Please take a moment to provide some feedback regarding how the efforts to screen every patient for depression and document it correctly. Also include efforts to implement follow up plans for patients identified as depressed.

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* 2. What is your email address?

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* 3. What quantitative measure  are you using to determine if your interventions are resulting in a positive outcome? (Quantitative Measures involve the collection of specific numbers, which is the opposite of qualitative data, that are observations)

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* 4. What successes have your depression screening interventions provided?

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* 5. What challenges have you experienced?

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* 6. Have you encountered any barriers? (if Yes, please specify)

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* 7. What will you do differently to address these barriers next month? (Put N/A if no barriers this month)

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* 8. What is your plan for the next PDSA cycle?
Any modifications to the PDSA plan should be documented and kept on file at the facility. The Network may request a copy of this new PDSA during the course of this project.

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* 9. Does your corporate entity utilize an algorithm for internal tracking of depression screenings?

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* 10. If yes to Question #9, does your facility fully utilize this algorithm? Explain below:

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* 11. If no to Question #9, will/has your facility developed an algorithm? Explain below:

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* 12. How easy was this questionnaire to complete?

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* 13. How much time did it take to complete this survey?

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