Postpartum Depression Screening at Well-Child Appointments: A Quality Improvement Project

Area of Science:

• Obstetrics and Gynecology
• Primary Care Medicine
• Psychiatry

Background:

• Postpartum depression (PPD) affects many mothers, impacting maternal and infant well-being.
• Early identification and intervention are crucial for managing PPD.
• Well-child appointments offer a valuable opportunity for PPD screening.

Purpose of the Study:

• To implement and evaluate a PPD screening program using the Edinburgh Postnatal Depression Scale (EPDS).
• To assess the feasibility of integrating PPD screening into routine well-child appointments up to one year of age.
• To identify mothers experiencing PPD in a faith-based primary care setting.

Main Methods:

• A quality improvement project utilizing the Plan-Do-Study-Act (PDSA) framework.
• The EPDS was administered to mothers aged 19+ during infant well-child visits.
• A positive screen was defined as an EPDS score of 10 or higher; protocol adjustments were made bi-weekly.

Main Results:

• 35 mothers completed the EPDS during a 9-week period, with a 97.3% participation rate.
• Staff compliance with EPDS administration was 78.7%, with 21.3% missed opportunities.
• Five mothers (14.3%) screened positive for PPD, aged 20-44 years.

Conclusions:

• Integrating PPD screening with the EPDS into well-child appointments up to one year is a viable strategy.
• This approach can effectively identify mothers with postpartum depression who might otherwise be missed.
• Routine screening during well-child visits represents a critical opportunity to address maternal mental health.