TY - JOUR
KW - Depressive Disorder/diagnosis/therapy
KW - Guideline Adherence/organization & administration
KW - Health Knowledge, Attitudes, Practice
KW - Humans
KW - Information Systems/organization & administration
KW - Patient Care Team/organization & administration
KW - Practice Guidelines as Topic
KW - Primary Health Care/organization & administration
KW - Quality of Health Care/organization & administration
KW - Questionnaires
KW - Self Care
AU - D. E. Nease Jr
AU - P. A. Nutting
AU - W. P. Dickinson
AU - A. J. Bonham
AU - D. G. Graham
AU - K. M. Gallagher
AU - D. S. Main
A1 - 
AB - BACKGROUND: Improving primary care depression care is costly and challenging to sustain. The feasibility and potential success ofa modified improvement collaborative model to create sustained improvements in depression care was assessed. METHODS: Sixteen practices from the American Academy of Family Physicians National Research Network and the American College of Physicians Practice-based Research Network completed a nine-month program. Two practice champions (PCs) from each practice attended three two-day learning sessions, where practice change strategies and key depression care elements were discussed. The nine-item Patient Health Questionnaire (PHQ-9) was used for screening, diagnosis, surveillance, tracking and care management, and self-management support. Pre- and postintervention depression care survey data were gathered from all practice clinicians, and qualitative data were collected via interviews with PCs and field notes from learning sessions. RESULTS: On the basis of PC reports at nine months, 16 practices had implemented the PHQ-9 for depression case-finding and 13 for monitoring severity; 5 practices had implemented tracking and care management and 1, self-management support. At the 15-month follow-up, nearly all changes had been sustained, and additional practices had implemented tracking/care management and self-management support. Significant pre-post improvements were reported on several subscales of the clinician survey, demonstrating substantial diffusion from the PC to other clinicians in the practice. DISCUSSION: The program led to measurable improvements in implementation of office procedures and systems known to improve depression care. The improvements were both sustained beyond the end of the program and substantially diffused to the other clinicians in the practice.
BT - Joint Commission journal on quality and patient safety / Joint Commission Resources
C5 - Financing & Sustainability; HIT & Telehealth; Healthcare Policy
CP - 5
CY - United States
IS - 5
JF - Joint Commission journal on quality and patient safety / Joint Commission Resources
N2 - BACKGROUND: Improving primary care depression care is costly and challenging to sustain. The feasibility and potential success ofa modified improvement collaborative model to create sustained improvements in depression care was assessed. METHODS: Sixteen practices from the American Academy of Family Physicians National Research Network and the American College of Physicians Practice-based Research Network completed a nine-month program. Two practice champions (PCs) from each practice attended three two-day learning sessions, where practice change strategies and key depression care elements were discussed. The nine-item Patient Health Questionnaire (PHQ-9) was used for screening, diagnosis, surveillance, tracking and care management, and self-management support. Pre- and postintervention depression care survey data were gathered from all practice clinicians, and qualitative data were collected via interviews with PCs and field notes from learning sessions. RESULTS: On the basis of PC reports at nine months, 16 practices had implemented the PHQ-9 for depression case-finding and 13 for monitoring severity; 5 practices had implemented tracking and care management and 1, self-management support. At the 15-month follow-up, nearly all changes had been sustained, and additional practices had implemented tracking/care management and self-management support. Significant pre-post improvements were reported on several subscales of the clinician survey, demonstrating substantial diffusion from the PC to other clinicians in the practice. DISCUSSION: The program led to measurable improvements in implementation of office procedures and systems known to improve depression care. The improvements were both sustained beyond the end of the program and substantially diffused to the other clinicians in the practice.
PP - United States
PY - 2008
SN - 1553-7250; 1553-7250
SP - 247
EP - 255
EP - 
T1 - Inducing sustainable improvement in depression care in primary care practices
T2 - Joint Commission journal on quality and patient safety / Joint Commission Resources
TI - Inducing sustainable improvement in depression care in primary care practices
U1 - Financing & Sustainability; HIT & Telehealth; Healthcare Policy
U2 - 18491688
VL - 34
VO - 1553-7250; 1553-7250
Y1 - 2008
ER -