Social Risk Screening and Referrals in the Pediatric Inpatient Setting

Many professional organizations recently recommended inpatient screening for social risks. Although prior studies have explored social risk screening rates in children's hospitals, many excluded community hospitals and lacked detail on screening practices. We aimed to describe national social risk screening and referral practices among hospitals caring for children.

We conducted a cross-sectional survey (August 2023-November 2023) through the Pediatric Research in Inpatient Settings Network. One clinical leader per institution was surveyed on inpatient social risk screening and referral processes, populations, tools and data tracking, and barriers/facilitators to social care. Descriptive statistics summarized survey responses.

Of the hospitals contacted, 80.2% (77/96) completed the survey. Overall, 66.7% of hospitals reported screening for social risks in some capacity, most commonly performed by nurses. Screening tools and domains varied widely, with 21.9% using a published tool and 12.5% using internally developed questions. Food insecurity was the most frequently screened domain (91.9%), whereas screening for legal needs was least common (0%). Most hospitals had systems to refer patients to in-hospital (98.4%) and out-of-hospital (96.8%) services, primarily through social work consultations (96.5%) and printed handouts (54.4%). Fewer than 10% partnered with community-based organizations. Less than 45% of screening hospitals had a data-tracking system for referrals, and only 2.5% collected patient health care use data. Staffing was the most cited barrier to screening.

Social risk screening and referral practices vary widely among hospitals caring for children. Standardized policies and support mechanisms may reduce variability and promote equitable social care practices across hospitals.