Outcomes From a Health-Related Social Needs Screening Initiative in Pediatric Orthopaedic Patients: A Prospective...

Area of Science:

• Pediatric Orthopaedics
• Health-Related Social Needs (HRSN)
• Quality Improvement (QI)

Background:

• Unmet health-related social needs (transportation, food, housing, financial, utility) are linked to adverse outcomes in pediatric orthopaedic patients.
• A prospective quality improvement (QI) study was designed to address this by implementing systematic screening and referral processes.

Purpose of the Study:

• To evaluate the feasibility and outcomes of a systematic screening initiative for health-related social needs (HRSN) in a pediatric orthopaedic clinic.
• To assess the impact of the initiative on screening rates, identification of social needs, and successful enrollment in resource management services.

Main Methods:

• A prospective QI study conducted at a tertiary care pediatric orthopaedic clinic.
• Implementation of an institutional social risk survey based on the Accountable Health Communities' HRSN Screening Tool.
• Comparison of data from a 9-month post-initiative period with a 3-month pre-initiative period, including demographic analysis and multivariable logistic regression.

Main Results:

• Screening rates significantly increased from 38% to 65% post-initiative (P<0.001), particularly for fracture/dislocation patients (37% to 76%).
• Among screened patients, 21% reported at least one social need, with financial insecurity (13%) and food insecurity (11%) being most prevalent.
• Referral rates increased to 87% and successful enrollment in services rose from 25% to 61% post-initiative (P=0.005).

Conclusions:

• Systematic screening for health-related social needs (HRSN) is feasible within pediatric orthopaedic settings.
• Orthopaedic encounters provide a valuable opportunity to identify families with unmet social needs and facilitate connections to essential resources.