Implementation and Impact of a Novel Protocol for Inpatient Asylum-Seeking Children.

In response to a record number of immigrant families arriving in the United States through the southern border, a multidisciplinary team at a tertiary care children's hospital developed an inpatient asylum protocol (IAP) whose goals were to identify, screen, and support hospitalized asylum-seeking patients and their families. Identified patients were provided with specialized social work, case management, and legal support and were longitudinally followed after hospital discharge to ensure successful engagement with community resources. A total of 47 patients were enrolled over 2.5 years. Our patient population demonstrated significant food, housing, and legal needs. Medical complexity was also substantial, with half of our patients requiring both inpatient subspecialty consultations and outpatient follow-up and 13% qualifying for our institution's complex care program. As a result of the IAP, all families received social work support that continued after discharge, 93% of families without legal aid on admission were connected with legal resources, and 96% of our patients without a primary care physician on arrival had established one on discharge. At the time of this review, half of our patients and families had graduated from the program, whereas the rest continued to require monthly follow-up because of ongoing needs. This novel program was successful in evaluating and addressing the needs of newly arrived asylum-seeking patients and their families in the inpatient setting. We hope that our protocol will aid other institutions in adopting similar interventions.