: 1546-0096 (Electronic) Linking ISSN: 15460096 NLM ISO Abbreviation: Pediatr Rheumatol Online J Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2007- : [London] : BioMed Central; Original Publication: [Chicago, Ill. : University of Chicago, 2003]- |
| MeSH Terms: | Lupus Erythematosus, Systemic*/complications ; Lupus Erythematosus, Systemic*/psychology ; Lupus Erythematosus, Systemic*/diagnosis ; Depression*/diagnosis ; Depression*/etiology ; Mass Screening*/methods ; Quality Improvement*; Rheumatology/standards ; Rheumatology/methods ; Humans ; Adolescent ; Child ; Female ; Male |
| Abstract: | Background: Depression adversely affects health outcomes in patients with childhood-onset systemic lupus erythematous (cSLE). By identifying patients with depressive symptoms, we can intervene early with referrals to mental health resources and improve outcomes. The aim of our quality improvement project was to increase and maintain rates of standardized depression screening for youth with cSLE seen within our pediatric rheumatology clinic.; Methods: Patients with cSLE 12 years of age or older seen for routine follow-up at our pediatric rheumatology clinic from September 16, 2019, through December 30, 2022, were offered the Patient Health Questionnaire-9 modified for adolescents (PHQ-A) to screen for depressive symptoms. A multidisciplinary team developed a key driver diagram to plan potential interventions to improve rates of screening. Plan‒Do‒Study‒Act (PDSA) cycles were used to prepare, implement, and evaluate interventions. Notable interventions focused on accurately identifying eligible patients, facilitating bidirectional communication between staff, and integrating and automating screening within the electronic health record (EHR). Statistical process control (SPC) methods were used for data analysis.; Results: The percentage of eligible patient encounters where depression screening was completed increased from 0 to 81% and was maintained for more than 6 months. This represents special cause variation, as evidenced by data shifts on our statistical process control chart. Among the 592 patients who completed depression screens, 114 (17%) were positive for moderate to severe symptoms, and 59 (9%) were positive for suicidal ideation (SI).; Conclusions: A high rate of standardized depression screening for youth with cSLE was achieved and maintained via integration and automation within our EHR. Establishing a highly reliable screening system is a critical first step in improving mental health care for this vulnerable population of youth.; (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Ethics approval and consent to participate: The authors received ethics board approval and exemption as a quality improvement study from Vanderbilt University Medical Center institutional review board (IRB #190126). Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests. |
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| Contributed Indexing: | Keywords: Childhood onset systemic lupus erythematosus; Depression; Quality improvement; Screening |
| Entry Date(s): | Date Created: 20250103 Date Completed: 20250106 Latest Revision: 20250106 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11699778 |
| DOI: | 10.1186/s12969-024-01038-3 |
| PMID: | 39754107 |
| Database: | MEDLINE |
Journal Article