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Implementing an inpatient postpartum depression screening, education, and referral program: a quality improvement initiative

  • Eynav Elgavish Accortt
    Correspondence
    Corresponding author: Eynav Elgavish Accortt, PhD.
    Affiliations
    Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA (Dr Accortt, Mses Haque and Buttle, and Dr Kilpatrick)

    Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, CA (Drs Accortt and Bamgbose)

    Reproductive Psychology Program, Cedars-Sinai Medical Center, Los Angeles, CA (Drs Accortt and Bamgbose)
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  • Lubaba Haque
    Affiliations
    Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA (Dr Accortt, Mses Haque and Buttle, and Dr Kilpatrick)
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  • Olusinmi Bamgbose
    Affiliations
    Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, CA (Drs Accortt and Bamgbose)

    Reproductive Psychology Program, Cedars-Sinai Medical Center, Los Angeles, CA (Drs Accortt and Bamgbose)
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  • Rae Buttle
    Affiliations
    Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA (Dr Accortt, Mses Haque and Buttle, and Dr Kilpatrick)
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  • Sarah Kilpatrick
    Affiliations
    Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA (Dr Accortt, Mses Haque and Buttle, and Dr Kilpatrick)
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Published:February 02, 2022DOI:https://doi.org/10.1016/j.ajogmf.2022.100581

      BACKGROUND

      Perinatal mood and anxiety disorders are common and may interfere with pregnancy, delivery, and the postpartum period. Best practice includes symptom screening, patient education, and appropriate referrals; however, many hospitals struggle to identify and support perinatal mood and anxiety disorders patients.

      OBJECTIVE

      Therefore, the Cedars-Sinai Postpartum Depression Screening, Education and Referral Program was initiated and evaluated.

      STUDY DESIGN

      Using the Standards for QUality Improvement Reporting Excellence 2.0 guidelines, we reported outcomes (N=19,564 deliveries) from 4 interventions: (1) nurse-champion training; (2) use of the 9-item Patient Health Questionnaire-9 in the postpartum unit; (3) a series of brief in-service trainings; and (4) a 10-minute video training. We collected data including nurse feedback, screening rates, screen-positive rates, and social work consultation rates.

      RESULTS

      The 4 interventions increased: (1) nurse-champion screening comfort and perinatal mood and anxiety disorder knowledge; (2) Patient Health Questionnaire-9 screening rates from 10% to 99% and screen-positive rates from 0.04% to 2.9%; and (3) rates of social work consultation from 1.7% to 8.4%.

      CONCLUSION

      Quality improvement results from the first 3 years of the program suggest that 4 interventions improved screening rates, screen-positive rates, and social work consultation rates. Future work will focus on method of screening, patients at highest risk of perinatal mood and anxiety disorders, and ongoing nurse training.

      Key words

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