好色先生

好色先生

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Abstract Details

Using Design Thinking to Improve a Resident’s Ability to Identify and Manage Social Determinants of Health Issues in the Outpatient Neurology Clinic
好色先生, Research, and Methodology
P5 - Poster Session 5 (8:00 AM-9:00 AM)
5-003
To Improve neurology residents' ability to identify and manage social determinants of health (SDoH) issues in their clinic.
A needs assessment found that residents lacked skills in recognizing SDoH issues, obtaining SDoH history and managing SDoH problems. A design thinking approach was used to determine the root of these problems, the scope of the need and a mechanism for improving SDH care skills in the outpatient clinic
Eight design thinking sessions (1-2 hours) over the course of 4 months were held to gain an understanding of  SDoH opportunities, engage stakeholders, develop a prototype and identify outcome measures. Residents collaborated with information technology and our SDoH department to develop an electronic health record (EHR) based tool that collected patient reported SDoH information for providers to review and a method to find SDoH solutions in our clinic.
Qualitative interviews found our residents’ SDoH history taking skills were limited, that they feared embarrassing patients or themselves, and that neither staff nor residents understood how to approach solving SDoH issues. The EHR tool was piloted over 9 months, screening 3108 patients (44% of clinic patients) of which 37.7% reported a need. Food insecurity (24%),transportation (11.5%), medications (8.8%) and utilities (7.8%) were the most common needs. Staff evaluation of the residents, pre/post implementation resident surveys and qualitative interviews showed improvements in residents’ confidence and skill in obtaining and addressing SDoH issues and improved ability of staff to manage SDoH issues. Staff evaluated residents more frequently as well.
Design thinking was an effective method for educating residents regarding SDoH and system based practice through active engagement in quality improvement. Residents gained valuable skills in systems thinking, interprofessional collaboration, and patient-centered care. Future residents will benefit from the ongoing use of the EHR tool. Metrics on patient outcomes and care delivery will be measured. 
Authors/Disclosures
Aashin Shah, MD (Geisinger)
PRESENTER 		Dr. Shah has nothing to disclose.
Megan E. Esch, MD (Geisinger Medical Center) The institution of Dr. Esch has received research support from PCORI.
J. David Avila, MD, FAAN (Geisinger Medical Center) Dr. Avila has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca. Dr. Avila has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alnylam Pharmaceuticals. Dr. Avila has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for argenx. Dr. Avila has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion Pharmaceuticals. Dr. Avila has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for UCB. Dr. Avila has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AstraZeneca. Dr. Avila has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda.
Isabel Friedenberg, MD Ms. Friedenberg has nothing to disclose.
Robert Cooney, MD An immediate family member of Dr. Cooney has received personal compensation for serving as an employee of ExpressScripts.
Scott M. Friedenberg, MD, FAAN (Geisinger Medical Center) The institution of Dr. Friedenberg has received research support from AMA. The institution of Dr. Friedenberg has received research support from Geisinger Medical Center.