Measurement based care for improving clinical depression and attention-deficit/hyperactivity disorders

Abstract

Background: Measurement based care is an evidence-based approach proven to enhance diagnosis and treatment of psychiatric disorders. This patient-centered strategy involves the routine use of clinically validated, self-report rating scales to quantify clinical outcomes over time and guide decision-making. Extensive research indicates that measurement based care improves the quality of psychiatric care and patient outcomes. Local Problem: Prior to implementation of the Doctor of Nursing Practice project, measurement based care for adults diagnosed with clinical depression and/or attention-deficit/hyperactivity disorders had not been implemented at a mental health clinic located in southwest Montana. Methods: Hence, the purpose of the Doctor of Nursing Practice project was to implement the Beck Depression Inventory II and the Adult ADHD Self-Report Scale for adult patients, treated in-person at the clinic, diagnosed with clinical depression and/or attention/deficit-hyperactivity disorder. Interventions: After approval by the Montana State University Institutional Review Board, qualifying patients were administered the appropriate self-report rating scale via iPad at the beginning of each clinical encounter. Immediately after patients completed the self-report rating scale, the clinician reviewed their scores and used this data to augment decision-making. Results: The results of the 11-week project revealed improved follow-up scores, suggesting that data collected from clinically validated, self-report rating scales may have enhanced earlier detection rates of deterioration and enhanced clinician responsiveness to subtle changes in morbidity. Conclusion: In summation, the Doctor of Nursing project underscores the importance of measurement based care for improving patient outcomes related to clinical depression and/or attention/deficit-hyperactivity disorders and provides valuable insights for future quality improvement initiatives.