Implementation of a Standardized Screening Protocol to Improve Post-traumatic Stress Disorder Surveillance in First Responders.

Abstract

The purpose of this quality improvement project was to implement a standardized screening protocol to identify post-traumatic stress disorder (PTSD) in first responders during employment physicals in a primary care setting. A pre-/post-intervention project design was used, utilizing the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (PCL-5) screening tool. Outcome measures included screening completion, positive screening rate, and referral rate. A total of 331 first responders presented for employment physicals. In the post-intervention cohort, 96% (152/158) of first responders were screened. From pre- to post-intervention, first responders who screened positive increased from less than 1% (1/173) to 4.6% (7/152). Of those screening positive, a total of five of seven (71%) patients were referred for mental health evaluation. A standardized screening protocol using a validated self-assessment tool improved PTSD surveillance in first responders and triggered referral.