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Related Experiment Videos

Using evidence-based quality improvement methods for translating depression collaborative care research into

Lisa V Rubenstein1, Edmund F Chaney, Scott Ober

  • 1Department of Medicine and Health Services Research, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. lisa.rubenstein@va.gov

Families, Systems & Health : the Journal of Collaborative Family Healthcare
|August 11, 2010
PubMed
Summary

The Translating Initiatives in Depression into Effective Solution (TIDES) program successfully adapted collaborative depression care for the Veterans Health Administration (VA). This evidence-based approach significantly improved patient outcomes, leading to national adoption and support.

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Area of Science:

  • Health Services Research
  • Mental Health Services
  • Quality Improvement Science

Background:

  • Collaborative care models are effective for treating depression but require adaptation for large healthcare systems.
  • The Veterans Health Administration (VA) sought to implement evidence-based depression care.
  • Translating Initiatives in Depression into Effective Solution (TIDES) was developed to address this need.

Purpose of the Study:

  • To adapt and implement a research-based collaborative care model for depression within the VA.
  • To evaluate the fidelity and patient outcomes of the adapted model.
  • To assess the feasibility of national implementation.

Main Methods:

  • Researchers utilized evidence-based quality improvement (EBQI) methods to adapt depression care models.
  • Regional leaders and primary care practices were engaged in the adaptation process.
  • Trained nurse depression care managers collected patient adherence and outcome data.

Main Results:

  • Mean PHQ-9 scores decreased from 15.1 to 4.7 (p < .001) among patients receiving care manager assistance.
  • 87% of patients achieved PHQ-9 scores below 10, indicating minimal depression.
  • Patients referred to mental health specialty also showed significant improvement (mean PHQ-9 from 16.4 to 9.0).

Conclusions:

  • TIDES successfully developed an evidence-based collaborative care model for depression within the VA.
  • The model demonstrated excellent patient outcomes and is undergoing national spread.
  • EBQI methods facilitated the adaptation and implementation of the collaborative care model.