Team Building & Workflow

In usual care, the depression treatment team has two members: the primary care provider and the patient. Collaborative Care adds two new team members: the care manager(s) and the psychiatric consultant. Each role is vital to ensuring high-quality, Collaborative Care. Effective Collaborative Care creates a team in which all of the providers work together on a single treatment plan. Its success relies to a great extent on each member of the treatment team understanding his/her role and believing he/she has the knowledge and skills necessary to fulfill that role. 


Team members will need to function outside of the traditional roles they were trained for and rely on each other in ways that may be new or uncomfortable. For example, primary care providers are familiar with an entirely different culture than behavioral health specialists, but both perspectives are extremely important and both need to be woven into a new collaborative culture that sees differences as strengths. The same goes for the culture of the community-based organization and/or family involved in patient care. The Implementation Leader should carefully consider the pros and cons of retraining existing staff versus hiring new staff, keeping in mind the challenges implementation brings and the personalities involved.

Team Building and Workflow Guide

  • Worksheet #1: Team Member Self Assessment
  • Worksheet #2: Task Summary Worksheet
  • Worksheet #3: Clinical Workflow Plan
  • Worksheet #4: Action Plan
  • Sample Workflow in table format.
    • This workflow has a lot of detailed information similar to the level of detail spelled out in Worksheet #3 above
  • Sample Workflow in diagram format (primary care clinic only)
    • This workflow has less detail but can be helpful as it provides a quick visual reference for members of the team
    • These diagrams are most useful when they show the workflow from the point of view of the patient, i.e. what happens when a patient walks into the clinic
    • Note: This workflow was not created by the AIMS Center. It is an actual workflow created by an FQHC in New York and is not meant to represent the ideal Collaborative Care workflow (although it is a very good workflow). Collaborative Care tasks can be done by different people in different settings and in a different order than what is presented in this diagram. There is no ideal workflow. Also, note that this particular one is fairly aggressive. It has the care team looking at patients' treatment responses and considering adjusting as early as 4-6 weeks into treatment if there hasn't been a significant response, (rather than the usual 10 weeks with a partial response or 4-6 weeks with no response). 

Care Partners Workflows

All Care Partners workflows can be found on the Clinic Workflow Diagrams page of the LCS.