Background: Efforts have been made to increase social determinants of health (SDoH) screening to connect patients and families to community-based organizations (CBOs) and other resources. Tracking closed loop referrals is one potential measure to assist in assessing whether the resulting referrals and interventions have affected the child’s SDoH or improved the family’s well-being. Our team [...]

Background: Racial and ethnic disparities in heart failure (HF) care and outcomes occur, despite rapid improvement in HF therapies and survival [1,2]. The Burden of Treatment Theory is a framework for illustrating and explaining how interactions between patients, healthcare systems, and support networks affect their ability to manage a chronic illness, including HF [3]. We [...]

Background: Growth faltering or failure to thrive is a common cause of admission in infancy and early childhood. In the United States, approximately 2-10% of children experience lower-than-expected growth associated with malnutrition (Tang et al). Growth faltering accounts for 3-5% of pediatric hospitalizations (Mazze et al, 2019). Malnutrition is associated with complications of increased risk [...]

Background: Social needs are associated with poor medical outcomes, including increased readmissions. Several studies compare demographic or ICD-10 code indices of social risk and readmissions, or social needs in disease-specific readmissions. Others found that addressing needs is associated with decreased readmissions. However, little is known about how needs differ between patients who are readmitted to [...]

Background: Social determinants of health (SDOH) are thought to account for up to half of modifiable outcomes related to health. Children from minority groups and/or lower socioeconomic backgrounds are at higher risk for hospitalization. Efforts have been made to screen for social risk factors in the outpatient setting. However, few studies describe inpatient SDOH screening [...]

Background: Historically, there has been a significant disparity in the number of patient experience Press Ganey survey responses between English-speaking patients and those who speak other languages. In 2022, our organization observed a remarkably low inpatient Press Ganey survey response rate for the Spanish-speaking patient population, standing at 5.7%. Out of 2,303 surveys sent, only [...]

Background: A patient’s hospitalization encounter is a valuable opportunity to align potential social and structural barriers with the healthcare multidisciplinary team’s (MDT) resources for intervention. Teaching learners to assess and address social determinants of health (SDH) is a key objective of medical education and becoming a physician. Few studies describe curricula implementing these skills during [...]

Background: The Association of American Medical Colleges identifies consideration of social determinants of health (SDoH) and patient-specific factors as key components of entrustable professional activities (Englander 2016). Prior studies of medical students and Internal Medicine (IM) residents demonstrated baseline gaps in integrating SDoH into clinical reasoning (CR) in the outpatient setting (Schwartz 2010, Wilhite 2020), [...]

Background: The Centers of Medicare and Medicaid (CMS) in 2024 will require hospitals to screen and report two of the following five health-related social needs (HRSN): food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (1). These regulations improve screening, however, institutions are still left with questions on how to address these HRSN, [...]

Case Presentation: A 45-year-old female with history of VSD presented with fever and fatigue. She had a systolic ejection murmur with palpable thrill best heard at the second intercostal space. Echocardiographic findings included severe RV hypertrophy (1.7 cm thick), infundibular pulmonary obstruction, perimembranous VSD (1.4×0.6 cm), and mobile tricuspid valve echodensities (Figure 1). Blood cultures [...]