Clinician and Staff Perspectives on a Social Drivers of Health Program Implementation

Area of Science:

• Health Services Research
• Public Health
• Social Determinants of Health

Background:

• Health systems are increasingly screening for social drivers of health (SDOH) to address health inequities.
• A large integrated health system implemented a universal SDOH screening program in 2019.

Purpose of the Study:

• To explore frontline clinician and staff attitudes regarding the feasibility, workflow, and implementation of a universal SDOH screening program.
• To identify facilitators and barriers to successful SDOH program implementation in primary care settings.

Main Methods:

• Semistructured interviews were conducted with 20 frontline clinicians and staff across five diverse primary care clinics.
• An inductive-deductive analysis was used to identify key themes and best practices for SDOH program implementation.

Main Results:

• Over 16,000 SDOH screenings were conducted, with screening rates varying significantly by clinic.
• Key barriers included staff time constraints, limited social service availability, and decreased staff morale.
• Facilitators included established triage protocols, standardized digital pre-visit screening, and fostering shared ownership through education and team huddles.

Conclusions:

• Universal SDOH screening in primary care may not be feasible due to time constraints and service availability.
• Future research should investigate targeted screening approaches and the trade-offs between SDOH programs and other clinical priorities.