PA PQC Moving on Maternal Depression (MOMD) Survey

Overview:

The PA PQC's Driver Diagram for Maternal Mortality lists key interventions to "Administer validated...mental health...screens during prenatal and postpartum visits...and Connect patients to mental health...and community-based social services...."

To adopt these key interventions, the PA PQC is recruiting birth hospitals and their prenatal/postpartum and pediatric offices to improve maternal depression screening and follow-up and reduce racial disparities.

To guide the adoption of these key interventions, a PA PQC Moving on Maternal Depression (MOMD) Task Force developed a MOMD Change Package with resources and key steps on how to achieve these two goals (see https://www.whamglobal.org/focus-areas/papqcmaternaldepression).

To join a cohort of PA PQC hospitals that will adopt the MOMD Change Package, please complete this survey by March 1, 2021 to assess your current processes and express interesting in joining MOMD.

Those who elect to adopt the MOMD Change Package (i.e., those who answer "yes" to question 17) will be connected to a PA PQC coach to guide their multi-disciplinary quality improvement team through the process of adopting the MOMD Change Package. Question 20 asks for the names and contact information for your key champions who will help to drive the adoption of the MOMD Change Package and engage their colleagues/peers in this quality improvement initiative.

These sites will begin to:

(1) assess their current condition workflows by observing and mapping out their current office and telehealth visit workflows,

(2) convene virtual community listening and action sessions with support from the PA PQC to inform how to incorporate maternal depression screening and follow-up processes into the workflows,

(3) develop future condition workflows with depression screening and follow-up processes,

(4) train teams in the new workflows,

(5) initiate the improvements to the depression screening and follow-up services, and

(6) start tracking depression screening and follow-up measures by race.

These initial steps can be guided by Section 2 in the MOMD Change Package, which focuses on "Implementing Depression Screening and Follow-up." The work to reduce racial/ethnic disparities will be guided by Section 3 in the MOMD Change Package, which focuses on "Closing Gaps in Racial Disparities." The PA PQC also recognizes that additional time will be needed to modify EHRs to incorporate the screening and follow-up functions. Sites can start with small Plan, Do, Study, Act cycles to test and improve pilot processes before making system-wide EHR and institutional policy changes.

Question Title

* 1. Your PA PQC Hospital or Affiliation

Question Title

* 2. Which settings are you completing this survey on behalf of?

OB Prenatal Office

OB Postpartum Office

Pediatric Offices

Primary Care Offices

Birth Center

Birth Hospital

NICU

Other (please specify)

Question Title

* 3. Do you screen people with a validated mental health screening tool during the prenatal period? (see Q6 for a list of validated screening tools)

Yes

Question Title

* 4. Do you screen people with a validated mental health screening tool during the postpartum period? (see Q6 for a list of validated screening tools)

Yes

Question Title

* 5. If you answered "yes" to Q3 and/or Q4,
What depression screening approach do you use?

Universal (every person)

Targeted (sub-set of the patient population based on risk factors)

Other (please specify)

Question Title

* 6. If you answered "yes" to Q3 and/or Q4,
What depression screening tool do you use? (Please check all that apply.)

Edinburgh Postnatal Depression Screen (EPDS)

Postpartum Depression Sale

Patient Health Questionnaire 9 (PHQ-9)

Patient Health Questionnaire 2 (PHQ-2)

Beck Depression Inventory

Beck Depression Inventory-II

Center for Epidemiologic Studies Depression Scale

Zung Self-Rating Depression Scale

Other (please specify)

Question Title

* 7. If you answered "yes" to Q3 and/or Q4,
Where does the depression screening process occur?

OB Prenatal Office

OB Postpartum Office

Pediatric Offices

Primary Care Offices

Birth Center

Birth Hospital

NICU

Other (please specify)

Question Title

* 8. Do you have a standardized protocol to follow-up on positive depression screens?

Yes

Question Title

* 9. If you answered "yes" to Q8,
What follow-up actions occur in your hospital or outpatient offices in response to a positive depression screen? (check all that apply)

Diagnosis

Medications

Referral to specialty mental health treatment

Referral or warm hand off to integrated behavioral health consultants or care managers

Referral to home visiting programs

Referral to other community resources

Systematic case reviews of depression cases with a multi-disciplinary team

Follow an organizational suicide risk response policy

Other (please specify)

Question Title

* 10. Which quality metrics do you use to inform continuous improvements to your depression screening and follow-up processes?

