BACKGROUND Prompt follow-up for positive depression screen results is important in providing high-quality care for adolescents. We sought to improve follow-up within 30 days for adolescents (≥12 years) with Patient Health Questionnaire-9 scores ≥10, or those with a positive question 9, from 25% to 40%. METHODS We conducted a quality improvement project at 6 primary care locations serving ∼33,300 patients (70% Black, 7.3% Hispanic, 80% Medicaid-enrolled). Our team identified key drivers and iteratively tested interventions, including contacting patients after antidepressant medication initiation, scheduling patients for follow-up during index visits, collaborating with integrated psychologists to expedite therapy for higher-risk patients, and reaching out to patients without scheduled follow-ups. RESULTS Pre-intervention, 13.3% (589 of 4427) of adolescent encounters met the criteria for follow-up within 30 days, and 25.8% had a documented follow-up within 30 days. During the intervention period, 12.3% (764 of 6224) of adolescent encounters met the criteria for follow-up within 30 days, and the mean follow-up rate increased to 43.1%. By monitoring process measures, we scheduled follow-up visits for 18.9% of patients during the index encounter. Outreach to the remainder led to 32.6% of these patients completing follow-up. Our balancing measure of monitoring integrated psychology visit volumes remained stable. CONCLUSIONS The application of quality improvement methods in primary care practices increased the frequency of follow-up care for high-risk adolescents after a positive depression screen.

中文翻译：

---

增加对有抑郁症状的青少年的随访。


背景 及时随访阳性抑郁筛查结果对于为青少年提供高质量的护理很重要。我们试图改善患者健康问卷 9 评分为 ≥10 分的青少年 （≥12 岁） 或 9 分为阳性的青少年 （25% 至 40%） 在 30 天内的随访。方法 我们在 6 个初级保健地点开展了一项质量改进项目，为 大约 33,300 名患者提供服务（70% 黑人，7.3% 西班牙裔，80% 加入 Medicaid）。我们的团队确定了关键驱动因素并反复测试了干预措施，包括在抗抑郁药开始后联系患者、在指数访问期间安排患者随访、与综合心理学家合作以加快对高危患者的治疗，以及联系没有计划随访的患者。结果 干预前，13.3% （4427 例中的 589 例） 的青少年在 30 天内符合随访标准，25.8% 在 30 天内有记录的随访。干预期间，12.3% （6224 例中的 764 例） 的青少年就诊在 30 天内符合随访标准，平均随访率提高到 43.1%。通过监测过程措施，我们在指数接触期间为 18.9% 的患者安排了随访。对其余患者的外展导致这些患者中有 32.6% 完成了随访。我们监测综合心理学就诊量的平衡措施保持稳定。结论 在初级保健实践中应用质量改进方法增加了抑郁症筛查阳性后高危青少年的随访护理频率。