Perinatal Depression and Anxiety — Implementing Screening and Response Protocols [6N

Abstract

INTRODUCTION: Perinatal mood and anxiety disorders are the most common pregnancy complications, and are associated with adverse maternal, infant and child outcomes. Recognizing this, the Council on Patient Safety in Women's Healthcare developed an evidence-based safety bundle to establish a standard of care for these disorders that is relevant to every woman in every clinical setting. Its objective was to outline how to implement current recommendations at the practice level. METHODS: To promote safety bundle dissemination, the American College of Obstetricians and Gynecologists invited 20 nationally representative obstetric and behavioral health providers to engage in a journey mapping process. The journey map followed the safety bundle format and addressed implementation steps needed to screen for and respond to perinatal mood and anxiety disorders. Opportunities to ease implementation were also assessed. RESULTS: The journey map focused on the process of addressing these disorders and identified multiple potential barriers. Each step of implementation must consider an ever changing obstetric practice environment, and the absence of related direct reimbursement. It is critical to focus on implementation until consensus is reached regarding outcomes measures to assess screening and treatment. CONCLUSION: As the implications of untreated perinatal mood and anxiety disorders are better understood, it is critical to develop and disseminate implementation processes to help obstetric practices screen for and address this issue. Implementation protocols need to be customized to each unique care setting. Further efforts are required to establish meaningful outcome measures.