"More than just giving them a piece of paper": Interviews with Primary Care on Social Needs Referrals to Community-Based Organizations.
"More than just giving them a piece of paper": Interviews with Primary Care on Social Needs Referrals to Community-Based Organizations.
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DOI：
10.1007/s11606-022-07531-3
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发表时间：
2022-12
影响因子：
5.7
通讯作者：
Fraze, Taressa K.
中科院分区：
文献类型：
--
作者：
Beidler, Laura B.;Razon, Na'amah;Lang, Hannah;Fraze, Taressa K.
初级保健做法正在响应将患者的社会风险因素（如住房、食物和经济不安全）纳入临床护理的呼吁。医疗保健可能依赖于社区组织的专业知识和资源来改善患者的社会状况，但对转诊过程知之甚少。通过初级保健实践描述转介到社区组织的特征。定性研究使用半结构化访谈负责社会护理工作的医疗保健管理人员在他们的组织。美国50个不同医疗保健组织的管理人员努力解决患者的社会风险。在初级保健中实施社会需求转介到社区组织的方法。接受采访的行政人员报告说，社会需要转介是他们社会关怀活动的一个基本要素。管理人员将理想的转诊项目描述为对护理团队施加有限的负担，为患者提供定制的转诊，并促进闭环转诊。我们确定了组织在尝试实施理想的推荐计划时遇到的三个关键挑战：(1)开发和维护资源列表；(2)将转诊与患者需求结合起来；(3)衡量转介的效能。总的来说，这些挑战导致组织依靠员工手动开发和更新资源列表，并且在大多数情况下，为患者提供一般转诊。管理人员不仅希望推荐平台可以帮助克服其中的一些障碍，而且还报告了平台在实施方面的挑战，包括员工之间不一致的接受和使用；与电子健康记录集成；资源的管理和优先次序；并与市场上的其他组织保持一致。转介到社区组织被用于初级保健，以改善患者的社会条件，但尽管有强烈的动机，受访者报告了向患者提供量身定制的最新信息的挑战。在线版本包含补充资料，可在10.1007/s11606-022-07531-3获得。
Primary care practices are responding to calls to incorporate patients’ social risk factors, such as housing, food, and economic insecurity, into clinical care. Healthcare likely relies on the expertise and resources of community-based organizations to improve patients’ social conditions, yet little is known about the referral process. To characterize referrals to community-based organizations by primary care practices. Qualitative study using semi-structured interviews with healthcare administrators responsible for social care efforts in their organization. Administrators at 50 diverse US healthcare organizations with efforts to address patients’ social risks. Approaches used in primary care to implement social needs referral to community-based organizations. Interviewed administrators reported that social needs referrals were an essential element in their social care activities. Administrators described the ideal referral programs as placing limited burden on care teams, providing patients with customized referrals, and facilitating closed-loop referrals. We identified three key challenges organizations experience when trying to implement the ideal referrals program: (1) developing and maintaining resources lists; (2) aligning referrals with patient needs; and (3) measuring the efficacy of referrals. Collectively, these challenges led to organizations relying on staff to manually develop and update resource lists and, in most cases, provide patients with generic referrals. Administrators not only hoped that referral platforms may help overcome some of these barriers, but also reported implementation challenges with platforms including inconsistent buy-in and use across staff; integration with electronic health records; management and prioritization of resources; and alignment with other organizations in their market. Referrals to community-based organizations were used in primary care to improve patients’ social conditions, but despite strong motivations, interviewees reported challenges providing tailored and up-to-date information to patients. The online version contains supplementary material available at 10.1007/s11606-022-07531-3.
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