Table 2 Common Barriers and Facilitators to Implementation of Social Needs Screening and Referral programs in Pediatric Primary Care settings
From: Social needs screening and referral in pediatric primary care clinics: a multiple case study
Barriers | Facilitators |
|---|---|
Caregiver Inability or Reluctance to Screening Sites reported that a substantial proportion of caregivers were either unable to complete the screening tool due to low literacy or were reluctant to complete screening due to privacy concerns. | Workflow Routinization Sites achieved higher screening completion when they were able to integrate the screening process into the normal clinic workflow in a seamless manner. Strategies to pre-identify patients eligible for screening before their visit also proved effective. |
Lack of Technological Resources Sites without resources to screen through electronic methods found paper-based screening to be cumbersome and data entry was time consuming. Providers were also not as aware of their patients’ social needs due to lack of automated EMR integration. | Availability of Technological Resources Sites that utilized tablet-based screening found it helpful for EMR integration and provider engagement in social needs discussions with families. |
Temporary/Part-Time Dedicated Staff Sites that utilized part-time volunteers to assist caregivers in filling out screening tools found it difficult to handle frequent turnover and gaps in coverage. | Full-Time Permanent Dedicated Staff The consistent presence of a staff member dedicated to helping caregivers complete screening assessments was found to be extremely valuable. |
Lack of Shared Clinic-CBO Tracking System Clinics and CBOs were generally unable to utilize the same data system due to HIPAA requirements, which made tracking and communicating about referrals challenging. | Strong Clinic-CBO Communication Establishing a system and cadence to facilitate communication between the clinic and CBO was seen as key to a successful partnership. |
Low Caregiver Engagement Post-Screening Clinic-CBO teams often struggled with reaching caregivers after the screening process to engage them in referral and services. | Shared CBO-Clinic Staff Sites that employed a shared staff member solely dedicated to assisting caregivers referred by the clinic partner found that it was effective at minimizing caregivers who were lost-to-follow-up after being referred to services. |
Sustainable Funding Sites did not have a formal plan in place for funding to sustain their programs after the grant period. | Institutional Support Sites that felt that their institution was open to ideas for finding a way to continue their program and potentially expand were hopeful they could sustain this work in the future. |