Prenatal Depression Screening Percentage (please refer to the definition of the HEDIS measure)

Prenatal Depression Screening Follow-up Percentage (please refer to the definition of the HEDIS measure)

Postpartum Depression Screening Percentage (please refer to the definition of the HEDIS measure)

Postpartum Depression Screening Follow-up Percentage (please refer to the definition of the HEDIS measure)

Depression Response Percentage (50% or greater reduction in symptoms measured by symptom tracking scales, such as the PHQ-9)

Depression Remission Percentage (e.g., PHQ-9 < 5)

Other

Do Not Know

* 19. If you answered "yes" to Q17:
Please indicate which of the following initial steps you think your team would like to focus on first.

Assess your current condition workflow by observing and mapping out your current office and telehealth visit workflows

Convene virtual community listening and action sessions with support from the PA PQC to inform how to incorporate maternal depression screening and follow-up processes into the workflows

Develop future condition workflows with depression screening and follow-up processes

Train initial teams in the new workflows

Initiate the depression screening and follow-up services at least at one office

Start tracking depression screening and follow-up measures by race

Please add any comments here.

Question Title

* 20. If you answered "yes" to Q17:
Who are your champions to adopt key interventions to improve this process? Please list as many champion roles as you can, and your team will expand over time.

(In each row, please write their First Name, Last Name, Credentials, Title/Role, Organization, and Email Address)

Women's Health Provider Champion

Pediatric Provider Champion

Data Collection Champion

Administrative Champion (Key Contact for Follow-up and Coordination)

Community Resource Champion

Patient/Family Champion

Question Title

* 1. Your PA PQC Hospital or Affiliation

Question Title

* 2. Which settings are you completing this survey on behalf of?

Question Title

* 3. Do you screen people with a validated mental health screening tool during the prenatal period? (see Q6 for a list of validated screening tools)

Question Title

* 4. Do you screen people with a validated mental health screening tool during the postpartum period? (see Q6 for a list of validated screening tools)

Question Title

* 5. If you answered "yes" to Q3 and/or Q4, What depression screening approach do you use?

Question Title

* 6. If you answered "yes" to Q3 and/or Q4, What depression screening tool do you use? (Please check all that apply.)

Question Title

* 7. If you answered "yes" to Q3 and/or Q4, Where does the depression screening process occur?

Question Title

* 8. Do you have a standardized protocol to follow-up on positive depression screens?

Question Title

* 9. If you answered "yes" to Q8, What follow-up actions occur in your hospital or outpatient offices in response to a positive depression screen? (check all that apply)

Question Title

* 10. Which quality metrics do you use to inform continuous improvements to your depression screening and follow-up processes?

Question Title

* 11. If you selected a metric in Q10: Do you stratify the maternal depression and follow-up measures by race?

Question Title

* 12. Have you conducted a quality improvement project to reduce racial disparities for maternal mental health quality measures?

Question Title

* 13. Does your organization analyze how institutional policies are facilitating or alleviating racial disparities in a standardized way?

Question Title

* 14. Does your organization provide staff-wide education on perinatal racial and ethnic disparities and root causes?

Question Title

* 15. Do you work with patient/family advocates or community resources to inform your maternal mental health screening and follow-up processes?

Question Title

* 16. Do you work with patient/family advocates or community resources to inform your work to reduce racial disparities?

Question Title

* 17. Do you want to join the PA PQC's Moving on Maternal Depression (MOMD) initiative starting to improve depression screening and follow-up and reduce racial disparities?

Question Title

* 18. If you answered "yes" to Q17:What part of the maternal depression screening and follow-up process does your team want to improve through MOMD?

Question Title

* 19. If you answered "yes" to Q17:Please indicate which of the following initial steps you think your team would like to focus on first.

Question Title

Question Title

* 21. Please write your name, role, organization, and contact information so the PA PQC can follow-up with you about next steps.

* 5. If you answered "yes" to Q3 and/or Q4,
What depression screening approach do you use?

* 6. If you answered "yes" to Q3 and/or Q4,
What depression screening tool do you use? (Please check all that apply.)

* 7. If you answered "yes" to Q3 and/or Q4,
Where does the depression screening process occur?

* 9. If you answered "yes" to Q8,
What follow-up actions occur in your hospital or outpatient offices in response to a positive depression screen? (check all that apply)

* 11. If you selected a metric in Q10:
Do you stratify the maternal depression and follow-up measures by race?

* 18. If you answered "yes" to Q17:
What part of the maternal depression screening and follow-up process does your team want to improve through MOMD?

* 19. If you answered "yes" to Q17:
Please indicate which of the following initial steps you think your team would like to focus on first.