PMID- 17264696
OWN - NLM
STAT- MEDLINE
DCOM- 20070316
LR  - 20220309
IS  - 1040-2446 (Print)
IS  - 1040-2446 (Linking)
VI  - 82
IP  - 2
DP  - 2007 Feb
TI  - Teaching systems-based practice to primary care physicians to foster routine 
      implementation of evidence-based depression care.
PG  - 168-75
AB  - Although health care organizations seeking to improve quality often must change 
      the system for delivering care, there is little available evidence on how to 
      educate staff and providers about this change. As part of a 2002-2003 Veterans 
      Health Administration multisite project using collaborative care to improve the 
      management of depression, the authors implemented the Translating Initiatives for 
      Depression into Effective Solutions (TIDES) program. Five steps were followed for 
      teaching systems-based practice: (1) determine providers' educational needs 
      (through administrative data, expert opinion, and provider discussion), (2) 
      develop educational materials (based on needs assessed), (3) help each of seven 
      sites develop an educational intervention, (4) implement the intervention, and 
      (5) monitor the intervention's effectiveness. Sites relied primarily on passive 
      educational strategies. There was variable implementation of the different 
      components (e.g., lecture, educational outreach). No site chose to write up its 
      education plan, as was suggested. The authors thus suggest that the educational 
      model was successful at identifying providers' needs and creating appropriate 
      materials, because the program was not advertised in other ways and because 
      almost all providers referred patients to the program. However, the educational 
      model was only partially successful at getting sites to develop and implement an 
      educational plan, although provider behavior did change. Overall, the program was 
      somewhat effective at teaching systems-based practice. The authors believe the 
      best way to enhance effectiveness is to build education into the system rather 
      than rely on a separate system for education.
FAU - Sherman, Scott E
AU  - Sherman SE
AD  - Veterans Health Administration (VA) New York Harbor Healthcare System, New York, 
      New York 10010, USA. scott.sherman@med.nyu.edu
FAU - Fotiades, John
AU  - Fotiades J
FAU - Rubenstein, Lisa V
AU  - Rubenstein LV
FAU - Gilman, Stuart C
AU  - Gilman SC
FAU - Vivell, Susan
AU  - Vivell S
FAU - Chaney, Edmund
AU  - Chaney E
FAU - Yano, Elizabeth M
AU  - Yano EM
FAU - Felker, Bradford
AU  - Felker B
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Review
PL  - United States
TA  - Acad Med
JT  - Academic medicine : journal of the Association of American Medical Colleges
JID - 8904605
SB  - IM
MH  - Cooperative Behavior
MH  - Depressive Disorder/*therapy
MH  - Humans
MH  - Primary Health Care/*organization & administration
MH  - Psychiatry/*education
MH  - Referral and Consultation/*organization & administration
RF  - 28
EDAT- 2007/02/01 09:00
MHDA- 2007/03/17 09:00
CRDT- 2007/02/01 09:00
PHST- 2007/02/01 09:00 [pubmed]
PHST- 2007/03/17 09:00 [medline]
PHST- 2007/02/01 09:00 [entrez]
AID - 00001888-200702000-00009 [pii]
AID - 10.1097/ACM.0b013e31802d9165 [doi]
PST - ppublish
SO  - Acad Med. 2007 Feb;82(2):168-75. doi: 10.1097/ACM.0b013e31802d9165.