Peri-Operative Optimization: Social Determinants of Health

This project investigated how clinicians at a rural Vermont family medicine practice observed various social determinants of health (SDOH) of their patient population affected patients' preparedness for surgery. Two clinicians involved in the community, a practicing family medicine physician and a practicing social worker, were interviewed to collect qualitative data on how various SDOH they have observed through their clinical practice have influenced patients' preparedness for surgery. This information was then utilized to create a "dot-phrase" that clinicians can use as part of a patient's pre-operative visit in the outpatient setting to assess SDOH and plan subsequent targeted interventions to address those SDOH. The clinicians identified specific SDOH of primary concern that they believe should be addressed in the pre-operative visit: family dynamics, financial considerations, and transportation. The proposed intervention includes a "dot-phrase" that can be utilized by clinicians during these encounters to specifically address these SDOH and coordinate additional interventions to address areas of need. Further investigation into the specific costs and savings of such an intervention, additional SDOH to be included in such interventions, and additional collateral information from surgical perspectives is warranted.