Improving Health-Related Social Needs Screening and Support Across a Pediatric Health Care System

Area of Science:

• Healthcare Quality Improvement
• Social Determinants of Health
• Patient-Centered Care

Background:

• Health-related social needs (HRSN) significantly impact patient outcomes, healthcare utilization, and quality of life.
• Effective management of HRSN requires integrating screening with timely interventions.
• Previous efforts highlighted the need for systematic approaches to address HRSN in clinical settings.

Purpose of the Study:

• To implement and evaluate a multimodal initiative integrating HRSN screening and intervention across multiple inpatient and outpatient divisions.
• To assess the feasibility and effectiveness of a standardized change package and centralized resource bank for addressing HRSN.
• To determine the impact of integrated HRSN interventions on the prevalence of identified needs, such as food insecurity.

Main Methods:

• A quality improvement team utilized a standardized change package to guide the integration of HRSN screening and interventions.
• The initiative was implemented across 9 diverse divisions within an urban, quaternary pediatric hospital system.
• Performance targets included screening 80% of patient encounters and ensuring interventions for all positive screens, utilizing a centralized resource bank.

Main Results:

• Over 31,000 screenings were conducted between January 2021 and October 2023, achieving a mean screening performance of 92%.
• Positive screens consistently received interventions, with sustained performance above 92% in the final 7 months.
• Food insecurity was identified in 17.6% of encounters, with a 56% reduction in prevalence upon repeat screening after intervention.

Conclusions:

• A centralized quality team and standardized change package effectively facilitate the implementation of HRSN screening and resource connection across diverse clinical settings.
• Integrated HRSN interventions show potential for reducing the prevalence of identified social needs over time.
• Regular rescreening is crucial for comprehensively identifying and addressing the evolving HRSN of families.