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Why Cedars-Sinai Screens All Inpatient Adults for Depression

John Commins, for HealthLeaders Media, April 23, 2014

HLM: What happens if you determine a patient has depression?

ID: We notify the patient's medical doctor and the social worker that the patient has screened positive. Every patient has a social worker assigned to them and the social worker does additional assessments to determine if the patient is already in care.

Do they have a treating psychiatrist, psychologist, or therapist who is able to educate the patient? The physician for the patient is also asked to assess the patient, to advise them about the findings of the screening and their relevance to their medical care and to assist them with a referral if the patient wants that referral.

HLM: Do you see these screenings become more common as hospitals shift to population health and value-based reimbursements?

ID: Absolutely! When we talk about bending the cost curve, which really means trying to get better outcomes without spending more for them, some of the greatest opportunities to do that are in improving the behavioral and mental health of patients.

HLM: How will you know if these screenings are successful and a good return on investment?

ID: The worthiness of the screening has been established by a number of other groups besides us. The U.S. Preventive Services Task Force has adopted depression screenings as a best practice. That is a function of extensive data supporting the idea that identifying and screening depression is cost effective and valuable.

At Cedars-Sinai our measures are how well we identifying patients. Are we screening every admitted patient? Are we educating our allied health providers and nursing staff? Eventually we are going to look at other things such as how do positive scores on depression relate to other important features of care, such as patient satisfaction with care, readmissions, length of stay in the hospital, are we able to increase the referral rate for treatment services for patients who screen positive, etc.

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