From Stephanie Breckenridge
SMHC RN Volunteer/Doctoral Candidate
Thank you SMHC staff and volunteers for your hard work on the Greater Twin Cities United Way grant’s mental health pilot project to improve depression screening and referral in the diabetic patient population, completed between 1/2017 and 9/2017!
The purpose of our pilot project was to standardize screening for depression and to systematize the referral and follow-up processes in order to i
mprove diabetic patients’ PHQ-9 scores within six months of a positive depression screen. A positive depression screen was identified as a PHQ-9 score of greater than or equal to 9, or patient communication of psychosocial distress that was out of sync with his or her PHQ-9 score. Findings from the pilot project are as follows:
- 72% of diabetic patients were screened for depression at least once during the pilot project timeline
- 47% of patients who were referred to therapy completed at least 3 sessions within 4 months of treatment initiation
- 35% of patients with positive depression screens completed 3-month PHQ-9 re-screens
- 6% of patients with positive depression screens achieved clinical remission by 6 months after treatment initiation, which is in line with the Minnesota Department of Health’s benchmark for patients enrolled in programs such as Medical Assistance
- 50% of behavioral health patient satisfaction survey respondents commented that interactions with their psychotherapists were particularly helpful in their treatment
- Survey respondents noted the benefit of working with a bilingual, bicultural therapist
The main findings from the pilot project include that follow-up for positive depression screens improved after implementation of a standardized screening, treatment, and referral process; and that care coordination by the social worker (Cathy Luiken) and community health worker (Katie Fuentes-Rivera) was critical to treatment success, especially when they were physically present in the clinic at the time of the initial positive depression screen. Additional learning included:
- trauma prevalence: 11% of patients were referred to Victim’s Assistance
- treatment preferences: equal preference for antidepressant medication and psychotherapy
- clinic staff awareness of subclinical depression: slightly more positive depression screens for expression of psychosocial distress versus an elevated PHQ-9 score
- effect of the national political climate during the pilot project timeline: significantly increased anxiety in the patient population
We appreciate all of your assistance in this project, as well as your continued work on the mental health initiative. We couldn’t do it without you!
From Rachel Fernandez - Lead Diabetes Coordinator
From the Diabetic Education Enhancement Program (DEEP) team
On May 24th we held an educational event for our volunteer nurses where they were provided with some in-depth information regarding diabetes and hypertension care at SMHC. An updated version of the Diabetes and, soon, the Hypertension algorithm can be found in the Physician Reference Manual at each clinic.
for Diabetic Power Point Presentation.
Overview of Cuídate
Similar to DEEP, SMHC’s Cuídate program will serve hypertensive patients by assisting with education, medication management and support of lifestyle changes including diet and exercise by way of consultations and on-going patient support.
of Cuídate will include patients who have 2 elevated blood pressure readings recorded at 2 separate visits, as well as patients with an existing diagnosis of hypertension.
They will receive:
- Education about managing and maintaining a healthy blood pressure, and the risks of hypertension
- Clinic services and medication therapy, as necessary
- On-going monitoring and support by SMHC staff
- RN clinic volunteers are responsible for measuring BP readings at clinic
- RN Care Coordinators are responsible for identifying Cuídate participants based on clinical readings
- Identified Cuídate participants will get a big sticker on their charts
Memo to come in the following weeks with more information.
From Chris Hanson - Volunteer Coordinator
- Beginning this month, all SMHC staff scheduled at clinic, will stay until the end of clinic to assist you, the volunteer team, with clean-up and other end of clinic tasks. We are grateful for the time you have volunteered and want to help you get out of clinic in a timely manner.
- Please watch your email for a Google Document link. We will have a library of information for volunteers to access news and updates from the office.
- THANK YOU for all you do for St. Mary's Health Clinics!
From Julia McCarthy - Programs Operations Manager
Interpreters are essential in our work with patients. They allow the provider and the patient to overcome language barriers and communicate clearly.
Four Tips on Working with Interpreters:
- DO speak directly to the patient, as if there interpreter was not in the room. For example, ask “how are you feeling today?” while looking at the patient, rather than “how is he feeling today?” while looking at the interpreter.
- DON’T ask the interpreter to do medical work without a nurse or doctor present. For example, don’t ask the interpreter to explain how a patient should take her medication.
- DO remember to pause often as you are speaking to a patient. This gives the interpreter a chance to remember everything you’ve said and repeat it in the patient’s language.
- DON’T have a side conversation with the interpreter while you are working with a patient. Remember that the interpreter’s job is to repeat everything you say in the patient’s language.
From Carol O'Connor - SAGE Coordinator
Thanks to everyone for all your hard work regarding
SAGE, the State Cancer Prevention Program.
The following shows the impact of your work since March 2017:
- 453 encounters for breast and cervical screenings
- $16,119.00 revenue brought in so far
Interested in the State Sage Program? Please click
for additional information.