Implementing Inpatient Social Needs Screening in an Urban Tertiary Care Children's Hospital

Area of Science:

• Pediatric Health
• Quality Improvement Science
• Social Determinants of Health

Background:

• The American Academy of Pediatrics advocates for screening unmet social needs in pediatric care.
• Growing literature supports inpatient screening for social needs.
• Standardized implementation of social needs screening in hospitalized children is an area of active development.

Purpose of the Study:

• To implement standardized social needs screening for hospitalized pediatric patients using quality improvement (QI) methods.
• To increase the percentage of screened pediatric inpatients.

Main Methods:

• Utilized the Model for Improvement with plan-do-study-act cycles for iterative intervention development.
• Interventions included structured questionnaires, standardized workflows, EHR modifications, and staff education.
• Primary outcome: percentage of discharged patients screened; defined as completed EHR questionnaire or social work evaluation.

Main Results:

• Mean monthly screening rates increased from 20% at baseline to 51% during the intervention period.
• Statistical process control charts indicated special cause variation for screening completion, EHR documentation, and social work consults.
• QI methods demonstrated effectiveness in improving screening rates.

Conclusions:

• Quality improvement methods facilitate the implementation of social needs screening in pediatric hospital settings.
• Future efforts should prioritize sustainability and the expansion of screening practices.
• Interdisciplinary team involvement is crucial for sustaining and spreading screening interventions to a larger pediatric inpatient population.