TY - JOUR
AU - R. R. Whitebird
AU - L. I. Solberg
AU - N. A. Jaeckels
AU - P. B. Pietruszewski
AU - S. Hadzic
AU - J. Unutzer
AU - K. A. Ohnsorg
AU - R. C. Rossom
AU - A. Beck
AU - K. E. Joslyn
AU - L. V. Rubenstein
A1 - 
AB - OBJECTIVES: To identify the care model factors that were key for successful implementation of collaborative depression care in a statewide Minnesota primary care initiative. STUDY DESIGN: We used a mixed-methods design incorporating both qualitative data from clinic site visits and quantitative measures of patient activation and 6-month remission rates. METHODS: Care model factors identified from the site visits were tested for association with rates of activation into the program and remission rates. RESULTS: Nine factors were identified as important for successful implementation of collaborative care by the consultants who had trained and interviewed participating clinic teams, and rated according to a Likert Scale. Factors correlated with higher patient activation rates were: strong leadership support (0.63), well-defined and -implemented care manager roles (0.62), a strong primary care physician champion (0.60), and an on-site and accessible care manager (0.59). However, remission rates at 6 months were correlated with: an engaged psychiatrist (0.62), not seeing operating costs as a barrier to participation (0.56), and face-to-face communication (warm handoffs) between the care manager and primary care physician for new patients (0.54). CONCLUSIONS: Care model factors most important for successful program implementation differ for patient activation into the program versus remission at 6 months. Knowing which implementation factors are most important for successful activation will be useful for those interested in adopting this evidence-based approach to improving primary care for patients with depression.
BT - The American Journal of Managed Care
C5 - Education & Workforce
CP - 9
CY - United States
IS - 9
JF - The American Journal of Managed Care
N2 - OBJECTIVES: To identify the care model factors that were key for successful implementation of collaborative depression care in a statewide Minnesota primary care initiative. STUDY DESIGN: We used a mixed-methods design incorporating both qualitative data from clinic site visits and quantitative measures of patient activation and 6-month remission rates. METHODS: Care model factors identified from the site visits were tested for association with rates of activation into the program and remission rates. RESULTS: Nine factors were identified as important for successful implementation of collaborative care by the consultants who had trained and interviewed participating clinic teams, and rated according to a Likert Scale. Factors correlated with higher patient activation rates were: strong leadership support (0.63), well-defined and -implemented care manager roles (0.62), a strong primary care physician champion (0.60), and an on-site and accessible care manager (0.59). However, remission rates at 6 months were correlated with: an engaged psychiatrist (0.62), not seeing operating costs as a barrier to participation (0.56), and face-to-face communication (warm handoffs) between the care manager and primary care physician for new patients (0.54). CONCLUSIONS: Care model factors most important for successful program implementation differ for patient activation into the program versus remission at 6 months. Knowing which implementation factors are most important for successful activation will be useful for those interested in adopting this evidence-based approach to improving primary care for patients with depression.
PP - United States
PY - 2014
SN - 1936-2692; 1088-0224
SP - 699
EP - 707
EP - 
T1 - Effective Implementation of collaborative care for depression: what is needed?
T2 - The American Journal of Managed Care
TI - Effective Implementation of collaborative care for depression: what is needed?
U1 - Education & Workforce
U2 - 25365745
VL - 20
VO - 1936-2692; 1088-0224
Y1 - 2014
ER -