Caregiver experiences with inpatient health-related social needs screening

OBJECTIVE: Screening rates and methods for health-related social needs (HRSNs) in the inpatient pediatric space vary across institutions. We aimed to understand caregiver perspectives regarding inpatient HRSN screening on a pediatric hospital medicine service. 

METHODS: This qualitative study used purposive and convenience sampling to recruit caregivers on a pediatric hospital medicine service after they were screened for food insecurity, housing concerns, and transportation limitations. A semistructured interview format using an interview guide driven by the health equity implementation framework was used. Topics that were discussed included thoughts on inpatient HRSN screening, experience with the screening process, and perspectives on screening format. Two-person transcript coding was completed via a hybrid inductive and deductive approach until sufficiency was reached, and themes were derived. 

RESULTS: Fourteen caregivers were interviewed. Three key themes were derived. First, screening shows families that the hospital cares about them. Second, who, how, where, and when screening happens matters. Most caregivers preferred private, in-person screening by the social work team to feel safe disclosing information. Many felt that the emergency department was not a good location to screen. Downtime during hospitalization was identified as a good time for screening, although day of discharge was not ideal. Finally, our inpatient screening approach employing family services associates made families feel comfortable and "more real." 

CONCLUSIONS: Caregivers believe that inpatient HRSN screening is important, and screening is well received. Specific preferences included in-person screening by the social work team in the patient's room prior to day of discharge.