DNP Scholarly Projects

Abstract

The purpose of this QI project was to improve the delivery of school physicals in the setting of an -friendly non-profit safety-net clinic by creating a patient-centered clinical pathway to improve focused screening and referrals for newly arrived migrant children and their families by routinely assessing and addressing behavioral health care (BH) and social determinants of health needs (SDoH).

Using QI methodology and Donabedian’s Structure Process Outcomes framework, the project team implemented a clinical pathway that included an immigration-focused history of present illness, systematic behavioral health (BH), and social determinants of health (SDoH) screenings embedded within an electronic health record template. The pathway included referrals to community health workers (CHWs), a social worker (SW), and behavioral health consultants (BHC). The team reviewed chart data and CHW reports to analyze patient characteristics, utilization of the EHR template, and whether patients were appropriately referred to wrap-around providers.

SDoH screening rates improved from 10% to 72% and BH screening rates from 40% to 76% of patients screened during the project implementation period. The process captured behavioral health or social needs for 60 patients and generated 58 referrals to wrap-around providers.

“Salir Adelante” demonstrates the feasibility of implementing a school physical clinical pathway tailored to the needs of a specific clinic structure and population and with the long-term goal of improving care delivery for multicultural, multilingual, newly arrived children in the context of a small, community-based nonprofit walk-in practice setting.

Date

Spring 4-25-2024

First Advisor

Elizabeth Morse

Second Advisor

David Philippi

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

well-child visits, migrant minors, screening, social determinants of health, behavioral healthcare, multicultural, health equity, resilience, uninsured children, quality improvement

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