In this public health practice vignette, we describe an ongoing community and system intervention to identify and address social determinants of health and related needs experienced by ChristianaCare patients and the greater community during the Coronavirus pandemic. This intervention, being conducted by the ChristianaCare Office of Health Equity, in partnership with ChristianaCare's embedded research institute, the Value Institute, and the Community Outreach and Education division of the Helen F. Graham Cancer Center and Research Institute, engages more than 25 community health workers, health Guides, Latinx health promoters and other social care staff as social first responders during the COVID-19 crisis. These experienced front-line social care staff screen patients and community members for social needs; make referrals to agencies and organizations for needed assistance (e.g., food, housing, financial assistance); assess people's understanding of COVID-19 and preventive measures; provide education about COVID-19; and, connect patients and community members to COVID-19 testing and any relevant clinical services. While this ongoing intervention is under evaluation, we share here some preliminary lessons-learned and discuss the critical role that social first responders can play in reducing the growing adverse social and health impacts of COVID-19 across the state of Delaware.

Health information technology implementation in the inpatient setting is associated with significant savings in labor hours and costs in non-registered nursing roles.

INTRODUCTION: Women with fetal growth restriction (FGR) are often counseled about the fetus being unable to tolerate induction of labor and the risk for cesarean delivery (CD) for non-reassuring fetal heart tracing (NRFHT), especially in the late preterm period (between 34.0 and 36.6 weeks, LPP). The purpose of our study was to determine the association between FGR and CD for NRFHT in the LPP. METHODS: We performed a single-center case control study of women undergoing induction of labor (IOL) in the LPP between January 2010 and January 2017. Women were included if they underwent IOL between 34.0 and 36.6 weeks gestation of pregnancy with a non-anomalous, vertex, singleton gestation. Women with a previous CD and contraindications to IOL were excluded. Rates of FGR in women undergoing CD for NRFHT were compared to those undergoing CD for other indication or vaginal delivery. RESULTS: The odds of FGR were statistically significant for women who underwent a CD for NRFHT as compared to those having a vaginal delivery or CD for other indication (AOR 4.0; 95% CI 1.97-8.08) and (AOR 3.08; 95% CI 1.13-8.43). African American women had higher odds of IUGR than their white counterparts (AOR 2.65; 95% CI 1.46-4.82). CONCLUSION: Women with a diagnosis of FGR are significantly more likely to have a CD for NRFHT than a CD for other indication or VD in the LPP. This information should be included in counseling women who are undergoing an IOL and have a diagnosis of FGR in the LPP regardless of their indication for induction.

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