Social determinants of health screening and intervention: A cystic fibrosis quality improvement process

Abstract

Introduction Lower socioeconomic status is associated with significantly poorer outcomes in weight, lung function, and pulmonary exacerbation rates in people with cystic fibrosis (PwCF). Global aim We aim to reduce health disparities and inequities faced by PwCF by screening for and addressing unmet social needs. Specific aims We aimed to increase routine social determinants of health (SDoH) screening of eligible PwCF from 0% to 95% and follow‐up within 2 weeks for those PwCF who screened positive and requested assistance from 0% to 95% by December 31, 2021. Methods The Model for Improvement methodology was used. A process map and a simplified failure mode effects analysis chart were created for the screening and SDoH follow‐up process. For those who screened positive for SDoH and requested assistance, follow‐up contact was made to offer intervention. Intervention Adult PwCF who had at least one UVA Clinic encounter in 2021 were screened for SDoH. The SDoH screening tool included eight domains: housing, food, transportation, utilities, health‐care access, medication access, income/employment, and education. Follow‐up was completed with all PwCF who screened positive for SDoH. Results A total of 132 of 142 (93.0%) PwCF eligible for screening completed the SDoH screening. Of the PwCF who completed screening, 56 (42.4%) screened positive for SDoH. A follow‐up rate of 100% was achieved in June 2021 and maintained through December 2021. Conclusion Implementing screening for SDOH and follow‐up to mitigate social difficulties in adult PwCF at UVA was successful and could be reproduced at other CF care centers.

Transcending Limitations: A Phenomenological Exploration of How Hygge Practices Enrich the Lived Experiences of Adults with Cystic Fibrosis

“…Not all individuals with CF can take the time required for self-reflection and mindful self-care behaviors. Many individuals with CF face socioeconomic burdens (e.g., poverty, unemployment, unreliable housing or utilities, food insecurity, lack of transportation, and limited access to health care or medications), all of which negatively impact CF outcomes (Jennings et al, 2022; Oates & Schechter, 2021). Thus, exploring screening and support for individuals with socioeconomic burdens in the CF community must be a primary step in identifying ways to improve self-care.…”

Increasing Social Determinants of Health Screening Rates Among Six Endocrinology Centers Across the United States: Results From the T1D Exchange Quality Improvement Collaborative

“…Through targeted interventions specific to each center, CGM use increased by 21% over 20 months. QI methods also have been successfully used to improve SDOH screening in other areas of medicine ( 23 – 25 ).…”

<b>Increasing Social Determinants of Health Screening Rates Among Six Endocrinology Centers Across the United States: Results From the T1D Exchange Quality Improvement Collaborative</b>

“…Through targeted interventions specific to each center, CGM use increased by 21% over 20 months. QI methods also have been successfully used to improve SDOH screening in other areas of medicine (23)(24)(25).…”