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Pediatric EM Fostering Community Partnerships to Provide Families With Social Resources
Drs. Smith and Karamatsu distributing diapers.
Fostering Community Partnerships to Provide Families With Social Resources
By Mia Karamatsu, MD; Monique de Araujo, MD, MPH; Melanie Ramirez; Cherrelle Smith, MD; Janine Bruce DrPH, MPH; and Nancy Ewen Wang, MD, on behalf of the SAEM Pediatric Emergency Medicine Interest Group
Emergency departments (EDs) are available 365 days a year, seven days a week, 24 hours a day to anyone in need. In addition to providing emergency care for trauma and serious medical conditions, many EDs address patients’ underlying social needs, serving as a social safety net. EDs are poised to fill the gap between community needs, available resources, and medical accessibility. Doing this effectively requires strategic community partnerships.
Strategic Partnerships
In 2018, the Stanford Pediatric ED joined the Mid-peninsula Pediatric Advocacy Coalition (iMPACt), a coalition of local safety net clinics serving the vast majority of low-income families with children 0-5 years old in the region. iMPACt is composed of pediatric providers (e.g., pediatricians, nurse practitioners, medical assistants), clinic and program administrators, and public health professionals to address social determinants of health at a population
“Diapers are a cost! I’m in a shelter right now and I can’t say thank you enough” — from a grateful family in the ED. level. To date iMPACt has addressed many key issues of importance to the community (e.g., food insecurity, early education, mental health, diaper insecurity, etc.).
Addressing Social Needs
COVID-19 required our team to urgently respond to the social needs
of our patients and their families. As an iMPACt partner, we leveraged resources procured by the coalition and distributed them directly to pediatric ED patients and their families. Starting in June 2020, we distributed a pandemic-related guide with hyper-local and language-specific resources (e.g., food, rental and financial assistance, legal and immigration support, among other local resources) developed by iMPACt partners and our residents in the Pediatric Advocacy Council. Resources for seven counties are available in English, Spanish, and Vietnamese. The Stanford resource library provided us with a URL to post the resources and we included a QR code and URL with each patient’s discharge paperwork so that patients could pick the resource guide for their appropriate language and county. These resource guides are updated regularly to ensure the most accurate information to families. To date, the website has been accessed more than 2,500 times.
Figure1. COVID Resources by County
In 2021, our ED also held two diaper distributions whereby pediatric patients of diaper-wearing age received free diapers. In partnerships with iMPACt and the nonprofit organization Help a Mother Out, we distributed more than 115 boxes of diapers.
Additionally, to combat lost learning opportunities resulting from the pandemic and the shift to virtual learning, we implemented “Talk, Read, Sing,” a national public awareness campaign through the Clinton Foundation’s Too Small to Fail initiative, which promotes early brain and language development in children 0–5 years old. In June 2021, with material support from iMPACT, we began distributing tote bags with two bilingual (English/Spanish) books, and a tip sheet with developmental milestones. To our knowledge, we are the first ED to participate in the campaign, with over 100 families served to date.
“A mi hija le gustan los libros. Muchas gracias” — from a pleased Spanishspeaking mother in our ED. “Sometimes it’s a choice between diapers and food for us. You folks really help a lot.” — from a thankful caregiver.
“Talk, Read, Sing” Bilingual Books and Tipsheet.
Impact on Providers and Families
Implementation of these initiatives in our ED has received enthusiastic buy-in from administrators, physicians, nurses, technicians, and child-life specialists. As a result of participation in iMPACt, our ED team has found a network of like-minded providers similarly driven to addressing the social needs of our mutual patient population. Staff enthusiasm regarding resource dissemination has resulted in an added level of trust that has promoted families’ acceptance of resources when they might have otherwise been reluctant. With support from our ED physician champion, we seamlessly integrated material distribution into the current workflow, protocols, and systems. Responses from families validate the importance of this work.
While these initiatives are imperfect, we are working to improve implementation and examine ways to present resources to families and to evaluate outcomes. The need is palpable, the gratitude contagious, and the importance of helping families is unmeasurable. We hope that many EDs across the nation can similarly develop critical partnerships to address the unmet social needs of families, moving toward greater health equity for all.
ABOUT THE AUTHORS
Dr. Barros de Araujo is a pediatrics resident in the department of pediatrics at Stanford University School of Medicine, Palo Alto, CA.
Melanie Ramirez, Stanford University School of Medicine, Department of Pediatrics. Palo Alto, CA.
Dr. Bruce is associate director, Office of Child Health Equity, and codirector, Scholarly Concentration in Community Health, department of pediatrics, Stanford School of Medicine.
Dr. Wang is a professor of emergency medicine and associate director pediatric emergency medicine at Stanford University School of Medicine, Palo Alto, CA.
