Table 3.

Themes and quotes.

Themes	Quotes
Current methods of assessing unmet basic needs are not standardized, inconsistently performed and documented	“Everyone gets the social work consult. The problem is- what’s contained within that consult is a black box. I don’t think that there is a systematic way that it happens each and every time. There’s definitely not a systematic way that it gets documented” (BMC Physician 2)
Addressing social needs of families is a central part of care for preterm infants	“In pediatrics, you don’t treat only the patient, you end up treating the family. I think that’s true here in the NICU, too, especially for the patients that are here for months and months and months.” (UMass Physician 5) “I think when we in the NICU discharge complex patients the effect of the social determinants of health is amplified…. I think it is an important job to identify if [SDOH] are there and at least try to address them, because it has an enormous impact on more than some of the things that happen in the NICU on the long term outcome.” (UMass Physician 10)
Use of a standardized screening tool is feasible and beneficial	“I do think it’s great to ask these questions and have standardization…. As nurses a lot of it’s [discussions of unmet basic needs] at the bedside. We’ll have conversations and recognize that they need help from different sources, but we don’t necessarily have, this is what we need to ask and this is where it’s documented that you find out this information.” (BMC Nurse 5) “I love this and I love how it’s organized and how the resources are organized” (UMass Physician 3)
Some community resources are increasingly scarce; families do not always recognize the limitations of the NICU team at addressing unmet basic needs	“I think a lot of people have heard by word of mouth on the street, ‘Come to BMC, they’ll give you everything you need.’ And, that’s just not so anymore. There was a time when this hospital was extremely generous. People were given car seats for free, they were given Pack ‘n Plays for free, they were given a lot of things for free. Those days are long, long gone, and yet the expectation is still there. So, I hear from many patients, ‘Well, my friends told me to ask you to help me get an apartment that you could help me get an apartment.’ I can’t do that. I just can’t. So, that’s the only thing that I worry about [with] a screener like this. You don’t know how it’s interpreted. It also depends [on] how questions are asked. Like, ‘Do you always have enough food?’ That’s a perfectly reasonable question.” (BMC, Social Worker 1)
Use of a SDH screening and referral system in the NICU needs to be tailored to the emotional needs of families with hospitalized infants	“People don’t always read things when they’re in a crisis. I know it firsthand. Working with families for the period of time I have, I give them resources and they disappear sometimes.” (UMass Social Worker 1)
Use of a SDH screening and referral system in the NICU needs to be tailored to existing NICU work flow	“I think that it could be something that we could do in the first family meeting.” (UMass Physician 5) “I would feel better about [a SDOH screener] if it was electronic. I always get concerned with paper being lost or like you said, not passed on to you. So, if at least it was electronic, [our NICU Social Worker] could go in and be like, “Oh look, they’ve done their screening and they need support here.” (NICU BMC Nurse 5)