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P040
Using Social Determinants in Pediatric Primary and Specialty Care Clinics
Purpose: The purpose of this project was to implement social determinants screening to assess patient and family needs in an outpatient pediatric primary and specialty care setting.
Description: Health equity and anti-racism work are critical priorities for healthcare organizations, including this organization. As part of the organization’s focus on delivering on the health equity and anti-racism action plan, social determinants screening was approved by organizational leadership in May 2021 to better understand patient needs and barriers to care, with a goal of implementation within 6 months of project approval.
To prepare for the implementation into the ambulatory care primary and specialty clinics, a multidisciplinary team was formed with members from nursing and provider leadership, nursing informatics, health educators, social work, marketing and communication, registration staff, and electronic health care analysts. The project team identified unique challenges in a pediatric setting that required addressing prior to executing this important screening. These circumstances include addressing concerns for the child’s awareness of any hardships or insecurities a family may be experiencing, navigating shared access to the electronic medical record for legal guardians, and ensuring patient and caregiver safety for specific domain responses that may identifying an immediate safety concern. Four domains were selected for implementation, including transportation, food security, housing, and financial resources.
The patient population eligible for screening included all patients and families with appointments with their healthcare provider. Patient screening occurred through electronic tablets with the responses loading directly into the patient’s medical record for review by the healthcare team. Starting in November 2021, implementation across specialties and sites of care across 3 states occurred in a phased approach over the course of a year. No new resources were created for the first phase of the go-live and follow-up on patients indicating needing follow-up occurred via existing organizational resources and channels.
Evaluation/outcome: As of July 2023, over 1000 patients per month are requesting support for resources related to transportation, food security, housing, and financial resources. In response to clinician feedback, decision support tools were also developed and implemented over the phased implementation, including reports in the electronic medical record to ensure every patient received follow up who requested so. This resulted in an improvement from baseline of 31% compliance to documentation standards to nearly 80% compliance standards. We were also able to demonstrate improved screening scores in over 1000 patients with on subsequent social determinants screening. As a result of this screening and to better address the needs of the patients in the community, an additional FTE resource was identified and added to the team for SDOH follow-up.
Description: Health equity and anti-racism work are critical priorities for healthcare organizations, including this organization. As part of the organization’s focus on delivering on the health equity and anti-racism action plan, social determinants screening was approved by organizational leadership in May 2021 to better understand patient needs and barriers to care, with a goal of implementation within 6 months of project approval.
To prepare for the implementation into the ambulatory care primary and specialty clinics, a multidisciplinary team was formed with members from nursing and provider leadership, nursing informatics, health educators, social work, marketing and communication, registration staff, and electronic health care analysts. The project team identified unique challenges in a pediatric setting that required addressing prior to executing this important screening. These circumstances include addressing concerns for the child’s awareness of any hardships or insecurities a family may be experiencing, navigating shared access to the electronic medical record for legal guardians, and ensuring patient and caregiver safety for specific domain responses that may identifying an immediate safety concern. Four domains were selected for implementation, including transportation, food security, housing, and financial resources.
The patient population eligible for screening included all patients and families with appointments with their healthcare provider. Patient screening occurred through electronic tablets with the responses loading directly into the patient’s medical record for review by the healthcare team. Starting in November 2021, implementation across specialties and sites of care across 3 states occurred in a phased approach over the course of a year. No new resources were created for the first phase of the go-live and follow-up on patients indicating needing follow-up occurred via existing organizational resources and channels.
Evaluation/outcome: As of July 2023, over 1000 patients per month are requesting support for resources related to transportation, food security, housing, and financial resources. In response to clinician feedback, decision support tools were also developed and implemented over the phased implementation, including reports in the electronic medical record to ensure every patient received follow up who requested so. This resulted in an improvement from baseline of 31% compliance to documentation standards to nearly 80% compliance standards. We were also able to demonstrate improved screening scores in over 1000 patients with on subsequent social determinants screening. As a result of this screening and to better address the needs of the patients in the community, an additional FTE resource was identified and added to the team for SDOH follow-up.
Learning Objective
- After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.
Speaker
Sara Storhoff, MSN, RN-BC
Specialties
General
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