Implementation and Impact of a Novel Protocol for Inpatient Asylum-Seeking Children

Area of Science:

• Pediatrics
• Public Health
• Social Work

Background:

• Record numbers of immigrant families arriving at the U.S. southern border present unique challenges for healthcare systems.
• Hospitalized asylum-seeking patients and their families often have complex social, legal, and medical needs.
• Tertiary care children's hospitals require tailored protocols to address the needs of this vulnerable population.

Purpose of the Study:

• To develop and implement an inpatient asylum protocol (IAP) to identify, screen, and support hospitalized asylum-seeking patients and families.
• To provide specialized social work, case management, and legal support during hospitalization and post-discharge.
• To evaluate the effectiveness of the IAP in addressing the multifaceted needs of newly arrived asylum-seeking families.

Main Methods:

• A multidisciplinary team developed and implemented the IAP at a tertiary care children's hospital.
• Patients were enrolled, screened for needs, and provided with integrated support services.
• Longitudinal follow-up was conducted post-discharge to ensure engagement with community resources.

Main Results:

• 47 patients were enrolled over 2.5 years, revealing significant food, housing, and legal needs.
• Half of patients required inpatient subspecialty consultations and outpatient follow-up; 13% qualified for complex care.
• The IAP successfully connected 93% of families to legal resources and 96% to primary care physicians, with all receiving ongoing social work support.

Conclusions:

• The novel Inpatient Asylum Protocol (IAP) effectively addressed the complex needs of hospitalized asylum-seeking patients and families.
• The program facilitated crucial connections to social work, legal aid, and primary care, improving patient and family outcomes.
• This protocol serves as a model for other institutions seeking to support newly arrived immigrant families in healthcare settings.