Associate Chief, Newborn Medicine Tufts University School of Medicine Boston, Massachusetts, United States
Background: Parental engagement and presence during the prolonged NICU stay is critical for improved neonatal outcomes and successful stress free discharge home. However, parental social determinants of health (SDoH) create significant barriers for both parental engagement as well as presence. Ability to support families with personalized support can positively impact the neonatal outcomes. Objective: We aimed to increase formal SDoH screening and resource provision for families of NICU infants admitted 7 days by 50% of baseline from 07/01/2023 to 12/31/2023 at a Level IIIb NICU. Design/Methods: As a part of a multi-site quality improvement (QI) collaborative in Massachusetts, we created a multi-disciplinary team at Tufts Medical Center. This team included physicians, nurses, social workers, ex- NICU parents and child life specialists. From 01/01/2023 to 6/30/2023 we collected baseline data for formal SDoH screening, and developed materials for parental education and welcome packages. Starting 7/01/2023 we implemented formal SDoH screening, performed and documented in the infant electronic health records (EHR) by the social service team members. These included screening for any unmet basic needs, followed by specific needs for housing, transportation, food, childcare, heat/utilities, employment and/or education. We also followed up on successful resolution of needs identified, with ongoing continued support from the social services team. Starting 10/01/2023 we began a family education and engagement PDSA cycle of sharing information and providing welcome packages. Our main outcome was percent of eligible families approached for screening. Our secondary outcomes were percent of families who received resources for needs identified, families who received welcome packages and families who consented to give feedback on their experiences through surveys. Results: We present data on 126 infants admitted 7 days from 1/01/23-7/31/23. Among 29 families approached after formal SDoH screening was instituted starting 7/01/2023 all 29 (100%) were screened. Of those screened 1 identified need for housing and 1 identified need for transportation and both of those received appropriate resources for their needs. Since implementing the family engagement PDSA thus far 21 families have received the welcome packages and all 21 consented to provide feedback on the project after discharge.
Conclusion(s): Implementation of SDOH screening and referral using formal screening is feasible to identify unmet basic needs. As next steps increasing engagement with families along with the screening will help personalize family support.
