Degree Name
Nursing Practice, DNP
Publication Date
4-27-2026
First Advisor
Sandy King
Second Advisor
Brandi Castle
Abstract
Depression and anxiety are leading causes of disability and are frequently underdiagnosed in outpatient psychiatric settings due to inconsistent screening and documentation practices. Evidence supports the use of standardized tools, such as the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to improve early detection and clinical outcomes. This quality improvement (QI) project evaluated whether implementing standardized electronic health record (EHR) templates and provider education would improve documentation of PHQ-9 and GAD-7 screenings. The aim was to increase the consistency of screening and documentation among psychiatric providers. The project was guided by the Plan-Do-Study-Act (PDSA) framework and Lewin’s Change Theory. A quantitative, quasi-experimental pre–post design was used in an outpatient psychiatric clinic with three psychiatric providers. The intervention included integrating PHQ-9 and GAD-7 templates into the EHR and delivering a structured one-hour provider training session. Data was collected through retrospective chart audits comparing pre-implementation (n = 131) and post-implementation (n = 130) documentation rates. PHQ-9 documentation increased from 7.6% (10/131) pre-intervention to 100% (130/130) post-intervention, while GAD-7 documentation improved from 8.4% (11/131) to 99.2% (129/130). These improvements were statistically significant (p < .001). Provider knowledge scores improved from pre-test scores of 4–5 to 10 post-training. Limitations included a small sample size and a single-site design, which may affect generalizability. Findings demonstrate that EHR-integrated templates and targeted provider education significantly improve mental health screening documentation and support sustainable workflow changes.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Joshua, Sharon Uchechi, "Quality Improvement Project: Improving Provider Workflow and Documentation for Routine Mental Health Screening in an Outpatient Psychiatric Clinic" (2026). Doctor of Nursing Practice Projects. 349.
https://arch.astate.edu/dnp-projects/349
