QI project timeline
| Year 1: getting started | Assembled our core QI depression and CF team and developed our screening algorithm and processes |
| Sent letter from our director to all eligible patients and families on depression and CF and inviting them to participate in depression screening | |
| Inclusion of mental health topics in our centre’s quarterly newsletter, Shooting the Breeze | |
| Began annual depression screening for all individuals with CF ≥12 years | |
| Year 2: improving our process | Added depression screening for caregivers of children with CF <18 years of age |
| Extended screening period for patients, and developed an inpatient screening process for individuals that do not attend outpatient CF clinic visits but present for CF exacerbations and for transplant patients who attend clinic visits annually | |
| Started a monthly multidisciplinary mental health meeting to promote team culture around mental health and involve stakeholders on the CF team | |
| Created a database to track screening | |
| Added mental health to preclinic paediatric and adult team meetings | |
| Developed guide to depression screening at a CF centre to share and disseminate with other centres | |
| Year 3: patient and caregiver satisfaction | Patient (≥18 years) and caregiver satisfaction surveys |
| Added annual anxiety screening for patients ≥12 years and caregivers | |
| Shared our process with the Ann & Robert H. Lurie Children’s Hospital of Chicago to obtain feedback | |
| Examined the efficiency of our process | |
| CF education night for family members and virtually with people with CF to reinforce importance of mental health screening | |
| Mental Health Corner added to quarterly CF Centre Newsletter for patients and their family members | |
| Year 4: disseminating our work and sustaining our work | Spreading our QI project:
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| Began billing for depression screening | |
| Hired a Mental Health Coordinator (MHC) to become the champion of annual screening and follow-up, coordinate treatment, and maintain our referral network. | |
| Year 5: sustaining our improvements | Expanded the role of the MHC |
| The MHC began to provide evidenced-based psychotherapy (EBP) within the CF centre | |
| Year 6: sustaining our MHC | Billing efforts for EBP |
| Advocacy with senior leaders | |
| Paediatric grand rounds to disseminate process to other paediatric specialty clinics | |
| Year 7: expanding our efforts | Adaptation of our algorithms and processes to substance misuse in CF |
| Expanding mental health treatment options within our centre |
CF, cystic fibrosis; QI, quality improvement.