Advancing equitable postpartum depression screening in a level-IV NICU: a quality improvement approach shaped by planned experimentation.

BACKGROUND

Given the incidence and impact of postpartum depression (PPD) on families in the NICU, we aimed to increase the percentage of birthing parents screened for PPD from 0 to 90% over 18-months and provide psychosocial support.

METHODS

Planned experimentation was used to design an effective screening framework in a level IV NICU. Interventions included process standardization, electronic health record (EHR) support, and data visualization for feedback. Data were displayed on a control chart and stratified for race and language to ensure equitable delivery.

RESULTS

Provider screening utilizing the PHQ-2 proved the most reliable screening framework in our context. Screening rates increased to a mean of 75%, with 90% of positive screens referred to a unit psychologist; rates were comparable across stratified groups.

CONCLUSION

Successful implementation of PPD screening in tertiary NICUs requires planning to ensure efficient and equitable processes and adequate psychosocial support.