Jana C. Leary MD, MS , Hannah Bagley BS , Frank P. Giacchetto BS , Kayley Pate BS , Amy M. Foote BSN, RN, CPN , Jennifer E. Murzycki MD, PhD , Karen M. Freund MD, MPH , Arvin Garg MD, MPH , Christopher P. Landrigan MD, MPH
{"title":"Feasibility, Acceptability, and Appropriateness of Screening and Referring for Social Risks in a Community Hospital Setting","authors":"Jana C. Leary MD, MS , Hannah Bagley BS , Frank P. Giacchetto BS , Kayley Pate BS , Amy M. Foote BSN, RN, CPN , Jennifer E. Murzycki MD, PhD , Karen M. Freund MD, MPH , Arvin Garg MD, MPH , Christopher P. Landrigan MD, MPH","doi":"10.1016/j.acap.2025.102872","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>feasibility</em>: 1) community/hospital resources enable social care, 2) challenging limitations in social service personnel; <em>acceptability</em>: 1) value added to inpatient care, 2) positive impact on families’ health, 3) inadequate expectation-setting concerns; and <em>appropriateness</em>: 1) natural fit within workflows, 2) desire for different modality/timing options.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102872"},"PeriodicalIF":2.8000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S187628592500097X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
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.
期刊介绍:
Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.