Performance Improvement Plan for Depression Screening for Medical Assistants
Introduction to the Issue
Depression screening is an important aspect of the healthcare process considering the high numbers of patients who present for care with varying degrees of the condition. Depression also affects the efficacy of treatment by impacting the relationship between medical personnel and their patients, or that between patients and their families (Guntuku et al., 2017). In many jurisdictions, supervised medical assistants are qualified to undertake depression screening at primary care because it is often the first point of contact with patients.
Importance of the Issue
Arguably, depression affects the treatment process by impacting communication with the patient and how they relate with their loved ones. Depression could also aggravate existing medical conditions when its medication and therapy conflicts with the subsequent medication and treatment regimes. According to Fraher et al. (2020), medical assistants must receive adequate training on the most effective and up-to-date depression screening methods to catch it early and ensure it is a consideration during treatment. Effective depression screening skills knowledge at the medical assistant community level prevents misdiagnosis and captures patient presentation that otherwise would be elusive.
Investigating the Issue
Several methods exist that enable scholars and medical assistants to investigate issues during skills development and performance improvement. The Cause-and-Effect Diagram by Ishikawa is an example of the effective methods of investigating issues in the medical and nursing environment (De Araújo et al., 2019). Each spine in the fishbone represents an additive to the problem which is represented by the fishbone diagram’s head. Some of the causes of inefficiency in medical assistant screening for depression include outdated techniques, low morale among medical personnel, and misdiagnosis as PTSD or anxiety syndromes. These causes are the spines while the fishbone head i the main issue. The generalized direction of the fishbone diagram represents how the causes lead to the effect or the main problem. The main issue in this performance improvement can be arrived at more efficiently using the Ishikawa Diagram.
Pareto Diagrams, more specifically cascading pareto diagrams, also enable scholars and medical staff to effectively investigate issues affecting their performance and learning processes. The generalized Pareto diagram is based on the Pareto principle where the majority of problems plaguing systems and organizations result from minority of causes (Mitchell, 2009). This relationship between problems where they cause problems in a small but cumulative manner is referred to as the Pareto Principle and it has found widespread application in medical services optimization. The majority of scholars agree that most of the problems causing inefficiencies and ineffectiveness in healthcare systems can be broken down into systemic Pareto diagrams. Cascading these Pareto diagrams by repeating them subsequently creates cascading Pareto diagrams that enable organizations, personnel or consultants to arrive at the root causes of their problems.
Performance Improvement Plan
Most healthcare methods subscribe to three main methods of diagnosing depression, namely patient health questionnaire, DSM-5 criteria, and psychiatric evaluation (Guntuku et al., 2017). Medical assistants can improve their depression screening performance and outcomes by following the objectives outlined below as part of a comprehensive performance improvement plan;
Continuous training to acquire the most up-to-date skills and to hone them. Continuous training and skills development enables medical assistants to grasp their skills and hone them. Such regular training sessions enable medical assistants to acquire the most modern techniques and identify problematic circumstances before they become challenges. Repetitive training sessions also provide assistants with the opportunities to fine-tune their depression screening skills and learn the relevant literature (Mitchell, 2009). During retraining and continuous learning processes, the training supervisors should remember to reiterate the medical and professional ethics associated with depression screening and management (Rogol, 2020). They include patient safety, protection from abuse, maintaining therapeutic boundaries, and confidentiality.
Regular supervised performance evaluations by medical personnel or team leads. Although medical assistants undertake training sessions from team heads and examiners, the healthcare supervisors must evaluate their depression screening performance. Such regular supervised performance evaluations enable medical assistants to take skills development associated with depression screening more seriously (Colligan et al., 2018). Mistakes and gaps in knowledge are easily identified to improve both the screening skills and patient handling due to the sensitivity of depression. It is common practice to use examination and written material to make such evaluations as official as possible.
Teamwork to reduce the likelihood of mistakes and disarm uncooperative or elusive patients. Medical assistants are often grouped into teams to empower their skills acquisition and make learning a group activity similar to patient care. Teamwork in depression screening exercises also reduces mistakes as each assistant observes his or her teammates (Mitchell, 2009). The medical assistants complement each other in literature, bodies of knowledge, and technique. Teamwork also makes management of uncooperative patients easier.
Combination therapy consisting of two or more methods such as patient health questionnaires and DSM-5 evaluation. It is common practice among medical assistants to combine depression screening techniques when patients present with conflicting or problematic symptoms. The conciseness of the DSM-5 criteria complements the specificity of a patient’s healthcare questionnaire making screening more accurate. Improving depression screening could occur when trained supervisors make such combination therapy mandatory for all patients to make mistakes less likely and reinforce skills acquired. Combination therapy also makes it easier for medical assistants to pinpoint the type of depression involved through elimination.
