Psychiatric Quarterly, Vol. 74, No. 1, Spring 2003 ( C  2003) IMPLEMENTING AN OFFICE SYSTEM TO IMPROVE PRIMARY CARE MANAGEMENT OF DEPRESSION Neil Korsen, M.D., Peter Scott, M.S.S., Allen J. Dietrich, M.D., and Thomas Oxman, M.D. Studies have shown that many patients treated for depression in primary care settings do not achieve the outcomes demonstrated to be possible in random- ized 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. KEY WORDS: depression; primary care; quality improvement; office systems. Neil Korsen, M.D., is affiliated with MaineHealth, Clinical Integration, Portland, Maine, and Maine Medical Center Family Practice Residency Program, Portland, Maine. Peter Scott, M.S.S., is affiliated with MaineHealth, Clinical Integration, Portland, Maine. Allen J. Dietrich, M.D., is affiliated with Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire. Thomas Oxman, M.D., is affiliated with Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire, and Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire. Address correspondence to Neil Korsen, M.D., Maine Medical Center Family Practice Residency Program, 272 Congress Street, Portland, Maine 04101. 45 0033-2720/03/0300-0045/0 C  2003 Human Sciences Press, Inc.