Pulse
Screening Mom at Baby’s Visit
Identifying postpartum depression in the clinical setting has always been tricky. A new mother is unlikely to experience depressive episodes immediately after giving birth when she’s under the care of hospital staff. Even six weeks later, at a routine postpartum visit with an obstetrician, symptoms of depression may go undetected. Physicians at Partners in Pediatrics, a pediatric practice with five clinics in the west metro area, have identified another opportunity to screen new mothers—during their baby’s well-child checkups.
Late last summer, Partners in Pediatrics began routinely screening women for postpartum depression during their babies’ two-month, four-month, and six-month visits. Physicians ask mothers to complete the Edinburgh Postnatal Depression Scale questionnaire, then score it to determine if the mother is exhibiting signs of postpartum depression. Those who screen positive are notified of their score and advised to follow up with their primary care provider. If the mother consents, the team will also send a letter to her primary care provider.
“We are able to see and talk with mothers four or five times before their child is 6 months old. In the meantime, they have seen their obstetrical provider once at six weeks postpartum, so it makes sense that we would be in an optimal position to gauge the mental well-being of the mother,” explains Wade Larson, M.D., a pediatrician with Partners in Pediatrics.
Because the postpartum depression program is still in its infancy, no data are available regarding the number of screenings administered or whether women receive follow-up care. But Larson speculates they have identified dozens of cases of postpartum depression. “By ensuring that the mother’s mental health needs are being met, we’re helping to ensure that their baby’s health needs are met. In order for the child to be well, the family has to be well.”—Jeanne Mettner
The Doctor Will See You Online
Blue Cross and Blue Shield of Minnesota is partnering with Fairview Health Services to offer its employees health care online. By logging onto a computer, Blue Cross employees will be able to meet with Fairview doctors. To facilitate use of the new program, Blue Cross has created three online care rooms at its campuses in Eagan and Virginia, Minnesota. The rooms are equipped with a computer, webcam, and diagnostic equipment to record weight, body mass index, blood pressure, and other measures.
A Call to Action
The Minnesota Hospital Association (MHA) is offering online resources to help prevent the top five adverse health events reported in Minnesota hospitals.
These “Calls to Action” include guidelines and checklists for providers as well as patient information. For example, the Safe Skin Call to Action, which addresses the prevention of pressure ulcers, includes a plan for developing a skin safety program, educational videos on how to inspect a patient, schedules for turning patients, and patient education materials.
Each Call to Action also outlines the responsibilities of various providers, including physicians. “Each one of these has a significant physician component,” says Julie Apold, director of patient safety for the MHA. A key component of the Safe Site Call to Action is a time out in which the surgical team double checks to make sure they’re performing the right procedure on the right patient and on the right part of the body. “That’s physician-initiated,” Apold says. “Marking the site of a procedure is also something the physician is accountable for.”
Apold says more than 100 hospitals in Minnesota are now using the Calls to Action. The MHA hopes to extend use of the ones for fall prevention, pressure ulcers, and wrong-site surgeries to clinics. The Calls to Action are available at www.mnhospitals.org/index/patient1.
“The other piece we’re pushing is making sure people speak up if they see a problem or see an error about to happen,” she says. The MHA just started giving out Good Catch awards to people who’ve been nominated by their institution for doing so.—Kim Kiser
Collaboration Trumps Competition
Allina Health System and HealthPartners have begun cooperating rather than competing with each other in the northwestern suburbs of the Twin Cities. The collaboration, aimed at improving the health of individuals as well as the community and making care more affordable, involves HealthPartners’ health plan as well as its clinics in Andover, Anoka, Coon Rapids, and Elk River, and Allina clinics in Champlin, Coon Rapids, Elk River, and Ramsey, along with Mercy Hospital, where HealthPartners physicians have admitted patients for years.
“We realized we were both serving the same communities in the northwest metro and decided we can do things much better together than trying to do them by ourselves and duplicate efforts,” says Penny Wheeler, M.D., chief clinical officer for Allina.
Representatives from the two health systems met for the first time in December to talk about the community’s health needs and how they can work together to better serve patients, especially those with chronic health conditions. “This will allow us to align some of our capabilities,” Wheeler says. “For example, HealthPartners has a good shared decision-making model for patients. It would be great for us to learn from them about that.” The two organizations also are working on making their electronic health record systems interoperable.
Wheeler and Brian Rank, M.D., medical director of HealthPartners Medical Group, say they would eventually like to marry clinical data from Allina’s and HealthPartners’ electronic health record systems with claims data from HealthPartners’ health plan to learn more about how patients use the health care system and outcomes of their encounters with it.
Although it’s in its infancy, the collaboration is attracting national attention. Rank says it was held up as an example to emulate at the Institute for Health Improvement’s national forum in December. “In the area around Mercy, we could be directly competing with each other, or we could say, Let’s work together to make the experience better for patients and more affordable,” he says.—Kim Kiser