Medical assistant seminars to discuss challenges and trouble-shoot solutions. Training and discussion seminars enable medical assistants and other medical trainees to improve skills and bodies of knowledge. The challenges of depression treatment benefit from such seminars as possible solutions get discussed. New screening and treatment methods are introduced and disseminated through such seminars. The healthcare curriculum must make such seminars mandatory for trainees and new hires.
The objectives of the performance improvement plans could be implemented using several strategies to optimize outcomes. First, strategic partnerships are essential for medical care stakeholders because depression is nondiscriminatory and relentless (Verma, 2019). Medical assistants could improve their depression screening skills by leveraging strategic partnerships. Hospitals, training institutions, accreditation bodies, depression welfare groups, and policy-makers could partner to improve depression screening more effective.
Second, additional resource allocation to depression skills, especially at primary care level, to empower medical assistant roles is an important implementation factor. Private and public primary care facilities must allocate more resources to depression screening as it is the first step to effective treatment. Additional resources include training material, equipment, and financial resources. Medical assistants at primary level depend on optimal facilitation to effectively manage depression.
Third, there is a pressing need for additional scholarly and industrial research effort to fine-tune skills and body of knowledge involving depression screening at primary care level for medical assistants and other junior healthcare professionals. Ongoing academic and industrial research continues to improve depression diagnosis methodologies. Medical assistants must be involved in these activities at all levels to complement existing skills and literature. Training supervisors could complement skills acquisition by optimizing training curricula and examination methods. The implementation of regular resource and facilitation reviews enables management and training administrators to identify gaps in resources pools. Depression is one of the under-facilitated medical needs in the United States making such regular interventions useful during performance improvement initiatives.
Evaluating the performance improvement plan involves individual assessment, team efficacy, and overall skills competence. Assessment on actual patient must be complemented with written evaluations to gauge literature and practice skills. The effectiveness of assistants’ skills and practice must be quantified by parameters such as patient satisfaction scores, mistake frequency, and written exams by accredited examiners (Colligan et al., 2018). The plan would achieve the desired results if tailored for individual primary healthcare bodies.
More specifically, the evaluation process of a performance improvement plan keen to optimize the depression screening skills of medical assistants might benefit from existing performance standards. The American Medical Association and other influential bodies with the necessary mandate have set forth standards in depression screening and management. Consequently, the improvement plan’s outcome after evaluation must align performance metrics with these standards.
One of the more common and modern practices in evaluation of performance improvement plans, more so in depression management phases such as screening, is setting out scheduling check-in points and review periods. Herein, the training medical personnel predetermine the entire medical assistant team’s check-in whereby they gain access to an actual screening to gauge performance based on organizational and industry standards (Fraher et al., 2020). Additionally, review periods consist of moments where the entire team is assembled for detailed reviews to compare performance metrics with predetermined metrics and standards. Any deviations or lags are pointed out and handled with additional or remedial action from both stakeholder groups.
References for Performance Improvement Plan for Depression Screening for Medical Assistants
Colligan, E., Cross-Barnet, C., Lloyd, J., & McNeely, J. (2018). Barriers and facilitators to depression screening in older adults: A qualitative study. Innovation in Aging, 2(suppl_1), 509-509. https://doi.org/10.1093/geroni/igy023.1890
De Araújo Patrício, A. C., De Lima, N. S., Lopes Rodrigues, B. F., Minhaqui Ferreira, M. A., Dos Santos, T. D., & De Brito Rodrigues, T. D. (2019). Ishikawa diagram: Causes and solutions of Hiv infection in nursing professionals due to sharps use / Diagrama de Ishikawa: Causas E Soluções Da Infecção AO Hiv Adquirida POR Profissionais de Enfermagem Através de Materiais Perfurocortantes. Revista de Pesquisa: Cuidado é Fundamental Online, 11(3), 707. https://doi.org/10.9789/2175-5361.2019.v11i3.707-712
Fraher, E. P., Cummings, A., & Neutze, D. (2020). The evolving role of medical assistants in primary care practice: Divergent and concordant perspectives from MAs and family physicians. Medical Care Research and Review, 78(1_suppl), 7S-17S. https://doi.org/10.1177/1077558720966148
Guntuku, S. C., Yaden, D. B., Kern, M. L., Ungar, L. H., & Eichstaedt, J. C. (2017). Detecting depression and mental illness on social media: An integrative review. Current Opinion in Behavioral Sciences, 18, 43-49. https://doi.org/10.1016/j.cobeha.2017.07.005
Mitchell, A. J. (2009). Why do clinicians have difficulty detecting depression? Screening for Depression in Clinical Practice. https://doi.org/10.1093/oso/9780195380194.003.0006
Rogol, A. M. (2020). Ethical issues in the evaluation and treatment of depression. FOCUS, 18(2), 201-204. https://doi.org/10.1176/appi.focus.20200006
Verma, P. (2019). Dawn of a new era: Performance improvement in public health. Journal of Public Health Management and Practice, 25(5), 515-517. https://doi.org/10.1097/phh.0000000000001057