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Purpose. The purpose of this quality improvement project was to implement and evaluate the usefulness of a trauma-informed care training video designed for telehealth professionals providing mental health services. Background. Trauma-informed care is a framework for practice that health professionals can use to understand the multidimensional challenges their patients may have experienced, as well as providing tools to empower, build trust, and avoid re-traumatization. While telehealth services are quickly expanding to reach underserved communities, it is unclear whether skills training in areas such as trauma-informed care is translatable to the digital mode of care delivery. Methods. Participants were healthcare professionals recruited from a telehealth-focused company that was providing counseling and medication management. The primary investigator created a 15-minute trauma-informed care training video intervention distributed via email. Qualtrics software was used to distribute a post-intervention survey. Results. Ten participants received the invitation to participate via email. The project was open to participants for a total of three weeks. Two of the participants reviewed the disclosure statement. None of the participants completed the post-intervention survey. It is unknown whether the participants viewed the training video. Results were discussed through the lens of the Health Belief Model framework. Conclusions. This project enabled the student to learn the quality improvement process. This project helped illuminate possible directions for future research such as exploring what training telehealth professionals may desire, and how remote workers assimilate and connect with their organization’s mission and values.

Purpose: The aim of this quality improvement (QI) project was to refresh the education of providers and support staff at CODAC on the open-ended questions, affirmation, reflection, and summary (OARS) technique of motivational interviewing (MI) and offer strategies to implement OARS. The long-term goal was to encourage providers to adopt this technique to reduce ambivalence and excessive drinking in patients with co-occurring schizophrenia and alcohol use disorder (AUD). Background: Schizophrenia is a mental disorder with a high rate of suicide compared to the general population. People with schizophrenia have a higher rate of alcohol use (47%) than the general population (16%). Research has shown that MI improves symptoms of schizophrenia, helps the patient overcome ambivalence, and reduces the inclination for excessive drinking. Method: This QI project was based on a change proposal outcome using the Plan-Do-Study-Act (PDSA) model. The design included a pre-and post-test survey that assessed the providers’ consistent use of the OARS technique. The pretest was administered 18 days before the implementation date via Qualtrics to determine the provider's knowledge of the OARS technique of MI. The post-test survey was conducted directly after the in-service to evaluate providers and support staff knowledge, intent, and readiness to use the OARS technique. Results: The pre-and post-surveys were analyzed using the difference in percentages. There were nine (N=9) providers and support staff who participated and completed the intervention. The findings showed an increase in knowledge, intent to use, and positive attitudes posttest towards using the OARS technique. Conclusion: Implementing the OARS technique of MI to change risky behavior in patients with co-occurring schizophrenia and AUD was supported by robust evidence from research, indicating that MI is an evidence-based intervention (EB) to change behavior effectively. Patients with co-occurring schizophrenia and AUD

Psychiatric advance directives have been used as a tool to help communicate patient’s wishes during psychiatric emergencies when the patient is unable to do so themselves. While psychiatric advance directives have been used since the early 2000’s, they have been slow to be used throughout the United States, especially in Western states such as California. The purpose of this quality improvement project was to educate outpatient psychiatric nurse practitioners on psychiatric advance directives, as well as to determine advantages and barriers to their use in clinical practice. This project was conducted at an outpatient psychiatric private practice with multiple locations throughout California, and participants included adult specialty psychiatric nurse practitioners. A total of four participants completed all portions of the intervention, which included a pretest to assess for knowledge, skills, and attitudes about psychiatric advance directives, a 30-minute educational session, and a posttest. Overall, the intervention helped increase provider’s knowledge and skills regarding discussing psychiatric advance directives with their patients. However, providers reported less intent to use and learn more about psychiatric advance directives in practice. Providers also provided feedback about practical barriers and facilitators to using psychiatric advance directives in clinical practice.

Purpose: The purpose of this quality improvement initiative was to increase knowledge of the RODS screening tool and intent to adopt at an outpatient psychiatry clinic called GenHealth. Background: General substance abuse screening tools fail to target opioid use disorder criteria directly but instead examine many drugs of abuse. Many of the tools available are also time- consuming, fail to recognize populations that may not already be on analgesic therapy, and designed to detect abhorrent use in those on analgesic therapy. With the rise of opioid use disorder, it is imperative to have the ability to screen patients with an OUD-specific tool to assess the severity. The RODS tool provides a quick and efficient way to screen for OUD while addressing screening barriers. Method: This quality improvement project consisted of a pre-survey and post-survey with an evidence-based educational intervention that was deployed via an asynchronous Panopto format and addressed current screening tools, barriers to screening, and the RODS screening tool. Pre- survey and post-survey questionnaires were deployed via email using Google Forms to create, obtain, and quantitatively analyze data. The participants were given 14 days to complete the education and the two surveys. Results were shared with the implementation site via meeting and written? summary. Results: All five recruited participants completed all aspects of the intervention, including completing the pre-survey, watching the educational video, and completing the post-survey. A median four-point increase in agreement on a five-point scale was noted in the data. The data quantitively showed that providers at the clinic gained knowledge about the RODS screen and intend to adopt the RODS screen in practice. Conclusion: This project has established that an evidence-based quality improvement project can examine current practice, provide education to participants on new evidence-based practice, and persuade the adoption of such pra

Purpose: This project aimed to increase obstetric healthcare providers’ willingness to administer depression screenings during pregnancy and increase depression screening practice frequency to provide a pathway in compliance with the ACOG and USPSTF recommendations.Background: Previous undiagnosed depressive episodes have been associated with postpartum depression resulting in serious concerns that affect the mother and the baby. There are multifactorial symptoms associated with pregnancy requiring depression screening during pregnancy using a universal tool. A lack of training and confidence in treating or referring patients that limit depression screening are barriers associated with the underdiagnosis of depression. There are also varying practices in the frequency of screening amongst providers. To satisfy the ACOG and USPSTF recommendations, screening for depression should occur at least once during pregnancy. Methods: Using a pretest/posttest design among a single group of obstetric healthcare providers in Arizona, participants were given a survey before and following an evidence-based educational intervention on perinatal depression screening using the patient health questionnaire-9 (PHQ-9). The pretest and posttests evaluated the participants’ current and future depression screening practices, knowledge of perinatal depression, understanding of the PHQ-9 depression screening tool, expertise level in administering the PHQ-9, the comfort level of administering the PHQ-9, and willingness to implement depression screening into practice in perinatal patients during pregnancy. Results: Seven participants completed the quality improvement project. Key findings indicated an increase in the participants' knowledge of perinatal depression, the expertise and comfort of administering and interpreting the PHQ-9, treating depression during pregnancy, and the number of participants who plan to always screen for depression during pregnancy in the future. Conclusions: The re