Building a program to improve postpartum depression screening, triage, and referrals at a large birthing hospital

Mental health conditions are a leading cause of maternal mortality. Although guidance exists for perinatal mental health screening frequency, the implementation of these guidelines can vary significantly for patients. Inpatient admissions represent an opportunity for screening that benefits both patients and hospital metrics. A quality improvement team of clinical and administrative personnel implemented a process improvement approach to improve frequency of behavioral health evaluations prior to hospital discharge following elevated depression screening response. Through clinical service foundation, nursing workflow adaptation, and automatic notification of elevated screening responses, the team was able to significantly improve evaluation frequency. The proportion of patients evaluated after an elevated screening increased from ~20% prior to interventions to >80% by conclusion of process improvement project. These results underscore the importance of behavioral health provider integration into obstetric settings and the role of technology in automating screening protocols to enhance patient care.