TEAMSS Change Package Measures Grid

The measure set that was developed for the TEAMSS project is for reference, adaptation, and use in your practice.

TEAMSS Measures Table

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Measure	Definition	Numerator	Denominator	Goal
Substance use screening	% of adolescents seen for a well visit with documentation in their chart that an accepted¹ or validated² substance use screening tool was administered and scored/interpreted	# patients meeting the following criteria: 12-18 years old Seen for a well visit Who have documentation in their chart that an accepted¹ or validated² substance use screening tool was administered, scored/interpreted	# patients meeting the following criteria: 12-18 years old Seen for a well visit	90%
Follow-up to positive screening for substance use	% of adolescents with a positive screening for substance use with documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive substance use screening Who have documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive substance use screening	90%
Depression screening	% of adolescent well visits with documentation that an accepted¹ or validated³ depression screening tool was administered and scored/interpreted.	# patients meeting the following criteria: 12-18 years old Seen for a well visit Who have documentation in their chart that an accepted1 or validated³ depression screening tool was administered and scored/interpreted.	# patients meeting the following criteria: 12-18 years old	90%
Follow-up to positive screening for depression	% of adolescents with a positive screening for depression with documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive screening for depression Who have documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive screening for depression	90%
Suicide risk screening	% of adolescent well visits with documentation that an accepted¹ or validated⁴ suicide risk screening tool was administered and scored/interpreted.	% of adolescent well visits with documentation that an accepted¹ or validated⁴ suicide risk screening tool was administered and scored/interpreted.	# patients meeting the following criteria: 12-18 years old Seen for a well visit	90%
Follow-up to positive screening suicide risk	% of adolescents with a positive screening for suicide risk with documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive screening for suicide risk Who have documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive screening for suicide risk	90%
Anxiety screening	% of adolescent well visits with documentation that an accepted¹ or validated⁵ anxiety screening tool was administered and scored/interpreted.	# patients meeting the following criteria: 12-18 years old Seen for a well visit Who have documentation in their chart that an accepted¹ or validated⁵ anxiety screening tool was administered and scored/interpreted.	# patients meeting the following criteria: 12-18 years old Seen for a well visit	90%
Follow-up to positive screening for anxiety	% of adolescents with a positive screening for anxiety with documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive screening for anxiety Who have documentation of receiving brief advice/brief intervention AND/OR referral to treatment and plan for follow up	# patients meeting the following criteria: 12-18 years old Seen for a well visit With a positive screening for anxiety	90%

Notes

¹Accepted screening tool:

A screening tool not in the “Validated” list below, but that has been reviewed by the project leader and QI coach and determined to be suitable to the clinic’s patient population and context.
Rationale: Bright Futures recommends universal screening for behavioral/social/emotional concerns, adolescent depression and suicide risk, and substance use at selected visits. Several validated tools are available for screening and the list below is not exhaustive. While we strongly recommend selecting a validated screening tool, we can provide guidance to participating clinics as they identify an acceptable screening approach that works best for their patient population and context.

²Validated substance use screening tools:

BSTAD (Brief Screener for Tobacco, Alcohol, and other Drugs)
CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble)
S2BI (Screening to Brief Intervention)

³Validated depression screening tools:

PHQ-2 (Patient Health Questionnaire-2) 
PHQ-A (Patient Health Questionnaire-Adolescent) 
PHQ-9 (Patient Health Questionnaire-9) 
CES-DC (Center for Epidemiologic Studies Depression Scale for Children) 
CDI (Children’s Depression Inventory) 
Beck Depression Inventory-II 
PSC (Pediatric Symptom Checklist)

⁴Validated suicide risk screening tools:

C-SSRS (Columbia Suicide Severity Rating Scale) 
ASQ (Ask Suicide-Screening Questions) 
Suicide Behaviors Questionnaire (SBQ)

⁵Validated anxiety screening tools:

GAD-7 (Generalized Anxiety Disorder-7) 
GAD-2 (Generalized Anxiety Disorder-2) 
SCARED (Screen for Child Anxiety Related Disorders)

Last Updated

05/12/2025

Source

American Academy of Pediatrics