Perinatal Mood and Anxiety Learning Laboratory in a Freestanding Children's Hospital

项目总结/摘要 产后抑郁症（PPD）是最常见的分娩并发症， 被忽视和忽视儿童医院是产后心理保健的理想场所 因为新生儿重症监护室（NICU）的母亲处于高风险状态， 儿科急诊科（PED）经常错过与儿科医生或产科医生的例行办公室访问。的 减少与未经治疗的PPD相关的负面后果的第一步是及时筛查和自我治疗。 对抑郁症状的认识。然而，筛查NICU母亲和PED并不常见， 昂贵、人员繁重且耗时。第二步是转诊和治疗， 多方面的，并要求家长导航医疗保健系统的不同部分，一个巨大的奋进， 抑郁的个体重新设计医疗保健系统，以允许无缝筛查，转诊和治疗 因此，迫切需要为患有产后抑郁症的母亲创造一个有效的“一站式解决方案”。我们的长期目标是 为接受治疗的婴儿的父母提供安全、全面、即时的心理健康服务， 儿童医院。总体目标是创建一个围产期情绪和焦虑障碍（PMAD）学习 实验室采用五阶段系统工程方法，为临床开发新的解决方案 PPD的识别和治疗。我们的具体目标是1。优化筛查、转诊和治疗， 产后抑郁症在新生儿重症监护室和PED使用系统动力学组模型构建技术。我们将 分析当前的工作流程，识别障碍，从利益相关者那里引出系统需求，绘制系统图， 并开发系统动力学仿真模型，以在虚拟环境中测试解决方案。2.设计一个 新颖的软件仪表板，用于实时跟踪符合条件的母亲及其附带的面向父母的应用程序 并开发一个预测模型来识别高危母亲。然后我们将开发一个测量系统， 监测关键绩效指标。3.实施新的解决方案，监控和评估系统， 实施前和实施后的意外后果。差异中的差异，以及成本效益 将进行分析以评估这些变化。我们的PMAD学习实验室是创新的，因为它是一个 显著偏离传统技术，使用新方法和新技术， 在NICU和PED的免费环境中大规模识别和治疗PPD， 常设儿童医院这是重要的，因为如果成功，它将推广到治疗 其他影响产后父母的心理健康障碍，并将有助于改善短期内， 风险高于一般产妇的父母和婴儿的长期健康结果 人口

PROJECT SUMMARY/ABSTRACT Postpartum depression (PPD) is the most common medical complication of childbirth that remains underrecognized and undertreated. Children’s Hospitals are ideal sites for postpartum mental healthcare because mothers in the Neonatal Intensive Care Unit (NICU) are at high risk and those seeking care in the Pediatric Emergency Department (PED) often miss routine office visits with a pediatrician or obstetrician. The first step to reducing the negative consequences associated with untreated PPD is timely screening and self- awareness of depressive symptoms. However, screening NICU mothers and in the PED is uncommon, expensive, personnel-heavy, and time-consuming. The second step is referral and treatment which is multifaceted and requires parents to navigate different parts of the healthcare system, a vast endeavor for a depressed individual. Redesign of healthcare systems to permit seamless screening, referral, and treatment of mothers with PPD creating an efficient “one-stop-shop solution” is urgently needed. Our long-term goal is to provide safe, comprehensive, point-of-care access to mental health services for parents of infants treated in children’s hospitals. The overall objective is to create a Perinatal Mood and Anxiety Disorder (PMAD) Learning Laboratory using a five-phase systems engineering approach that develops new solutions for clinical recognition and therapy for PPD. Our specific aims are 1. To optimize screening, referral, and treatment for postpartum depression in the NICU and PED using system dynamics group model building techniques. We will analyze the current workflow, identify barriers, elicit system requirements from stakeholders, map the system, and develop a system dynamics simulation model to test solutions in a virtual environment. 2. To design a novel software dashboard for real-time tracking of eligible mothers with its accompanying parent-facing app and develop a predictive model to identify at-risk mothers. We will then develop a measurement system to monitor key performance indicators. 3. To implement new solutions, monitor, and evaluate the system for unintended consequences before and after implementation. A difference in difference, and cost-benefit analysis will be conducted to evaluate the changes. Our PMAD Learning Lab is innovative because it is a significant departure from traditional techniques using novel approaches and new technology to assist in the recognition and treatment of PPD on a large scale in real-world settings in the NICU and PED of a free- standing children’s hospital. This is significant because if successful it will be generalizable to the treatment of other mental health disorders that affect postpartum parents and will contribute to improvement in short- and long-term health outcomes of parents and infants who are at a higher risk than the general maternal population.