Degree Name
Nursing Practice, DNP
Publication Date
8-12-2025
First Advisor
Lisa Drake
Second Advisor
Kristie Givens
Abstract
The inconsistent management of depression in primary care settings persists despite numerous available treatments, which current behavioral health literature frequently addresses. A review of the project site highlighted the inconsistency in diagnosing and managing depression due to varying levels of provider familiarity with current guidelines and a lack of integrated decision-support tools within the Electronic Health Record (EHR) system. This project aims to evaluate the impact of integrating a clinical decision-making tool and patient outcomes in managing depression. This Quality Improvement (QI) project implemented UpToDate as an evidence-based clinical resource within the EHR system to address inconsistent application of evidence-based guidelines in diagnosing and treating depression at a Southwestern Arizona clinic. The project sought to enhance diagnostic accuracy, standardize treatment protocols, and improve patient outcomes. Guided by the Donabedian Model, which evaluates healthcare quality through structure, process, and outcome, the six-month implementation period generated monthly data on provider UpToDate usage, depression severity, and patient satisfaction scores. Monthly data was collected from the project’s samples of twenty primary care providers (PCPs) managing adult patients diagnosed with depression. The results showed that provider guideline adherence rose substantially from 10.5% before the intervention to 72.5% after its completion. Using the 5-point Likert scale, the depression severity scores decreased, while patient satisfaction scores demonstrated significant improvement. The implementation of real-time, evidence-based tools within EHR workflows leads to reduced variability in provider practices and better behavioral health outcomes. The project demonstrates how a nurse-led QI initiative can apply research findings to clinical practice through digital resources to enhance mental health service delivery.
Rights Management
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Ojoye, Theresa, "Quality Improvement Project Integrating Clinical Decision-Making Tools within an EHR System for Provider-Enhanced Diagnosis and Treatment of Depression in Primary Care" (2025). Doctor of Nursing Practice Projects. 136.
https://arch.astate.edu/dnp-projects/136
