Be aware! There’s a Joint Commission focus on pregnancy and mental health conditions. TJC recently published Quick Safety Issue 67: Mental Health Conditions Leading Cause of Pregnancy-Related Deaths.

The TJC article covers the recent report from the Centers for Disease Control and Prevention (CDC) evaluating causes for maternal death. The CDC report identified Pregnancy Related Deaths that were related to mental health. Issues such as depression, anxiety and death by suicide as the most frequent underlying cause for maternal death. So, let’s take a deep dive into this patient safety issue for both Hospitals and Behavioral Health Care organizations.

Joint Commission Focus: Pregnancy and Mental Health Conditions

Successfully managing the underlying causes of suicidality is instrumental in reducing the risk of suicide in perinatal and postpartum women. Challenging aspects of treatment for this group include psychiatric medication management, stabilizing mental health conditions, treatment of opioid use disorders, and withdrawal management. Fortunately, there are some excellent resources available on this topic.

For instance, there’s an excellent resource available from the Substance Abuse and Mental Health Administration: Clinical Guidance for Treating Perinatal and Postpartum Women with Opioid Use Disorder and Their Infants. In addition, check out the following references for the management of psychiatric medications:

• Pregnancy and Mental Health
• ACOG Guidelines on Psychiatric Medication Use During Pregnancy and Lactation
• The Management of Alcohol Withdrawal During Pregnancy
• Ethical Considerations in Treating Women with Mental Illness During Pregnancy

Also, you can find resources for Suicide Prevention on the Joint Commission Suicide Prevention Portal. Lastly, there’s some excellent resources for suicide assessment tools for perinatal women at Policy Center for Maternal Mental Health.

Implications for Your Joint Commission Survey

So, with this Joint Commission focus on pregnancy and mental health conditions, what are the implications for your survey? Clearly, if your organization serves perinatal and/or postpartum women, surveyors will evaluate whether you’ve considered perinatal and/or postpartum aspects when screening and assessing for suicide risk and planning for care, treatment, and services.

For example, during individual tracers, surveyors will review suicide screening and assessment tools, policies/procedures, MARs, care/treatment plans. They’ll also interview staff and patients/individuals, to ensure you’re implementing practices to safeguard pregnant and/or postpartum women.

Additionally, surveyors will further explore gaps they’ve identified in safe practices through system tracers:  primarily Medication Management, and Competence Assessment sessions.  Be prepared for these sessions by making the following information available:

• Medication Management policies, procedures, and protocols including any related to safe practices for care, treatment and services of perinatal and/or postpartum women as applicable.
• Competence assessments related to the care of perinatal and/or postpartum women as applicable.
• Policies & procedures related to suicide screening and assessment; physical and psychiatric assessment and the care plan/plan for care treatment and services for perinatal and/or postpartum women as applicable.

Barrins & Associates Consultation

With this Joint Commission focus on pregnancy and mental health conditions, we’re ready to customize our consultation if your organization serves this patient population.  As always, our team of TJC and CMS expert consultants is available to help you attain and sustain your Joint Commission accreditation through a Mock Survey, Custom Consultation and/or a Continuous Readiness Consultation.