Depression is a highly prevalent but under-recognized condition in the primary care population. To help improve the screening and care of depression, various quality metrics have been instituted nationwide. We identified a number of obstacles in our standard workflow that contributed to the underperformance in depression screening and follow up care. Utilizing continuous PDCA cycles, we implemented new workflows, developed ongoing training programs, built new web-based and EHR-based tools, monitored local performance, and regularly implemented optimization strategies. With our innovations in health IT, the depression risk screening rate at UCLA dramatically increased 4 fold within 1 year, with over 70% of adult patients being screened for depression in the primary care setting, and over 90% rate of completing follow up diagnostic evaluation where appropriate. In this presentation, we will discuss our optimized workflow and the significant clinical outcome.