PDF(Pubmed)
Abstract：
UNASSIGNED: Social needs screening can help modify care delivery to meet patient needs and address non-medical barriers to optimal health. However, there is a need to understand how factors that exist at multiple levels of the healthcare ecosystem influence the collection of these data in primary care settings.
UNASSIGNED: We conducted 20 semi-structured interviews involving healthcare providers and primary care clinic staff who represented 16 primary care practices. Interviews focused on barriers and facilitators to awareness of and assistance for patients\' social needs in primary care settings in Maryland. The interviews were coded to abstract themes highlighting barriers and facilitators to conducting social needs screening. The themes were organized through an inductive approach using the socio-ecological model delineating individual-, clinic-, and system-level barriers and facilitators to identifying and addressing patients\' social needs.
UNASSIGNED: We identified several individual barriers to awareness, including patient stigma about verbalizing social needs, provider frustration at eliciting needs they were unable to address, and provider unfamiliarity with community-based resources to address social needs. Clinic-level barriers to awareness included limited appointment times and connecting patients to appropriate community-based organizations. System-level barriers to awareness included navigating documentation challenges on the electronic health record.
UNASSIGNED: Overcoming barriers to effective screening for social needs in primary care requires not only practice- and provider-level process change but also an alignment of community resources and advocacy of policies to redistribute community assets to address social needs.
UNASSIGNED: We conducted 20 semi-structured interviews involving healthcare providers and primary care clinic staff who represented 16 primary care practices. Interviews focused on barriers and facilitators to awareness of and assistance for patients\' social needs in primary care settings in Maryland. The interviews were coded to abstract themes highlighting barriers and facilitators to conducting social needs screening. The themes were organized through an inductive approach using the socio-ecological model delineating individual-, clinic-, and system-level barriers and facilitators to identifying and addressing patients\' social needs.
UNASSIGNED: We identified several individual barriers to awareness, including patient stigma about verbalizing social needs, provider frustration at eliciting needs they were unable to address, and provider unfamiliarity with community-based resources to address social needs. Clinic-level barriers to awareness included limited appointment times and connecting patients to appropriate community-based organizations. System-level barriers to awareness included navigating documentation challenges on the electronic health record.
UNASSIGNED: Overcoming barriers to effective screening for social needs in primary care requires not only practice- and provider-level process change but also an alignment of community resources and advocacy of policies to redistribute community assets to address social needs.
摘要：
■社会需求筛查可以帮助改变护理服务，以满足患者的需求，并解决非医疗障碍，以实现最佳健康。然而,有必要了解医疗生态系统多个层面存在的因素如何影响初级保健机构中这些数据的收集.
■我们进行了20次半结构化访谈，涉及医疗保健提供者和初级保健诊所工作人员，他们代表了16种初级保健实践。访谈的重点是马里兰州初级保健机构中患者社会需求意识和援助的障碍和促进者。访谈被编码为抽象主题，突出了进行社会需求筛选的障碍和促进者。主题是通过归纳方法组织的，使用社会生态模型描绘了个人-，临床-，以及系统层面的障碍和促进者，以识别和解决患者的社会需求。
■我们确定了几个个体障碍，包括患者对表达社会需求的污名，提供者在引出他们无法解决的需求时感到沮丧，和提供者不熟悉基于社区的资源来满足社会需求。诊所层面的认识障碍包括有限的预约时间和将患者与适当的社区组织联系起来。系统层面的认识障碍包括在电子健康记录上导航文档方面的挑战。
克服初级保健中有效筛选社会需求的障碍不仅需要实践和提供者级别的流程变革，还需要调整社区资源和倡导政策，以重新分配社区资产以满足社会需求。
■我们进行了20次半结构化访谈，涉及医疗保健提供者和初级保健诊所工作人员，他们代表了16种初级保健实践。访谈的重点是马里兰州初级保健机构中患者社会需求意识和援助的障碍和促进者。访谈被编码为抽象主题，突出了进行社会需求筛选的障碍和促进者。主题是通过归纳方法组织的，使用社会生态模型描绘了个人-，临床-，以及系统层面的障碍和促进者，以识别和解决患者的社会需求。
■我们确定了几个个体障碍，包括患者对表达社会需求的污名，提供者在引出他们无法解决的需求时感到沮丧，和提供者不熟悉基于社区的资源来满足社会需求。诊所层面的认识障碍包括有限的预约时间和将患者与适当的社区组织联系起来。系统层面的认识障碍包括在电子健康记录上导航文档方面的挑战。
克服初级保健中有效筛选社会需求的障碍不仅需要实践和提供者级别的流程变革，还需要调整社区资源和倡导政策，以重新分配社区资产以满足社会需求。
