P2.O290: Increasing Postpartum Depression Screening In At-Risk Mothers at 2, 4, and 6 Month Well Child Visits

Purpose/Objectives: Postpartum Depression can have a negative impact on the physical, cognitive, and behavioral development of children. According to recent local studies, only 11% of mothers with Postpartum Depression reported receiving a Depression diagnosis from a healthcare provider. Between April 2023 and August 2023, only 60.8% (284/467) of eligible mothers at our pediatric clinic were screened for Postpartum Depression. The objective of this intervention is to increase the amount of PD screenings conducted in the pediatric clinic by 10%.

Design/Methods: Pilot data was gathered through chart review of all well child visits for children ages 2 months, 4 months and 6 months between April 2023 and August 2023. A completed Postpartum Depression Screening was considered to be one of the following: a patient note with PHQ-9 or PHQ-A Screening entered electronically with answers to each of the 9 questions provided, a patient note with only PHQ-9 Screening results recorded in the patient’s assessment and plan without individual answers recorded, a patient note with the ICD-10 Code for “Encounter for Postpartum Depression Screening” [Z13.32] entered in the patient’s Problem List with the PHQ-9 result included. An in-service was then conducted with all staff in the Pediatric Clinic. The providers were also provided access to a database with PHQ-9 Screening tests available in 30 different languages. Post-intervention results were collected in a similar fashion for the next two months following the in-service. A second cycle was then collected for another four months.

Results: After the intervention, Postpartum Depression Screenings increased from 60.3% (108/179) to 89.6% (43/48) in 2 month visits, 66.7% (100/150) to 75.6% (34/45) for 4 month visits, and from 55.1% (76/138) to 85.7% (24/28) for 6 month visits. The overall percentage of completed Postpartum Depression Screenings was 83.5%, a 22.7% increase from the original 60.8% prior to the intervention. Data gathered from the second cycle yielded an even greater improvement in each age category with an increase to 92.13% (117/127) in 2 month, 79.63% (86/108) in 4 month, and 96.55% (84/87) in 6 month well child visits and a 28.33% increase from the initial pre-intervention data to 89.13%.

Conclusion/Discussion: Emphasizing the importance of screening and providing access to the PHQ-9 in multiple languages played an integral role in increasing the amount of screenings that were completed. Mothers who scored 10 or above on the PHQ-9 were referred to the clinic Healthy Steps program which is run by an in-house social worker who connects the affected mothers to resources to provide aid for food insecurity, mental health issues, and housing insecurity. In order to force function and hold the current gain, the EMR provider for the Pediatric Clinic has been contacted to place mandatory boxes in the patient's electronic chart for PHQ-9 Screening.