Caregiver Perspectives on Social Needs Screening and Interventions in an Urban Children's Hospital.

OBJECTIVES: Caregiver opinions of inpatient social needs screening and ways of addressing positive screens are not well understood. We aimed to explore caregiver perspectives and goals surrounding inpatient screening and determine how helpful provided resources are at meeting these goals. METHODS: We conducted a qualitative study using semistructured interviews with caregivers of pediatric patients admitted to an urban tertiary care children's hospital from April to August 2021. English- and Spanish-speaking caregivers who screened positive for at least 1 social need on a standardized 10-item questionnaire were invited to participate in an interview 2 to 4 months after discharge. Interviews were recorded, transcribed, and analyzed by 2 independent coders using rapid qualitative methods. RESULTS: We completed 20 interviews, with 14 English-speaking and 6 Spanish-speaking caregivers. Four themes emerged: (1) All caregivers expressed support for inpatient social needs screening. (2) Many caregivers cited it as an effective means to support families and help providers better understand their social situation. (3) Caregivers who recalled receiving a resource packet found it useful and at times even shared the resources with others. (4) The majority of caregivers expressed interest in longitudinal support, such as contact after discharge. CONCLUSIONS: Caregivers are in support of inpatient screening as a means for providers to optimize comprehensive care that explores how unmet social needs influence health. Although inpatient social work and resource packets may be helpful, longitudinal support after discharge may improve the effectiveness of social needs interventions, patient outcomes, and caregiver satisfaction.

The Influence of the Electronic Health Record on Achieving Equity and Eliminating Health Disparities for Children.

The electronic health record (EHR) has been heralded as a transformative approach to modernizing health care and advancing health equity. Access to the EHR can facilitate shared clinical decision-making and improved communication with patients, families, and among health care providers. Recent legislative and regulatory efforts have been passed to increase the transparency as well as the initiatives to increase the meaningful use of the EHR. Yet despite these well-intended efforts, challenges to addressing health equity through the EHR persist. This article reviews three distinct challenges to addressing health equity related to the EHR. We discuss (1) both the implicit and explicit bias that exist in EHR documentation, (2) the gaps that remain between screening for social determinants of health and the effective inclusion and billing of that screening into the EHR, and (3) the disparities that exist with the use of patient portals. Addressing these three areas will enhance the opportunities to advance health equity through the use of the EHR and bring us one step closer to eliminating health disparities in pediatric health care. [Pediatr Ann. 2022;51(3):e112-e117.].