Related Experiment Video
Updated: Sep 19, 2025
Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
Feasibility, Acceptability, and Appropriateness of Screening and Referring for Social Risks in a Community Hospital
Jana C Leary1, Hannah Bagley2, Frank P Giacchetto3
1Division of General Pediatrics (JC Leary and CP Landrigan), Boston Children's Hospital, Boston, Mass.
Insights
A new pediatric inpatient social care system was successfully implemented in a community hospital, proving feasible, acceptable, and appropriate. Key challenges and improvements were identified for future social care system strategies.
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.
Objective:
In response to American Academy of Pediatrics and Centers for Medicare & Medicaid Services recommendations, a growing number of hospitals are implementing inpatient social care systems, but nearly all pediatric studies to date have been conducted in children's hospitals. In 2022, a university-affiliated community hospital implemented a pediatric inpatient social risk screening and referral system. We aimed to assess the feasibility, acceptability, and appropriateness of this system in the community hospital setting.
Methods:
We used a concurrent mixed methods approach from March to December 2023, surveying parents of hospitalized children and clinicians who perform or respond to screening, to assess implementation outcomes-feasibility, acceptability, and appropriateness-using validated measures based on 5-point Likert scales. We concurrently performed semistructured interviews assessing clinician and parent experiences with implementation and performed a thematic analysis.
Results:
Forty-three parents (67%) and 31 clinicians (78%) completed surveys, and 20 interviews (11 parents and 9 clinicians) were performed. Among parents and clinicians, respectively, 95% and 97% rated implementation as feasible, 97% and 93% as acceptable, and 95% and 97% as appropriate. Interview themes emerged regarding feasibility: 1) community/hospital resources enable social care, 2) challenging limitations in social service personnel; acceptability: 1) value added to inpatient care, 2) positive impact on families' health, 3) inadequate expectation-setting concerns; and appropriateness: 1) natural fit within workflows, 2) desire for different modality/timing options.
Conclusions:
Implementation of a pediatric inpatient social care system was feasible, acceptable, and appropriate in a community hospital setting; however, challenges and key areas for improvement were identified that can serve as leverage points for future implementation strategies.
Related Concept Videos
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Preventive Healthcare Services
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...