Imlementing Routine Screening for Obsessive-compulsive Disorder in an Outpatient Psychiatric Clinic

Obsessive-compulsive disorder (OCD) affects 1%-3% of the world's population and causes significant dysfunction throughout life. Local Problem: Many mental health providers (MHPs) report difficulty diagnosing and treating OCD despite the demonstrated efficacy and accessibility of standardized OCD screening tools. Diagnostic and treatment barriers include a lack of provider training and time barriers that make OCD screening and treatment challenging. Methods: This quality improvement project aimed to increase MHPs' knowledge of OCD and the frequency and providers' proficiency in using OCD screening tools. MHPs (n=9) working in an outpatient behavioral health clinic completed a pre-intervention needs assessment survey to determine knowledge and attitudes about OCD and using OCD screening tools. MHP participants viewed an informative OCD PowerPoint and received a resource toolkit, which included the Yale-Brown Obsessive-Compulsive Screener (Y-BOCS), Obsessive-Compulsive Inventory-Revised (OCI-R), evidenced-based OCD resources, and names of local OCD-trained therapists. Additional educational materials were given to help providers distinguish OCD from other conditions with overlapping symptom presentations, and case consultation was made available during the 15-week intervention period. Participants completed a post-intervention survey to assess the effectiveness and provider satisfaction. Interventions: A presentation was held during weekly provider meetings to introduce resources and answer questions regarding OCD symptoms and diagnosis. A second presentation was held at the end of the intervention period to present the results of this quality improvement project. Results: Pre-intervention, 44% (n=4) of participants felt comfortable in using an OCD screening tool, and 22% (n=2) of participants reported neutral in knowing what to do if their patient screens positive for OCD. All participants (n=9) reported interest in learning more about OCD screeners and how to use them. Post-intervention, 78% (n=7) of participants felt comfortable in using the OCD screening tools provided in the toolkit, and 100% (n=9) reported knowing what to do if their patient screens positive. All participants reported that the OCD toolkit was beneficial in OCD identification among their patients. Implementing Clinicom (2024) during the intervention period affected the providers' use of the toolkit's mental health screeners. Clinicom is an online adaptive augmented intelligence mental health screening tool that assesses 80+ diagnostic conditions classified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), from a single self-reported patient encounter. Four participants (44%) reported in the post-survey that they would be using Clinicom in place of an OCD screening tool in the future, even though it does not assess symptom severity. Conclusion: Providing education on the use of an OCD screening tool in a psychiatry clinic setting can increase accurate diagnosis and treatment for OCD. Future steps in this project include streamlining the process of sending an OCD screening tool to prospective patients and those who screen positive through Clinicom. Additional provider education regarding the ongoing need to utilize OCD screening tools to assess the severity of symptoms and treatment effects would be beneficial.