WIP 78 - Improving Screening for Social Drivers of Health in Hospitalized Pediatric Patients

Publication Number: WIP 78.7468

Charissa Lau, CHOC Children's Hospital of Orange County, Orange, CA, United States; Holly Birkinshaw, CHOC Children's Hospital of Orange County, Orange, CA, United States; Erika Jewell, CHOC Children's Hospital of Orange County, Orange, CA, United States; Shelby K. Shelton, Children's Hospital of Orange County, Orange, CA, United States; Raymen R. Assaf, CHOC Children's Hospital of Orange County, Orange, CA, United States; Britanny Winckler, University of California, Irvine, School of Medicine, Orange, CA, United States

Background: The Centers for Medicare & Medicaid Services mandated inpatient screening for social drivers of health (SDOH) in 2024. These SDOH are associated with poor health outcomes including longer hospital stays, greater hospital readmission rates, and higher morbidity and mortality. Hospitalization provides an opportunity to identify social needs and provide interventions, with the ultimate goal of improving patient health. Baseline data at our institution revealed an average inpatient SDOH screening rate of 7%, representing an opportunity for improvement.

Objective: We applied improvement science methodology with the objective to increase SDOH screening of pediatric patients hospitalized in acute care units from 7% to 20% within six months.

Design/Methods: A multidisciplinary team of physicians, residents, nurses, and social workers (SW) was formed at our free-standing, suburban, tertiary children’s hospital. A process map, key driver diagram, and Ishikawa diagram were created. The project was approved by the Institutional Review Board. The primary measure was the percentage of admitted patients screened for SDOH (process). Additional measures included the percentage of positive SDOH screenings (process) and percentage of urgent SW assessments completed (outcome). Balancing measures included length of stay, staff satisfaction, and perceived impact on other duties. Plan-Do-Study-Act Cycles (C) began in June 2024. C1: A new electronic SDOH screening tool, accessible by QR code, was developed. A new screening process was piloted on one unit. C2. The tool was expanded to another unit. C3: Unit secretaries conducted daily rounds, ensuring patients had received the tool. C4: The tool was expanded to all inpatient units. SW stopped offering the old tool. C5: Additional unit secretaries implemented daily rounds. C6. Computer signs were posted, reminding physicians to confirm patients had received the tool. C7: Additional staff education was provided. Gemba walks, staff surveys, and patient/family interviews were conducted and control charts were analyzed for impact.