Jessica Lander Schnell

Despite national guidelines promoting early cancer detection, adherence to screening recommendations remains below the USPSTF Healthy People 2030 targets. Nationally, only 71.8% of eligible adults receive colorectal cancer (CRC) screenings and 75.9% receive breast cancer (BC) screenings. Rates are significantly lower in uninsured or low-income populations, with just 7.5% and 35% receiving CRC and BC screenings, respectively. To improve presentation care delivery, a patient registry was developed at an urban, student-run free clinic serving the uninsured to track CRC and BC eligibility and screening orders. Baseline screening rates were identified through a retrospective chart review of clinic patients seen from 2021 to 2023. Process mapping was used to identify failure points in the screening workflow. A patient registry was implemented over 15 months (January 2024-March 2025) to monitor eligibility and increase screening order rates. Data collection focused on the proportion of eligible patients with appropriate screening orders placed. Average screening rates for CRC and BC prior to intervention were 18.3% and 12.6%, respectively. Following the implementation of the patient registry, rates increased to 34.4% for CRC and 30.3% for BC. The improvement in CRC screening was statistically significant, while BC screening showed early signs of positive change. Targeted identification of screening-eligible patients, regardless of visit reason, improves screening order rates. This approach may promote earlier cancer detection and improved outcomes. It is cost-effective, replicable, and adaptable to other chronic condition monitoring in student-run free clinics.

Objectives This study aimed to explore the experiences of caregivers of children with medical complexity (CMC) enrolled in a complex care program, focusing on their interactions with the healthcare system and the impact on caregiver well-being. Methods Qualitative interviews were conducted with 20 caregivers, and data were analyzed using interpretative phenomenological analysis. The interviews covered topics such as navigating the medical system, accessing resources, and interactions with healthcare providers. Results Caregivers faced challenges in navigating the healthcare system, including scheduling appointments, finding suitable treatment plans, and managing hospitalizations. They expressed the need for more practical, financial, and informational resources to support their caregiving responsibilities. Access to respite care was identified as a significant challenge, with limited availability and affordability. Caregivers highlighted the importance of connecting with other caregivers and accessing accurate information specific to their child’s condition. Conclusions for Practice The findings emphasize the unmet needs of caregivers of CMC and the barriers they face within the healthcare system. To support caregiver well-being, interventions should address these barriers by improving infrastructural support, enhancing training for in-home caregivers, and advocating for comprehensive support services for the entire family. Involving caregivers in the development and implementation of interventions is crucial to ensure their feasibility, applicability, and desirability. By addressing these challenges and tailoring interventions to the unique needs of caregivers of CMC, healthcare providers can promote better outcomes for both caregivers and their CMC.

Background: Families of children with medical complexity (CMC) have been negatively affected by the COVID‐19 pandemic, experiencing challenges such as decreased access to services, increased financial hardship and increased isolation. However, there are few qualitative studies which explore parental experiences. The aim of the present study was to describe the impact of the COVID‐19 pandemic on families of CMC.Methods: Caregivers of CMC were recruited from a large hospital in the Midwestern United States. They completed a semistructured qualitative interview assessing the impact of COVID‐19 on their child's care, which was analysed using interpretive phenomenological analysis.Results: Twenty caregivers who were predominantly White, married and female participated. Emergent themes included the importance of protecting their child's health to ensure their physical safety, greater social isolation and missed medical services related to concerns about exposure, clinic closures and/or other logistical changes. Participants noted that the convenience of telehealth was a positive outcome of COVID‐19 that facilitated care while reducing time and resource challenges.Conclusions: This study highlights the importance of protecting the health of CMC through continued safe access to in‐person or telehealth services. It is important to prioritise emotional support services for families of CMC as they have experienced increased stress and social isolation during and after the COVID‐19 pandemic. This topic should be explored among diverse families with CMC across multiple healthcare systems.

Pediatric Annals | The role of patients and families has evolved over the years, from being viewed as entities who were told what to do, to consumers of health services, to being central to health system design and clinical decision-making. When designing health care practices and programs to be patient- and family-centered, we believe that parents of children with medical complexity (CMC) bring valuable viewpoints