The role of pediatric networks in managing social health needs

Gunn, Veronica L.; Brixey, Suzanne N.

doi:10.1016/j.cppeds.2021.101066

Cited by 5 publications

(16 citation statements)

References 15 publications

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“…It is argued in the literature that pediatrics must evolve to address upstream care-care that addresses underlying social risk through strategic partnerships with community organizations-to help avoid potential adverse childhood events. [30][31][32][33] A crucial step in that evolution is as a more durable, pragmatic, and ethically sound approach to EDbased social care. [33][34][35] However, even a "perfect" social care system in the ED may fail at times, and most pediatric EDs remain without an integrated social care system as evidenced by our study.…”

Section: Discussionmentioning

confidence: 99%

“…Together, these findings demonstrate a discord between existing systems and providers’ perceived value of social care delivery in the ED. It is argued in the literature that pediatrics must evolve to address upstream care—care that addresses underlying social risk through strategic partnerships with community organizations—to help avoid potential adverse childhood events 30‐33 . A crucial step in that evolution is better equipping the ED to address patient social needs in an organized fashion of systematically screening and referring in coordination with community resources.…”

Section: Discussionmentioning

confidence: 99%

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Social care practices and perspectives among U.S. pediatric emergency medicine fellowship programs

Barber‐Doucet

Assaf²,

Graff

2022

AEM Education and Training

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Background The emergence of social emergency medicine—the incorporation of social context into the structure and practice of emergency care—has brought forth greater embracement of the social determinants of health by medical professionals, yet workforce practices and training have remained elusive. Academic literature particularly in the field of pediatric emergency medicine (PEM) fellowship training is lacking relative to general pediatrics and adult emergency medicine. Methods The primary objective of this study was to assess the social care knowledge, perspectives, and training of PEM program directors (PDs) and fellows across a national cross‐sectional sample. A secondary aim was to uncover key actionable areas for the development of social care curricula in PEM training programs. A social care practices assessment tool was developed via snowball sampling interviews among clinician researcher experts and disseminated to PEM PDs and fellows nationally in accredited academic PEM training institutions. Results A total of 153 participants—44 PDs (49% response rate) and 109 fellows (28%)—completed the assessment tool. Responses among PDs and fellows were highly concordant. Only 12% reported regular use of a standardized social needs screening tool. The majority felt unprepared to assist families with social needs and less than half felt comfortable talking to families about social need. At the same time, social care was highly valued by 73% of participants. All participants felt that providing social care training during PEM fellowship would be beneficial. PDs and fellows identified five priority areas for PEM curricular development. Conclusions PEM PDs and fellows have an overall favorable perception of social care yet report significant deficits in current practice organization and training. This study is part of a larger national collaborative advocacy project to organize and advance social care delivery across academic PEM training institutions through evidence‐based approaches, best practices, and expert consensus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Social care practices and perspectives among U.S. pediatric emergency medicine fellowship programs

Barber‐Doucet

Assaf²,

Graff

2022

AEM Education and Training

View full text Add to dashboard Cite

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“…in the ED has expanded and process improvement models have been developed for social risk assessment, referral, and service coordination but are yet to be broadly adapted into practice. 2,3,7,12,[16][17][18][19][20] This national research identifies a connection between physician social risk awareness and assistance practices (screening and referral activity, respectively) with ED organizational capacity. PEM PDs and fellows were more likely to perform social risk screening and referral when there was a social care systematic workflow in place.…”

Section: Discussionmentioning

confidence: 99%

“…Despite a surge of literature demonstrating significant unaddressed social needs among families in the emergency department (ED) and their impact on child health, there remains no standard organizational practice of social care in the ED 1–4 . Social care includes activities that address health‐related social risk and social needs, whereas social risk encompasses social conditions associated with poor health, social needs are the specific conditions in which patients and their families request assistance 5 .…”

Section: Introductionmentioning

confidence: 99%

“…In the ED, effectively addressing social needs poses systemic dilemmas in workforce training, resource allocation, clinical operations, and workflow 2 . Successful models have been published by individual medical centers; however, the majority of pediatric emergency departments (PEDs) lack comprehensive structure to support two primary social care functions: awareness and assistance 3,5,6,11,12 . Awareness includes health care system activities that identify social risk, while assistance refers to those that reduce social risk by connecting patients with relevant community resources 5…”

Section: Introductionmentioning

confidence: 99%

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Pediatric emergency department organization and social care practices among U.S. fellowship programs

Assaf¹,

Doucet

Graff

2022

AEM Education and Training

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Background: Social care has become increasingly relevant to the emergency physician and includes activities that address health-related social risk and social needs. The literature has consistently documented substantial health care provider challenges in incorporating social care into routine practice. Yet, interventions on the health care organizational level hold promise to bring about more widespread, sustainable impact. Methods: This study was a subanalysis of the 2021 National Social Care Practices Survey data set among pediatric emergency medicine (PEM) program directors (PDs) and fellows. The purpose was to investigate the association between health care organizational factors and PEM physician social care practices and perceptions among PEM PDs and fellows. We performed binary and ordinal logistic regressions of organizational factors and five specific PEM physician social care perspective and practice outcomes. Results:The sample population included 153 physicians-44 PDs (49% response rate) and 109 fellows (28%). PDs and fellows with access to a social care systematic workflow in their pediatric emergency department (PED) had higher odds of comfort assessing social risk (odds ratio [OR] 2.1%, 95% confidence interval [CI] 1.1-4.0), valuation of social care (OR 3.2, 95% CI 1.3-7.9), preparedness to assist families (OR 2.4, 95% CI 1.1-5.2), screening tendency (OR 2.2, 95% CI 1.1-4.5), and ability to refer to community resources (OR 2.3, 95% CI 1.2-4.6). A similarly directed, but less pronounced pattern was noted with access to a community resource database for referrals and 24-h access to a social worker in the PED.

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Foreword for clinically integrated networks and the future of primary care

Harrington¹,

Brixey²

2021

Current Problems in Pediatric and Adolescent Health Care

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The role of pediatric networks in managing social health needs

Cited by 5 publications

References 15 publications

Social care practices and perspectives among U.S. pediatric emergency medicine fellowship programs

Social care practices and perspectives among U.S. pediatric emergency medicine fellowship programs

Pediatric emergency department organization and social care practices among U.S. fellowship programs

Foreword for clinically integrated networks and the future of primary care

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