Evaluating a social risk screening and referral program in an urban safety-net hospital emergency department.

Autor: Loo S; Department of Health Law, Policy, and Management Boston University School of Public Health Boston Massachusetts USA., Anderson E; Boston University School of Medicine Boston Massachusetts USA., Lin JG; Boston University School of Medicine Boston Massachusetts USA., Smith P; Department of General Internal Medicine Boston Medical Center Boston Massachusetts USA., Murray GF; Department of Public Health Policy and Management, School of Global Public Health New York University New York New York USA., Hong H; Department of Emergency Medicine Boston Medical Center Boston Massachusetts USA., Jacquet GA; Boston University School of Medicine Boston Massachusetts USA.; Department of Emergency Medicine Boston Medical Center Boston Massachusetts USA., Koul R; Department of Emergency Medicine Boston Medical Center Boston Massachusetts USA., Rosenmoss S; Boston University School of Medicine Boston Massachusetts USA., James T; Boston University School of Medicine Boston Massachusetts USA.; Department of Emergency Medicine Boston Medical Center Boston Massachusetts USA., Shankar KN; Department of Emergency Medicine Boston Medical Center Boston Massachusetts USA.; Department of Emergency Medicine Brigham and Women's Hospital Boston Massachusetts USA., de la Vega PB; Boston University School of Medicine Boston Massachusetts USA.; Department of General Internal Medicine Boston Medical Center Boston Massachusetts USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2023 Jan 23; Vol. 4 (1), pp. e12883. Date of Electronic Publication: 2023 Jan 23 (Print Publication: 2023).
DOI: 10.1002/emp2.12883
Abstrakt: Objective: The emergency department (ED) is an opportune venue to screen for unmet social needs and connect patients with social services. This quality improvement study incorporates both qualitative and quantitative data to examine unmet social needs among ED patients and program implementation.
Methods: From September 2020 to December 2021, an urban safety-net hospital adult ED implemented a social needs screening and referral program. Trained emergency staff screened eligible patients for 5 social needs (housing, food, transportation, utilities, employment), giving resource guides to patients who screened positive (THRIVE+). We collected screening data from the electronic health record, conducted semi-structured interviews with THRIVE+ patients and clinical staff, and directly observed discharge interactions.
Results: Emergency staff screened 58.5% of eligible patients for social risk. Of the screened patients, 27.0% reported at least 1 unmet social need. Of those, 74.8% requested assistance. Screened patients reported housing insecurity (16.3%) as the most prevalent unmet social need followed by food insecurity (13.3%) and unemployment (8.7%). Among interviewed patients, 57.1% recalled being screened, but only 24.5% recalled receiving resource guides. Patients who received guides reported little success connecting with resources and supported universal guide dissemination. Staff expressed preference for warm handoff to social services. Of 13 observed discharge interactions, clinical staff only discussed guides with 2 patients, with no positive endorsement of the guides in any observed interactions.
Conclusions: An ED social needs screening program can be moderately feasible and accepted. We identified housing as the most prevalent need. Significant gaps exist between screening and referral, with few patients receiving resources. Further training and workflow optimization are underway.
Competing Interests: The authors declare no conflict of interest.
(© 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)
Databáze: MEDLINE
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