Gunn Rose, Pisciotta Maura, Volk Molly, Bowen Megan, Gold Rachel, Mossman Ned
From the OCHIN, Inc. Portland, OR (RG, MP, MV, MB, RG, NM); Kaiser Permanente Center for Health Research, Kaiser Permanente, Portland, OR (RG).
J Am Board Fam Med. 2023 Oct 11;36(5):803-816. doi: 10.3122/jabfm.2023.230047R1. Epub 2023 Aug 30.
Screening and referral programs for social isolation and loneliness in older patients increased during the COVID-19 pandemic in primary care settings to mitigate associated adverse health outcomes. This study explores community health centers' experiences implementing a social isolation and loneliness screening program involving a community resource referral platform integrated into the electronic health record to support referrals.
A formative mixed methods evaluation in 4 community health centers. Semistructured interviews, observation of implementation meetings, facilitated group discussions, surveys, and utilization data extracted from the electronic health record and community resource referral platform were collected and analyzed concurrently.
Screening for social isolation and loneliness can heighten health center staff knowledge and prioritization of socially isolated older patients. Participants indicate using an integrated community resource referral platform may only be useful in certain circumstances, particularly for those located outside urban areas. The experiences of these health centers indicate that when implementing interventions to mitigate patients' social isolation and loneliness, it is necessary to consider other resource directories, needed adjustments to referral and documentation workflows, and potential impacts on patients and care teams.
Screening older patients for social isolation could increase care team awareness of social risk; assistance related referral options should be considered carefully.
在新冠疫情期间,基层医疗环境中针对老年患者的社会隔离和孤独感筛查及转诊项目有所增加,以减轻相关的不良健康后果。本研究探讨了社区卫生中心实施社会隔离和孤独感筛查项目的经验,该项目涉及一个整合到电子健康记录中的社区资源转诊平台,以支持转诊。
在4个社区卫生中心进行了一项形成性混合方法评估。同时收集并分析了半结构化访谈、实施会议观察、小组讨论、调查以及从电子健康记录和社区资源转诊平台提取的使用数据。
对社会隔离和孤独感的筛查可以提高卫生中心工作人员对社会孤立老年患者的认知和重视程度。参与者表示,使用整合的社区资源转诊平台可能仅在某些情况下有用,特别是对于那些位于城市以外地区的患者。这些卫生中心的经验表明,在实施减轻患者社会隔离和孤独感的干预措施时,有必要考虑其他资源目录、转诊和记录工作流程所需的调整,以及对患者和护理团队的潜在影响。
对老年患者进行社会隔离筛查可以提高护理团队对社会风险的认识;应仔细考虑相关的转诊选择。