Table 1.

Relation of the Conceptual Framework to the DIAMOND Initiative and Study

Domain	Elements	Data Source*
Priority	Priority for depression care improvement relative to all other organizational priorities	0–10 scale on PPC-RD
Change Process	Leadership support, development of new systems, orientation of staff, engagement of physicians, hiring of care manager, contracting for psychiatry consultation	CPCQ + ICSI documentation
Practice Systems	Coding changes, routine use of PHQ9 at onset and 6/12 months of care, systematic evaluation of co-morbidities, registry, tracking and monitoring, care coordination, self-management support, follow-up, treatment intensification, relapse prevention, performance measurement and reporting, quality improvement, standing orders	PPC-RD
Best Care Process	Shared decision-making, personalized care plan, assessed side effects, connected to community programs, assessed depression severity frequently, assessed alcohol use and suicidal thoughts, provided written information, provided with care manager, called to check on progress Anti-depressant fills, refills, changes, follow-up visits	Patient survey Payer data
Depression Improvement	Change in PHQ9 score from baseline at 6 & 12 months (response and remission rates)	PHQ9 score changes
Productivity, Healthcare Utilization, and Costs	Change in absenteeism and presenteeism Total, inpatient, and outpatient costs, use of mental health specialists and	Patient survey Payer claims data
Payment Change	Use of special DIAMOND claims code	Payer data
ICSI Facilitation	Specification of changes needed, training, certification, measurement, consultation, and improvement collaborative	Documentation of each step

^*PPC-RD = Survey of clinical leaders for priority and practice systems for depression

CPCQ = Survey of administrative leaders for change process capability

ICSI = Institute for Clinical Systems Improvement