Visits at pediatric hospitals related to suicidal ideation and attempts have nearly doubled over the past decade. To better identify patients struggling with depression who might not otherwise communicate their intentions to self-harm, Rady Children’s Hospital in San Diego began using Epic to ensure that adolescents are asked about symptoms of depression during visits.
In the first year of the program after go-live, Rady Children’s completed an average of over 5,500 screenings a month, more than a fourfold increase from their initial depression screenings in 2016. In less than a year, Rady Children’s identified over 2,200 at-risk adolescents and connected them with community resources such as counselors, education, and emergency services.
To assess patients’ risk of self-harm during clinic visits, front-line clinical staff, such as MAs, ask patients to answer a health questionnaire in Epic that includes questions that screen for depression. Selecting answers on the computer screen helps patients be more candid while their parents or other guardians are still in the room. Reminders in Epic prompt clinical staff to have patients complete the questionnaire when they’re due for a screening.
If a patient’s answers indicate risk for self-harm, the clinical staff member provides the patient and caregivers with resources and education on how to receive help. If the patient is at a high risk, a notification appears in Epic telling the staff member to initiate safety precautions, including notifying the care team.
During the COVID-19 pandemic, Rady Children’s began piloting screening for depression at the start of video visits for three specialty clinics, too.
“When COVID-19 hit, we began seeing most of our patients over video,” said Isabel Garcia, director of specialty clinics at Rady Children’s. “We extended depression screening to video visits so we could better identify mental health needs during a critical time.”