Increasing Rates of Health-related Social Needs Screening in a Pediatric Critical Care Setting Through Quality Improvement.

Introduction: Prior research has linked health-related social needs (HRSNs) with poor pediatric health outcomes. Studies have demonstrated the implementation of HRSN screening in lower-acuity settings, but few have been conducted in pediatric intensive care units (PICUs). Our primary aim was to increase HRSN screening from 4% to 75% between February 2024 and May 2025. Our secondary aim was to increase referral rates for community health workers (CHW) from 0% to 75% for those with unmet HRSNs. Methods: A multidisciplinary team used quality improvement (QI) methodology to implement interventions in a 26-bed PICU at an urban, tertiary-care children's hospital. The study included all patients admitted to the PICU. We implemented six interventions over multiple plan-do-study-act cycles to optimize screening and CHW resource navigation workflow. Results: Data collection included sociodemographic characteristics and monthly HRSN screening completion, positive screens, and CHW referral rates. During our intervention period, there were 1,256 direct admits to the PICU. By the end of the study period, an average of 76% of patients had a completed HRSN screen, just over our anticipated goal. The mean HRSN screening increased from a baseline of 17.9% to 76.5. Among screened patients, 27.7% reported ≥1 unmet HRSN, with a mean CHW referral rate of 64%. Conclusions: A multidisciplinary team approach and use of QI methodology led to an increase in monthly HRSN screenings in our PICU. Next steps will focus on increasing CHW referral rates and connecting patients with resources for unmet HRSNs.