Study: Improvements needed in adverse SDOH screening, documentation

A new study has revealed some of the greatest barriers and facilitators to screening, documenting, and addressing social determinants of health (SDOH) across United States’ emergency departments (ED).

The JAMA Network Open study examined a sample of 280 academic and nonacademic EDs across the country. In particular, this study focused on reporting policies that screen for housing instability, difficulty paying for utilities or transportation, or food insecurity.

The study aimed to identify the most common impediments in SDOH screening, such as the following:

• Social need questions were often addressed during triage with the social workers on-hand; however, social workers are often only available during business hours
• Many clinicians expressed reservations about the utility of such screenings; additionally, ED patients themselves often do not wish to divulge personal social needs information
• Lack of resources, staffing, and time often impaired successful screening and subsequent linkages to social needs services

Accordingly, and based upon the testimonies of the 280 emergency departments, the authors concluded that the following solutions are necessary:

• Address electronic health record system limitations
• Include ED leadership and staff in adverse SDOH screening implementation efforts
• Increase the availability of social workers, navigators, and case managers to address identified needs
• Reduce documentation burdens for an already overburdened ED staff

Editor’s note: A version of this article originally appeared in CDI Strategies, ACDIS’ weekly e-newsletter.