Implementing an office system to improve primary care management of depression.

Studies have shown that many patients treated for depression in primary care settings do not achieve the outcomes demonstrated to be possible in randomized controlled trials. In general, multifaceted interventions have been more successful than single focus interventions in improving care of depression in this setting. This article reports on the implementation of such a mulitfaceted intervention in primary care practices. Part of the strategy in this case is to introduce the intervention through an intermediary organization that has a relationship with the practices and has a quality improvement infrastructure to support the implementation and help to sustain changes.