Author(s): William Minor, MHA, CPHQ
Outcomes Specialist
Atrium Health Levine Children's Hospital

Ashley Carr, MSPH, CPHQ
Outcomes Specialist
Atrium Health Levine Children's Hospital

Sarah Mabus, MLA
Project Manager
Atrium Health Levine Children's Hospital

Talia Buitrago-Mogollon, MHA, CPHQ
Quality Improvement Coach
Atrium Health Levine Children's Hospital

Beth White
Senior Clinical Data Analyst
Atrium Health

Lauren Stillwell, MPH
Performance Improvement Coordinator
Atrium Health

Shruti Mittal
Assistant Professor
Advocate Health – Atrium Levine Children's

Competency Domain: Population Health & Care Transitions

Description: QI coaches for 9 subspecialties spanning inpatient and outpatient environments with widely varied workflows and resource availability used QI tools to facilitate communication across this network of teams to initiate Social Drivers of Health (SDOH) screening and interventions. A key driver diagram and a dashboard of individual divisions' run charts knit together to inform and propel work that was simultaneously unified and unique. As interventions from the key driver were tested, the impact became visible on the dashboard. A core team of 4 coaches and 3 data analysts used this tool pairing to ensure all teams met standardized requirements. Tool:The Atrium Health Levine Children's Service Line SDOH Key Driver Diagram and SDOH Dashboard, used in combination to track and compare interventions across sites. Problem:This project sought to initiate SDOH screening plus intervention across 9 divisions spanning multiple locations with different workflows and resources. The goal was to increase from zero screenings to 80% screened at least annually AND each positive screen receive an agreed-upon intervention with electronic health record documentation by 12/2023. Tool Selection:The key driver was essential given the quantity and diversity of participating teams, ensuring all participants work from the same playbook using agreed-upon interventions. The annotated dashboard was equally valuable, allowing teams to see which interventions were most consistently impactful, thus benefiting from shared learning to spread those changes rapidly. Usage:The key driver was developed at project inception to align work across initial divisions, revisited for review, and used to onboard new divisions as work spread across the service line. Annotated run charts within the dashboard were reviewed monthly among the coaching team, and used for teaching/discussion at division meetings. Results:All teams met or exceeded goal. Performance improved from zero to 94%, sustained during the project's final 6 months. Barriers included standardizing documentation, operational definitions, and data mining, plus an EMR transition triggering a temporary but significant drop in results. All barriers were ultimately resolved.