This dissertation project will explore a new methodological approach to understanding the organizational and physician factors which inhibit successful implementation of the collaborative care model for depression. It is known that in order to improve the quality of care for chronic illnesses, both medical groups and individual physicians must enact change: Medical groups must redesign the system of care; physicians must improve their skill and knowledge of care for patients with chronic illnesses. However, the relative importance of the clinic and the individual physicians' role in quality improvement, and the specific factors that inhibit change remain unclear. In this project, a structural model of implementation will be developed which specifies the role of the clinic and the physician in quality improvement. This research will help target the key barriers to implementation and clarify the relative importance of the clinic and the physician in quality improvement. Findings from this study can be used to inform quality improvement initiatives, and to expand the tools available for research on the implementation of evidence-based care. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31MH075719-02
Application #
7118499
Study Section
Special Emphasis Panel (ZMH1-ERB-I (06))
Program Officer
Light, Enid
Project Start
2005-06-06
Project End
2006-08-01
Budget Start
2006-06-06
Budget End
2006-08-01
Support Year
2
Fiscal Year
2006
Total Cost
$3,283
Indirect Cost
Name
Harvard University
Department
Type
Other Domestic Higher Education
DUNS #
082359691
City
Cambridge
State
MA
Country
United States
Zip Code
02138
Henke, Rachel M; Zaslavsky, Alan M; McGuire, Thomas G et al. (2009) Clinical inertia in depression treatment. Med Care 47:959-67
Henke, Rachel M; McGuire, Thomas G; Zaslavsky, Alan M et al. (2008) Clinician- and organization-level factors in the adoption of evidence-based care for depression in primary care. Health Care Manage Rev 33:289-99