Collaborative Depression Care in a Safety Net Medical Home: Facilitators and Barriers to Quality Improvement

Popul Health Manag. 2016 Feb;19(1):46-55. doi: 10.1089/pop.2015.0016. Epub 2015 Jun 18.


Little is known about how to integrate primary care with mental/behavioral services outside of clinical trials. The authors implemented a collaborative care model (CCM) for depression in a safety net patient-centered medical home. The model focused on universal screening for symptoms, risk stratification based on symptom severity, care management for intensive follow-up, and psychiatry consultation. CCM increased rates of primary care physician encounters, timely follow-up for monitoring symptoms of depression, and documentation of treatment response. Contextual factors that facilitated or hindered practice redesign included clinic leadership, quality improvement culture, staffing, technology infrastructure, and external incentives/disincentives for organizational change.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cooperative Behavior*
  • Depression / drug therapy*
  • Electronic Health Records
  • Female
  • Humans
  • Male
  • Medical Audit
  • Middle Aged
  • New Orleans
  • Patient-Centered Care / standards*
  • Poverty*
  • Quality Improvement*
  • Retrospective Studies