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Identification and Documentation of Patient Social Risk Factors in the Prehospital Setting: A Pilot Implementation
Molly McCann-Pineo1, Elizabeth Young1, Ji Yoon Lee1
1Northwell, New Hyde Park, New York.
Prehospital Emergency Care
|June 4, 2026
Summary
Emergency Medical Services integrated a social risk factor (SRF) tool, finding low documentation rates. Further investigation is needed to improve SRF identification and reporting by clinicians.
Area of Science:
- Public Health
- Health Services Research
- Emergency Medicine
Background:
- Social risk factors (SRFs) are increasingly recognized as critical drivers of health outcomes.
- Emergency Medical Services (EMS) are exploring ways to identify and address SRFs in prehospital settings.
- Current integration of SRF screening into routine EMS practice is not standardized.
Purpose of the Study:
- To evaluate the integration of a prehospital social risk factor documentation tool within an EMS agency.
- To assess the prevalence and identification rates of SRFs in emergency medical encounters.
Main Methods:
- A 14-item prehospital SRF documentation tool was integrated into the EMS charting platform.
- A retrospective cohort study analyzed adult emergency and non-emergency calls over a six-month period.
- Descriptive and bivariate statistics were used to characterize the sample and evaluate SRF prevalence.
Main Results:
- Out of 57,899 encounters, 4.0% had at least one documented SRF.
- The most common SRFs identified were substance use (31.3%), housing instability (25.7%), and disability (25.4%).
- Patients with documented SRFs were older and more likely to be female compared to those without.
Conclusions:
- Documented SRFs were low, indicating a need to identify barriers to recognition and reporting.
- Young males represent a high-risk group for repeated EMS encounters.
- Improved mechanisms are needed for EMS clinicians to document and communicate SRF information to emergency departments.
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