The following are examples of projects supported by WCN, the Leadership Action Coalition, and other partners to address social determinants of health (SDOH) and advance health equity. These projects were supported in part by Nursing Innovation Grants from the Robert Wood Johnson Foundation.
Example #1: Linking Screening for Social Determinants of Health by Nurses and Healthcare Teams to Improved Outcomes
WCN recently collaborated with Virginia Mason Franciscan Health in Seattle for a systematic approach to social determinants of health screening of patients and track performance towards improved health outcomes. Social risk factors of patients were identified at the point of care and gave the nurses and hospital staff the opportunity to coordinate social services or resources to support the patient. The staff discovered that patients shared more information with the use of the SDOH screening tool, even when staff had an established relationship with the patient. Examples are inability to pay for medication or needed transportation for their appointments.
The confidence and comfort level of hospital staff increased after the development of tools, resources, and trainings aimed at strengthening staff skills to lead SDOH conversations and support patients. The result is preliminary data such as potential shorter length of stay with early interventions.
This project is being led by Alison Bradywood, DNP, MPH, RN-NEA-BC Senior Director of Clinical Practice, Professional Development, and Quality at Virginia Mason and Co-Chair of the WA Nursing Leadership Action Coalition.
Example #2: Culturally Tailored Care to Protect Elders Against Social Isolation during COVID-19
The Leadership WNAC strongly supported WCN's partnership with Bayanihan King County to apply for a Campaign for Action Nursing Innovation Fund grant to provide COVID-19 response support to isolated Filipino seniors. This project is led by a Filipina nurse practitioner and Assistant Professor at the Seattle University College of Nursing: Therry Eparwa, DNP, MSN, RN, FNP-BC. She worked with other Filipino leaders in medicine, social services, and business. Like other local chapters, the King County chapter of Bayanihan Response is community-centered and tailors interventions based on the specific needs of their community.
Key components include bilingual volunteers providing weekly phone check-ins with elders who are members of the International Drop-In Center: Filipino Senior & Family Services (IDIC) in Seattle, a weekly grocery and meal delivery program that serves 150 elders, and a community wellness survey and focus groups to understand how COVID-19 has impacted community members. The survey and focus groups will inform the newly created Filipino Community Health Board.
The National Alliance for Filipino Concerns (NAFCON) launched the Bayanihan Response to COVID-19, which is part of a national health and wellness campaign to respond to the immediate and long-term needs of impacted Filipino communities in the United States and the Philippines.
Example #3: Growing Public Health Nurse Leaders and Amplifying Voices of Nurses from Underrepresented Communities
The Washington Leadership Nursing Action Coalition, with a Robert Wood Johnson Foundation Public Health Nurse Leaders grant, embarked on a series of projects to increase leadership among nurses with regards to addressing the SDOH. These initiatives were in part funded by a RWJF Public Health Nurse Leaders grant to obtain information and develop tools with practicing nurses about how to incorporate the social determinants of health into nursing practice.
This included multi-media education on the SDOH efforts shown to significantly increase nurses’ knowledge of SDOH, including a video, A Healthier Washington Starts with Nurses, co-produced with the Washington State Health Care Authority, the state’s largest public health care purchaser. In addition, toolkits are available on the WCN website.
WCN staff held focus groups across the state of Washington, engaging about 300 practicing nurses in both rural and urban areas. This experience resulted in a toolkit to support nurses and the following article submitted for publication: “Addressing Social Determinants of Health at the Point of Care in Washington State: Centering the Voices of Underrepresented Nurses.” The focus of the manuscript is to examine how patient social needs are addressed at the point of care as well as barriers and facilitators in doing so in Washington State using the voices of underrepresented nurses to structure the production of this knowledge as an anti-racist research strategy. These findings will be of interest to the broad base of healthcare and public health professionals given systems-driven inequities and growing calls to diversify the healthcare workforce. These findings highlight how centering underrepresented voices in healthcare identifies new priorities and solutions to addressing health disparities, especially at the point of care. The Washington Leadership Action Coalition worked with Dr. Wendy E. Barrington, PhD, MPH, an Associate Professor in the School of Nursing and Adjunct Associate Professor in the School of Public Health at the University of Washington, Seattle.