(96) Integrating Social Determinants of Health Screening into Resident Workflow in a Level IV NICU

Background: Social disparities are associated with decreased follow-up rates in premature infants [Swearingen et all, 2020]. Despite the recognized importance of addressing unmet needs, only 23% of US Level II-IV NICUs report implementing screening for social determinants of health (SDoH) [Cordova-Ramos et al, 2022]. At Children’s Wisconsin (CW), a Level IV NICU, nearly 20% of families identified resource needs when screened during admission [Hoffman et al, 2024]. Despite this significant finding, no formal workflow for SDoH screening exists to ensure consistency in screening and follow-up prior to discharge.

Objectives: The aim of this project is to integrate SDoH screening into the NICU resident team workflow, with the goal of increasing the number of families with a completed SDoH questionnaire documented in EPIC during the patient’s hospitalization.

Design/Methods: All residents rotating in the NICU were emailed a project overview, including instructions on accessing the SDoH screener in EPIC and encouraged to discuss the questionnaire with families during hospitalization from January to April 2025. Residents were also asked to document completed screenings by adding a standard phrase in the discharge summary.

Results: Baseline data of completed screenings prior to implementation was 25% (9 completed screens/35 admissions). There was no significant improvement of screenings after new workflow implementation [18/62, p=0.8]. Only 4.8% (3/62) of discharge summaries included SDoH details.

Conclusions: Barriers to implementation included limited resident awareness, task burden during a high-acuity rotation, and uncertainty about addressing identified social needs. Future iterations will focus on simplifying the workflow by (1) shifting the screening goal to “any time during admission,” (2) removing the discharge summary requirement, and (3) offering both digital and paper-based screening options to improve accessibility and uptake.