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To develop and vet a process for creating effective partnerships between primary care practices and community-based organizations (CBOs), this project will facilitate the development of a screening, referral, and feedback process model that encourages effective follow-up between primary care providers and selected CBOs. The project will be carried out at CHN’s Jamaica and Sulphin Boulevard Health Centers.
The project will leverage resources already available, including screening tools developed through UHF’s Partnerships for Early Childhood Development initiative, and will consist of four distinct activities. These include: 1) social determinants screening development; 2) primary care workflow redesign; 3) CBO partnership and feedback loop development; and 4) testing, measuring, and improving the entire process.