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. 2022 Apr;22(3):470-477.
doi: 10.1016/j.acap.2021.09.015. Epub 2021 Sep 30.

Clinical Stakeholder Perspectives on Pediatric Inpatient Screening for Social Needs

Jana C Leary  1 , Leena Rijhwani  2 , Natalie M Bettez  3 , Amy M LeClair  4 , Anays Murillo  3 , Maria Rodriguez Berrios  4 , Arvin Garg  5 , Karen M Freund  4
Affiliations

Clinical Stakeholder Perspectives on Pediatric Inpatient Screening for Social Needs

Jana C Leary et al. Acad Pediatr. 2022 Apr.

Abstract

Objectives: Social determinants of health are major drivers of health outcomes and quality of life. While several social needs screening tools have been created for use in primary care settings, the best procedures to incorporate these tools into hospital workflow remain unclear. This study aimed to elicit clinical stakeholder perspectives on proposed screening for social needs during pediatric hospitalizations, with particular focus on informing implementation strategies.

Methods: We conducted 23 semistructured interviews with pediatric clinical stakeholders (physicians, nurses, social workers, and case managers) at 1 tertiary and 2 community hospitals between July 2020 and January 2021, on topics including social needs screening practices, benefits and challenges to inpatient screening, and optimal screening and referral processes within hospital workflow. Interviews were recorded, professionally transcribed, and analyzed thematically.

Results: Participants ranged in age from 25 to 62 years, with nearly half working in community hospitals. Regarding inpatient social needs screening, themes emerged about benefits, including enabling clinicians to identify vulnerable patients/moments, and providing clinicians with comprehensive understanding of social context; barriers, including prioritization of medical needs, lack of clinician education surrounding screening, and lack of pre-established relationships; facilitators, including duration of time spent with families, and multidisciplinary clinicians; screening process preferences, including verbal screening, and integration into pre-existing systems; and referral process preferences, including resource provision with family empowerment, and care transition to outpatient clinicians.

Conclusions: Clinical stakeholders identified multiple barriers, facilitators, and process preferences for pediatric inpatient social needs screening, which may inform the future development of feasible and sustainable implementation strategies.

Keywords: Qualitative; Screening; Social determinants of health.

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Conflict of interest statement

Conflict of Interest: The authors have indicated they have no potential conflicts of interest to disclose.

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