Implementing a Safety Bundle to Improve Screening and Care for Perinatal Mood and Anxiety Disorders

Abstract

ObjectiveTo improve screening and care of individuals with perinatal mood and anxiety disorders (PMAD) through the implementation of a perinatal mental health safety bundle. DesignRapid-cycle quality improvement model using four plan–do–study–act cycles over the course of 90 days. Individuals between 28 and 32 weeks gestation and at their 6-week postpartum follow-up visit were screened and offered stage-based care for PMAD. Setting/Local ProblemAt baseline, only 15% of clients of a suburban, private-practice women’s health clinic were receiving PMAD screening with a validated tool, and the site lacked standardized PMAD care practices among health care providers. ParticipantsHealth care providers (n = 2), staff (n = 4), and eligible patients (n = 78) at a private-practice women’s health clinic. Intervention/MeasurementsA screening, brief intervention, referral, and treatment/follow-up (SBIRT) model was used to screen eligible patients, provide treatment options, and appropriately refer for follow-up to mental health services. Team engagement occurred via weekly meetings. Measurements included pre–post maternal and team engagement survey results, biweekly chart review, and run chart analysis. ResultsEffective PMAD screening and right care were achieved for 85% of eligible individuals; this included receiving screening, referral to treatment, a scheduled mental health appointment, and clinic follow-up to ensure mental health care uptake. ConclusionUse of the SBIRT model to implement a safety bundle may contribute to improved mental health outcomes for individuals receiving perinatal care in a private-practice outpatient health care setting. Education and engagement among clinicians, staff, and patients are key to successful implementation of a safety bundle.