A Simple Health-Related Social Needs Referral Workflow in a Pediatric Emergency Department

To determine the rate at which families requesting health-related social needs (HRSN) resources in our Pediatric Emergency Department (PED) successfully connect with social services based on an automated electronic health record (EHR)-based referral workflow where resource guides are automatically printed with discharge summaries, as part of a larger Quality Improvement initiative.

We attempted to contact all families who presented to the PED March-August 2025, endorsed ≥1 unmet HRSN on screening, and requested connection to resources. Staff contacted patients aged >17 years or caregivers (if patient aged ≤17 years) 1-2 months after the PED encounter to administer an 8-item telephone survey. Surveys assessed perceptions of helpfulness of the resource guide, attempt to contact and ability to connect with services, and barriers encountered. We calculated descriptive statistics including Chi-square and t-tests between groups.

Of 229 total eligible patients/caregivers, 101 (44.1%) completed follow-up surveys. Of these, 46.5% remembered receiving a resource guide, and 25.8% reported the resource guide was somewhat or very helpful. Overall, 23 (22.8%) reported being able to connect with a service. Among the 13 (12.9%) who attempted but failed to connect, the primary barrier was having a bad experience with the service (n = 8). Among the 65 (64.4%) who never attempted contact, the primary barrier was losing the contact information (n = 36).

Almost one in four families who completed follow-up surveys were able to connect with a social service through a simple, automated referral workflow in the PED. Further initiatives will address barriers to improve rates of connections.