{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T23:25:00Z","timestamp":1787181900165,"version":"build-2736575974"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"National Center for Advancing Translational Sciences, National Institutes of Health","award":["K12TR004411"],"award-info":[{"award-number":["K12TR004411"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The objective of this study is to evaluate whether a nursing-led postdelivery inpatient workflow increased universal perinatal depression screening and improved referrals to behavioral health services. A secondary objective was to evaluate implementation process using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework.<\/jats:p>\n                  <jats:p>This retrospective cohort study included all postpartum patients delivering at an urban academic hospital from February through June 2024. We developed a standardized workflow with nursing leadership and reproductive psychiatry, training nurses to administer the Edinburgh Postnatal Depression Scale (EPDS), to all postpartum patients on postpartum day 0. Scores \u2265 10 prompted nurses to place a social work consult and request the obstetric provider to place a reproductive psychiatry consult. Reach and effectiveness were evaluated using a pre\u2013post study with social work referrals as the primary outcome. Secondary outcomes included EPDS completion rate, screen-positive rate, and psychiatry referrals. Logistic regression was used for adjusted analyses. Adoption was assessed through provider workflow adherence, and implementation was assessed through semistructured patient interviews and nursing surveys.<\/jats:p>\n                  <jats:p>Among 522 postpartum patients (260 preintervention and 262 postintervention), screening completion increased from 25.7 to 95.0% (67\/260 vs. 249\/262, p\u2009&lt;\u20090.001). Positive screens rose from 1.5 to 6.8% (1\/67 vs. 17\/249, p\u2009&lt;\u20090.001). Social work referrals rose from 34.6 to 47.7% (90\/260 vs. 125\/262, p\u2009=\u20090.002). In an adjusted analysis, the intervention remained associated with higher odds of social work referral (adjusted odds ratio: 1.56; 95% confidence interval: 1.02\u20132.41, p\u2009=\u20090.04). Reproductive psychiatry referrals increased but were not statistically significant. Most nurses reported comfort with the workflow, and patients indicated screening was acceptable and helpful.<\/jats:p>\n                  <jats:p>A simple and scalable nursing-led workflow achieved near-universal inpatient perinatal depression screening, improved identification of depressive symptoms, and increased behavioral health referrals. This workflow is feasible, acceptable to nurses and patients, and offers a replicable framework for hospitals seeking to integrate inpatient perinatal depression screening into standard practice.<\/jats:p>","DOI":"10.1055\/a-2936-5577","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T23:13:14Z","timestamp":1786576394000},"source":"Crossref","is-referenced-by-count":0,"title":["Redesigning Inpatient Postpartum Care to Achieve Universal Depression Screening and Early Connection to Behavioral Health Support"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8408-2562","authenticated-orcid":false,"given":"Shobha","family":"Jagannatham","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center\/Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Obstetrics and Gynecology and Women's Health, Division of Maternal Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3828-455X","authenticated-orcid":false,"given":"Anna","family":"Cavallino","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Obstetrics and Gynecology and Women's Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0231-0734","authenticated-orcid":false,"given":"Marlee","family":"Madora","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Psychiatry and Behavioral Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0689-1660","authenticated-orcid":false,"given":"Rubiahna L.","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Psychiatry and Behavioral Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1236-8641","authenticated-orcid":false,"given":"Qi","family":"Gao","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Epidemiology and Population Health, Division of Biostatistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8890-8798","authenticated-orcid":false,"given":"Ying","family":"Jin","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Epidemiology and Population Health, Division of Biostatistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1370-7366","authenticated-orcid":false,"given":"Kevin","family":"Fiori","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Pediatrics, Division of Community and Population Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-3005","authenticated-orcid":false,"given":"Kavita","family":"Vani","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center\/Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Obstetrics and Gynecology and Women's Health, Division of Maternal Fetal Medicine"]},{"name":"Albert Einstein College of Medicine, New York, United States","place":["Bronx"],"department":["Department of Pediatrics, Division of Community and Population 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mental health service utilization among women at highest risk","volume":"39","author":"L M River","year":"2019","journal-title":"Zero Three"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1001\/jamapsychiatry.2013.87","article-title":"Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings","volume":"70","author":"K L Wisner","year":"2013","journal-title":"JAMA Psychiatry"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"e20183260","DOI":"10.1542\/peds.2018-3260","article-title":"Incorporating recognition and management of perinatal depression into pediatric practice","volume":"143","author":"J Rafferty","year":"2019","journal-title":"Pediatrics"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3389\/fpubh.2019.00064","article-title":"RE-AIM planning and evaluation framework: adapting to new science and practice with a 20-year 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Daehn","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1466150","DOI":"10.3389\/fpubh.2024.1466150","article-title":"Acceptability of identification and management of perinatal anxiety: a qualitative interview study with postnatal women","volume":"12","author":"R Meades","year":"2024","journal-title":"Front Public Health"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.2196\/mental.5611","article-title":"A thematic analysis of stigma and disclosure for perinatal depression on an online forum","volume":"3","author":"D Moore","year":"2016","journal-title":"JMIR Ment Health"}],"container-title":["American Journal of 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