Feasibility, Acceptability, and Appropriateness of Screening and Referring for Social Risks in a Community Hospital...

Area of Science:

• Healthcare Management
• Pediatric Health Services
• Social Determinants of Health

Background:

• Hospitals are increasingly adopting inpatient social care systems, driven by recommendations from the American Academy of Pediatrics and Centers for Medicare & Medicaid Services.
• Most existing research on pediatric inpatient social care is limited to children's hospitals, leaving a gap in understanding implementation in community settings.

Purpose of the Study:

• To evaluate the feasibility, acceptability, and appropriateness of a pediatric inpatient social risk screening and referral system implemented in a university-affiliated community hospital.
• To identify implementation challenges and areas for improvement in community hospital settings.

Main Methods:

• A concurrent mixed-methods approach was employed from March to December 2023.
• Surveys using validated Likert scales assessed implementation outcomes (feasibility, acceptability, appropriateness) among parents and clinicians.
• Semistructured interviews were conducted with parents and clinicians to explore their experiences, followed by thematic analysis.

Main Results:

• High ratings for feasibility (95% parents, 97% clinicians), acceptability (97% parents, 93% clinicians), and appropriateness (95% parents, 97% clinicians) were reported.
• Key themes included the enabling role of community/hospital resources, limitations in social service personnel, perceived value and positive health impacts for families, and workflow integration.
• Areas for improvement included managing expectations and exploring alternative service delivery modalities and timing.

Conclusions:

• The implementation of a pediatric inpatient social care system is feasible, acceptable, and appropriate within a community hospital setting.
• Identified challenges and areas for improvement provide valuable insights for refining future social care implementation strategies in similar environments.