Organizational factors and depression management in community-based primary care settings

Abstract Background Evidence-based quality improvement models for depression have not been fully implemented in routine primary care settings. To date, few studies have examined the organizational factors associated with depression management in real-world primary care practice. To successfully implement quality improvement models for depression, there must be a better understanding of the relevant organizational structure and processes of the primary care setting. The objective of this study is to describe these organizational features of routine primary care practice, and the organization of depression care, using survey questions derived from an evidence-based framework. Methods We used this framework to implement a survey of 27 practices comprised of 49 unique offices within a large primary care practice network in western Pennsylvania. Survey questions addressed practice structure (e.g., human resources, leadership, information technology (IT) infrastructure, and external incentives) and process features (e.g., staff performance, degree of integrated depression care, and IT performance). Results The results of our survey demonstrated substantial variation across the practice network of organizational factors pertinent to implementation of evidence-based depression management. Notably, quality improvement capability and IT infrastructure were widespread, but specific application to depression care differed between practices, as did coordination and communication tasks surrounding depression treatment. Conclusions The primary care practices in the network that we surveyed are at differing stages in their organization and implementation of evidence-based depression management. Practical surveys such as this may serve to better direct implementation of these quality improvement strategies for depression by improving understanding of the organizational barriers and facilitators that exist within both practices and practice networks. In addition, survey information can inform efforts of individual primary care practices in customizing intervention strategies to improve depression management.http://deepblue.lib.umich.edu/bitstream/2027.42/78269/1/1748-5908-4-84.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78269/2/1748-5908-4-84-S1.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78269/3/1748-5908-4-84.pdfPeer Reviewe

Center-commissioned external review of International Water Management Institute: Consolidated report, 19-29 May 2003

Agricultural research / Research institutes / Research policy / Research priorities / Planning / Monitoring / Evaluation / Financial resources / Gender

World city network research at a theoretical impasse::On the need to re-establish qualitative approaches to understanding agency in world city networks

From the late 1990s, the establishment of a new relational ‘turn’ in the study of world city connectedness in globalization has run parallel to the wider relational turn occurring in economic geography. Early work, built firmly upon a qualitative approach to the collection and analyses of new inter-city datasets, considered cities as being constituted by their relations with other cities. Subsequent research, however, would take a strong quantitative turn, best demonstrated through the articulation of the inter-locking world city network (ILWCN) ‘model’ for measuring relations between cities. In this paper, we develop a critique of research based around the ILWCN model, arguing that this ‘top down’ quantitative approach has now reached a theoretical impasse. To address this impasse, we argue for a move away from Structural approaches in which the firm is the main unit of analysis, towards qualitative approaches in which individual agency and practice are afforded greater importance

What is a system? NASA's phased project description

NASA phase A and B projects are addressed. The Phase A study is the preliminary analysis of a space concept. These concepts could have come from a pre-Phase A study or from other sources within or external to NASA. The majority of concepts that are studied at MSFC are assigned by NASA Headquarters and funded accordingly. The overall program schedule depicts important milestones that establish the start and finish dates of each study phase, including design, development, launch, and operations. The Phase B of the project consists of the refinement of preliminary requirements, cost estimates, schedules and risk assessments prior to starting final design and development. The goal of a concept definition activity is to determine the best and most feasible concept(s) that will satisfy the mission and science requirements

Graduate Catalog, 1980-1981 & 1981-1982

https://scholar.valpo.edu/gradcatalogs/1009/thumbnail.jp

Educating and Training Accelerator Scientists and Technologists for Tomorrow

Accelerator science and technology is inherently an integrative discipline that combines aspects of physics, computational science, electrical and mechanical engineering. As few universities offer full academic programs, the education of accelerator physicists and engineers for the future has primarily relied on a combination of on-the-job training supplemented with intense courses at regional accelerator schools. This paper describes the approaches being used to satisfy the educational interests of a growing number of interested physicists and engineers.Comment: 19 pages, 3 figure

Graduate Catalog, 2001-2002

https://scholar.valpo.edu/gradcatalogs/1028/thumbnail.jp