Standardized SDOH screenings increased awareness of unmet needs and supported partnerships between the medical and social work teams. Rapid PDSA cycles and frequent data collection were critical to improving the percentage of patients with a completed screen. Key to sustainability will be further integration with the electronic health record. This quality improvement project aims to increase visibility to the medical team of important social and environmental factors that are known to disproportionately impact health care outcomes. As part of this ongoing work, an original pediatric oncology social determinants of health screening tool was implemented to quickly identify barriers that impact patient care and facilitate discussion about patients’ unmet needs. The tool was created with input from all stakeholders to ensure optimal feasibility and functionality for everyone. Success stories from this project demonstrate an overall enhanced awareness of patients’ needs and strengthened partnerships between care teams.
Problem: Disparities in survival outcomes for childhood cancers persist and may continue to widen. Social determinants of health can impact patients’ abilities to obtain a timely diagnosis, receive appropriate treatment, and adhere to therapy. Despite the significant repercussions of these factors, they can be difficult to recognize and discuss
Measurement: One measured goal for this project is to increase the percentage of newly diagnosed oncology or admitted bone marrow transplant patients with a completed SDOH screen to 80%. Data is visualized using run charts. Other tools utilized include a key driver diagram, process flowcharts, and Plan-Do-Study-Act cycles for rapid testing
Analysis: Data collection began in February 2022, and results are evaluated using run charts to monitor improvements over time. Standard run chart rules are applied: signals of nonrandom variation identify improvement. Results are obtained through monthly chart audits and messaging within the electronic medical record
Implementation: The psychosocial team reviewed evidence-based health screeners to develop a unique SDOH screening tool for pediatric oncology. Limited time to complete screens and communicate results to the broader care team was approached through stakeholder engagement, PDSA cycles, and standardization. Others can apply this tool to facilitate patient-centered communication.-wide
