Emergency Department Comprehensive Social Risk Screening and Resource Referral Program

Area of Science:

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

Background:

• The emergency department (ED) is a critical access point for identifying and addressing patients' social risks.
• A standardized process for social risk screening in the ED is currently lacking.
• This study addresses the need for a systematic approach to social risk assessment in emergency settings.

Purpose of the Study:

• To describe the implementation and findings of a social risk screening and resource referral program in an urban academic ED.
• To evaluate the effectiveness of a comprehensive screening questionnaire in identifying social determinants of health.
• To analyze demographic associations with the burden of social risk.

Main Methods:

• Prospective cohort study conducted in a single academic, urban ED from July 2022 to April 2023.
• Trained staff screened eligible ED patients (aged 18+, medically stable, able to consent) using a 19-question survey covering 12 social determinant domains.
• Resource referral was facilitated via an online platform or direct social worker contact; data analyzed using univariate logistic regression.

Main Results:

• Of 1,677 eligible patients, 1,473 (87.8%) consented to screening, and 1,078 (73.2%) reported at least one social risk.
• The most prevalent risks were social isolation (39%) and depression (23%).
• High success rates for resource provision were observed for medium (88.9-96.8%) and high (80.8-100%) social risk categories. Female and Black patients showed significantly higher odds of multiple social risks.

Conclusions:

• A comprehensive social risk screening and referral program was successfully implemented in a large, urban academic ED.
• Findings highlight the prevalence of social isolation and depression, informing institutional resource prioritization.
• The developed model offers a framework for other institutions to adapt for their social risk management strategies.