Understanding and increasing awareness of social determinants of health of patients with cancer treated by the MD Anderson Oncology Program at Lyndon B Johnson Hospital.

Abstract

e23237 Background: Harris Health serves nearly a quarter of Harris County, the third most populous county in the United States. As a safety-net healthcare system, its patient outcomes are largely impacted by social determinants of health (SDOH). This is especially relevant for patients with cancer who receive care through Harris Health. We aimed to assess medical oncology provider awareness of and confidence in identifying and addressing SDOH during patient visits at the Lyndon B. Johnson (LBJ) Hospital, one of Harris Health’s two flagship hospitals. Oncology care at LBJ operates in close partnership with MD Anderson Cancer Center Oncology Program. Methods: A survey was created and distributed through the Research Electronic Data Capture (REDCap) web-based application to 32 medical oncology fellows, faculty, and nurses who treat patients with cancer at LBJ Hospital. Project approval was obtained from the MD Anderson Cancer Center Quality Improvement Assessment Board. Results: Twenty respondents (12 fellows, 5 faculty, 1 APP, and 2 nurses) completed the survey. Four of 20 (20%) respondents indicated being more than “moderately familiar” with the concept of SDOH. Three of 20 (15%) respondents indicated they “always” ask patients about SDOH during their initial patient visits, with four respondents (20%) indicating “never” or “rarely”. No respondents indicated they feel “extremely comfortable” identifying and utilizing resources to address their patients’ SDOH. Eleven of 20 (55%) respondents indicated that the limited amount of time during patient visits was a “very impactful” factor in being able to discuss SDOH with their patients. The top three factors affecting respondents’ ability to address SDOH were “amount of time during patient visits”, “workforce capacity to navigate accessing community resources”, and “community resource availability”. Sixteen of 20 (80%) respondents indicated they experience feelings of stress or frustration caused by their patients’ SDOH at least weekly. Conclusions: We identified a significant need to improve awareness of and confidence in identifying and addressing SDOH affecting patients with cancer at LBJ Hospital. A quality improvement project encompassing an educational program and implementation of an easily accessible mechanism in the electronic medical record (EMR) to identify individual patients’ SDOH will be implemented in 2025 to address this need.