Family Health Centers of San Diego Depression Cluster

1
Family Health Centers of San DiegoDepression
Cluster
2
Family Health Centers of San Diego

• nine fixed-site clinics in San Diego County
• three mobile medical units
• three child development focused Family Resource
• Centers
• three mental health clinics
• school-based mental health services in multiple
  schools
• 54 providers

3

• Programs offered
• General and specialized adult medicine
• Pediatrics
• Adolescent medicine
• Womens health services
• Dentistry
• Optometry
• Child Development Services
• Mental Health Services
• Health Education and Prevention
• Population Served
• In 2003, 89,000 unduplicated patients, of whom
  16,390 were homeless. 68 Latino, 7 African
  American, 19 Caucasian, 1 Asian/Pacific
  Islander.

4
North Park Family Health Centers (Project site)

• 6 Providers
• Programs offered
• General and Specialized Adult Care
• Pediatrics
• Primary Care and Mental Health Services for HIV
  positive adults
• Prenatal Care
• Mental Health Services Service Expansion
  funding Health Disparities Collaborative
• Population Served
• In 2003, 11,986 unduplicated patients 61
  Latino 10 African American 28 Caucasian 1
  Asian/Pacific Islander

5
Team Members
6
FAMILY HEALTH CENTERS OF SAN DIEGOHEALTH
DISPARITIES COLLABORATIVEAIM STATEMENT
In keeping with its commitment and focus on
quality initiatives, (such as maintenance of
JCAHO accreditation, participation in the FTCA,
and other ongoing quality improvement efforts
around diabetes, immunizations, and asthma)
Family Health Centers of San Diego (FHCSD) will
redesign its system of care for patients with
depression. FHCSD will do this by implementing
the Care Model provided by Health and Human
Services Health Disparities Collaboratives.  
7
FAMILY HEALTH CENTERS OF SAN DIEGOHEALTH
DISPARITIES COLLABORATIVE
 
POPULATION OF FOCUS   Population of focus
Family Health Centers of San Diegos (FHCSD)
initial population of focus will be one hundred
people with depression. They are the patients of
the two primary care providers at FHCSDs North
Park clinic site who see adults. Other depressed
patients with a particular screening focus on
those with a diagnosis of diabetes and/or
hypertension will be added to the registry as
they come to the clinic for services and are
newly diagnosed.    
8
Key Depression Measures
CSD Clinically Significant Depression
9
Registry

• Family Health Centers of San Diego populated its
  registry by requesting a data run for its North
  Park site. This data run listed patients seen in
  the previous year who were diagnosed with
  depression. These patients were flagged for
  project screening upon subsequent visits for
  health care.
• The data entry process began with parallel
  steps completing the depression chart
  abstraction tool and learning PECS via the
  internet training. Two people are familiar with
  using PECS the primary person responsible for
  data entry initially fills out the chart
  abstraction tool and enters the data. Subsequent
  data entry occurs after the patients next visit
  and the PHQ-9 has been completed. A tracking
  system is being perfected to capture patients
  future visits, self-management plan formulation
  and updates, as well as future PHQ-9 scores.
• Seventy-nine names appeared in the data run
  mentioned above currently fifty have been
  entered into PECS.

10
Key Partnerships

• Consumer Groups (such as NAMI San Diego
• Pharmaceutical Companies (Pfizer, Glaxo Smith
  Kline, Astra Zeneca)
• Faith-based/Shelter Programs (St. Vincent de
  Paul Village, Crisis
• House, YWCA)
• Research Efforts (Chrono Record)
• Hospitals (Scripps Mercy)
• Physician (Psychiatrist) Champion (Rodrigo Muñoz,
  M.D., past
• President, APA Past President, San Diego
  County Medical Society).