Building a System of Perfect Depression Care in Behavioral Health

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Background: Depression, a common, serious disorder, may result in suicide in up to 10% of afflicted persons.

Methods: In 2001, the Division of Behavioral Health Services of the Henry Ford Health System (Detroit) launched an initiative to completely redesign depression care delivery using the Six Aims and the Ten Rules from the Institute of Medicine report Crossing the Quality Chasm. This "Perfect Depression Care" initiative, whose key goal was the elimination of suicide, entailed performance improvement activities in four domains—partnership with patients, clinical care (planned care model), access, and information flow.

Results: The rate of suicide in the patient population decreased by 75% (p = .007), from ∼89 per 100,000 at baseline (2000) to ∼22 per 100,000 for the four-year follow-up interval (the average rate for 2002–2005).

Discussion: This sustained reduction in suicide rate suggests that the process improvements implemented as part of the Perfect Depression Care initiative substantially improved the care of persons with depression. The initiative is the prototype for a comprehensive redesign of behavioral health care. Work is under way to "perfect" the care of persons with anxiety or psychotic disorders, and similar care systems are being developed for violence prevention and medication safety, with a particular focus on perfecting communication between providers. Pursuing perfection is no longer a project or initiative but a principle driving force embedded in the fabric of our care.

Document Type: Research Article

Publication date: April 1, 2007

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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