567 - Healthcare Team Members’ Views on Social Determinant of Health Screening and Referral Practices in a Pediatric Emergency Department

While social determinants of health (SDH) screening and referral are recommended in clinical guidelines and their implementation is extending to pediatric emergency departments (PEDs), there is limited understanding of views from PED healthcare team members (HTM) on this evolving practice.

Objective:

To explore PED HTMs’ views on SDH screening and referral processes

Design/Methods:

We conducted a cross-sectional, descriptive study to understand PED HTMs’ views on SDH screening and referral at a quaternary level children’s hospital. We collected data from a multidisciplinary health team in the PED via distribution of an electronic survey. SDH screening efforts at this PED had been in place for 1 year prior to survey distribution and utilized research assistants (RAs) for workflow. Study participants included physicians, advanced-practice providers, nurses, techs, social workers, registration staff. The survey was based on best practice framework of goal identification and assessed SDH screening practices, comfort and personal habits in screening, prioritization of SDH domains, workflows to perform screening, and perceived barriers to screening. Data were analyzed using descriptive statistics for quantitative measures.

Results:

There were 63 HTMs (48% response rate), most were physicians (46%), age 35-44 (38.5%), and woman (64.1%). All participants (100%) reported social needs screening efforts should continue in the PED, yet 36% were unaware of the current social needs screening efforts with RAs occurring in the PED. Participants reported a median comfort level rate of 47.5 out of 100, with the highest reported barrier being “lack of knowledge/skill on resources” (77.3%), and reported asking patients about social needs on average 33% of the time (Figure 1). Regarding the screening processes of current SDH practices with RAs, approximately half of respondents suggested improvements be made in the areas of “integration of screening” and “variability of screening” (Figure 2). Timing of SDH screening was preferred “during the PED visit” (66.7%) versus at triage, discharge, or etc. Delivery of SDH screening was preferred by someone other than clinical HTM (nurse, tech, provider) by 83.3% of participants, yet 90.5% reported that SDH screening should be performed electronically by patient (Figure 3).

Conclusion(s):

HTMs support continuing the process for screening and referring patients for SDH but suggest improvements on screening and referral processes. HTM want training, education, and screening and referral resources support to address social needs and ultimately improve patient health outcomes.