Perinatal psychiatric practitioner consultation program delivers rapid response to OB/GYN practitioners.

INTRODUCTION: Screening and treatment initiation for perinatal psychiatric conditions is a recommended competency in OB/GYN practitioners, yet perinatal psychiatry is rapidly evolving. Practitioner-to-psychiatrist consultation programs have the potential to improve the management of psychiatric conditions in perinatal women. This study describes utilization of a statewide perinatal psychiatric consultation service by OB/GYN practitioners through examination of the volume, responsivity, content and outcomes of clinical inquiries, and satisfaction. METHODS: This quality improvement study describes the 460 telephone or e-mail consultations requested by OB/GYN practitioners over 2 years and housed within a REDCap database. Data include the characteristics of consult users, month-over-month and total utilization, the patient's perinatal status, the reason for contact, current symptoms and medications, and the consulting psychiatrist recommendations. Practitioner satisfaction with consultation is also described. RESULTS: After completion of triage, the psychiatrist returned the practitioner's call ≤5 min in 59% of consultations. The most common inquiries were for pregnant (64%) women for depressive (51%) or anxiety (46%) symptoms with 47% of inquiries reporting the patient was currently taking a psychiatric medication. Had consultation not been available, referral to mental health (41%) or starting a medication (15%) were most often reported. CONCLUSIONS: This perinatal psychiatric consultation service rapidly and effectively met the needs of practitioners practicing in OB/GYN settings across a state having a critical psychiatry shortage and varying urban and rural geography. Future recommendations include the assessment of direct patient outcomes, practitioner skill attainment, and long-term cost savings of this perinatal psychiatric consultation model.

Differences in Utilization of Perinatal Psychiatric Teleconsultation Line Between Primary Care and Mental Health Providers.

PURPOSE: Teleconsultation has been a newly recognized avenue by which to provide psychiatric services to perinatal populations being treated either by psychiatric or primary care providers. The Periscope Project (TPP) is a business-hours teleconsultation line providing enrolled clinicians with access to a subspecialty-trained psychiatrist, as well as community resources and provider education. This study examines the differences in consultation between enrolled providers. METHODS: Encounter data was entered into REDCap by TPP's team members. Data was analyzed using summary statistics. Satisfaction information was attained by follow-up survey. RESULTS: During the first 24 months of program activity, TPP had a total of 737 referred encounters, 70.4% from primary care and 20.5% from psychiatry. There were statistically significant differences between psychiatric and primary care providers in terms of recommendations for use of certain types of medications and use of diagnostic screenings, as well as differences in what providers would have recommended in absence of TPP's involvement. CONCLUSIONS: Differences in enrollee's rationale for consultation allows for better understanding of the needs of front-line providers. Tailoring educational information and even teleconsultation information based on provider group can allow for more efficient patient care and resource utilization. Providers across the spectrum found TPP beneficial, indicating that continued availability to all providers caring for women of reproductive age is important.