719 Implementation of postpartum depression screening for deliveries complicated by ICU admission: a quality improvement study

Abstract

Medical complications of pregnancy have been shown to be a risk factor for postpartum depression (PPD). We aimed to improve PPD screening and access to mental health care for patients who required ICU admission during their delivery admission. In this retrospective cohort study of women admitted to ICU who delivered in 2019 and 2020, we compared rates of PPD risk in women before and after implementation of a quality improvement initiative to improve inpatient PPD screening rates The initiative included utilization of the Patient Health Questionnaire-9 (PHQ-9) and an outpatient phone follow-up from a social worker two to four weeks after discharge for additional PPD screening and referral to care. Between January 2019 and February 2020, 26 patients were admitted to the ICU during their delivery encounter and eligible to complete PPD screening. Before the intervention, we found a 73% inpatient PPD screening rate, as well as an 88% inpatient social work referral rate. Following intervention, between March and August 2020, 12 patients were admitted to the ICU. We noted a 92% inpatient PPD screening rate and an 83% inpatient social work referral rate. Notably, 100% of these 12 patients were contacted 2-4 weeks postpartum and connected to care. Improvement of inpatient PPD screening and implementation of outpatient phone follow up for women who required ICU care during their delivery admission facilitates referral to mental health care for this high risk group.