A Systemwide Postpartum Inpatient Maternal Mental Health Education and Screening Program

Area of Science:

• Maternal Health
• Quality Improvement Science
• Mental Health Services

Background:

• Significant variation existed in maternal mental health screening, referral, and education practices across a 66-center hospital system.
• Increasing rates of severe maternal morbidity and the COVID-19 pandemic heightened concerns about maternal mental health care quality.

Purpose of the Study:

• To expand a hospital system's maternal mental health program by standardizing screening for perinatal mood and anxiety disorders.
• To implement a consistent approach to maternal mental health care across diverse settings.

Main Methods:

• A quality improvement initiative utilized a continuous Plan-Do-Study-Act (PDSA) cycle.
• An "all-or-none" bundle methodology measured adherence to system standards for screening, referral, and education.
• A comprehensive toolkit was developed and implemented, including training for perinatal nurses, chaplains, and social workers.

Main Results:

• Initial system bundle adherence was 76% in 2017, increasing to 97% in 2018.
• Despite the COVID-19 pandemic, overall adherence remained high at 92% from 2020-2022.
• The initiative demonstrated successful standardization of maternal mental health practices.

Conclusions:

• A nurse-led quality improvement initiative successfully standardized maternal mental health care across a diverse hospital system.
• High and sustained adherence rates demonstrate a commitment to high-quality perinatal mental health care.
• The implemented program effectively improved screening, referral, and education for perinatal mood and anxiety disorders.