Evaluating the Impact of a Pediatric Inpatient Social Care Program in a Community Hospital.
Jana C Leary, Hannah Bagley, Iris T Chan, Jennifer L Coates, Amy M Foote, Jennifer E Murzycki, Tiffany A Perkins, Christopher P Landrigan, Karen M Freund, Arvin Garg
Author Information
Jana C Leary: Department of Pediatrics, Tufts Medicine Pediatrics with Boston Children's Hospital.
Hannah Bagley: Department of Medicine, Tufts Medical Center, Boston, Massachusetts.
Iris T Chan: Tufts University School of Medicine, Boston, Massachusetts.
Jennifer L Coates: Tufts University School of Medicine, Boston, Massachusetts.
Amy M Foote: Department of Pediatrics, Lowell General Hospital, Lowell, Massachusetts.
Jennifer E Murzycki: Department of Pediatrics, Tufts Medicine Pediatrics with Boston Children's Hospital.
Tiffany A Perkins: Department of Pediatrics, Tufts Medicine Pediatrics with Boston Children's Hospital.
Christopher P Landrigan: Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Karen M Freund: Department of Medicine, Tufts Medical Center, Boston, Massachusetts.
Arvin Garg: Department of Pediatrics, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts.
OBJECTIVES: To evaluate the impact of implementing a stakeholder-informed social risk screening and social service referral system in a community hospital setting. METHODS: We implemented a stakeholder-informed social care program at a community hospital in April 2022. The evaluation included patients aged 0 to 17 years admitted to the pediatric unit between April 2021 and March 2022 (1 year preimplementation) and between April 2022 and March 2023 (1 year postimplementation). For a random subset of 232 preimplementation and 218 postimplementation patients, we performed manual data extraction, documenting program process measures and preliminary effectiveness outcomes. We used χ square and Wilcoxon rank tests to compare outcomes between the preimplementation and postimplementation groups. Multivariable logistic regression was used to assess the preliminary effectiveness of the social care program in identifying social risks. RESULTS: Screening rates were higher in the postimplementation group for nearly all social domains. Compared with preimplementation, the postimplementation group had higher rates of social risks identified (17.4% vs 7.8% [P < .01]: adjusted odds ratio 2.9 [95% confidence interval 1.5-5.5]) on multivariate testing. Social work consults were completed more frequently and earlier for the postimplementation group (13.8.% vs 5.6% [P < .01]) and median (19 hours vs 25 hours [P = .03]), respectively. Rates of communication of social risks in discharge summaries were higher in the postimplementation group (46.8% vs 8.2% [P < .001]). CONCLUSIONS: The implementation of a stakeholder-informed social care program within a community hospital setting led to the increased identification of social risks and social work consultations and improved timeliness of social work consultations and written communication of social risks in discharge summaries for primary care providers.
