Jeffrey D Colvin1, Jessica L Bettenhausen2, Kaston D Anderson-Carpenter3, Vicki Collie-Akers4, Laura Plencner2, Molly Krager2, Brooke Nelson5, Sara Donnelly5, Julia Simmons2, Valeria Higinio6, Paul J Chung7. 1. Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Mo; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Mo. Electronic address: jdcolvin@cmh.edu. 2. Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Mo; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Mo. 3. Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Calif. 4. Work Group for Community Health and Development, University of Kansas, Lawrence, Kans. 5. Department of Social Work, Children's Mercy Hospitals and Clinics, Kansas City, Mo. 6. Turner House Children's Clinic, Kansas City, Kans. 7. Departments of Pediatrics and Health Policy & Management, University of California, Los Angeles, Calif; Children's Discovery and Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif; RAND Health, The RAND Corporation, Santa Monica, Calif.
Abstract
OBJECTIVE: It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. METHODS: During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. RESULTS: A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). CONCLUSIONS: A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs.
OBJECTIVE: It is critical that pediatric residents learn to effectively screen families for active and addressable social needs (ie, negative social determinants of health). We sought to determine 1) whether a brief intervention teaching residents about IHELP, a social needs screening tool, could improve resident screening, and 2) how accurately IHELP could detect needs in the inpatient setting. METHODS: During an 18-month period, interns rotating on 1 of 2 otherwise identical inpatient general pediatrics teams were trained in IHELP. Interns on the other team served as the comparison group. Every admission history and physical examination (H&P) was reviewed for IHELP screening. Social work evaluations were used to establish the sensitivity and specificity of IHELP and document resources provided to families with active needs. During a 21-month postintervention period, every third H&P was reviewed to determine median duration of continued IHELP use. RESULTS: A total of 619 admissions met inclusion criteria. Over 80% of intervention team H&Ps documented use of IHELP. The percentage of social work consults was nearly 3 times greater on the intervention team than on the comparison team (P < .001). Among H&Ps with documented use of IHELP, specificity was 0.96 (95% confidence interval 0.87-0.99) and sensitivity was 0.63 (95% confidence interval 0.50-0.73). Social work provided resources for 78% of positively screened families. The median duration of screening use by residents after the intervention was 8.1 months (interquartile range 1-10 months). CONCLUSIONS: A brief intervention increased resident screening and detection of social needs, leading to important referrals to address those needs.
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