未经评估:急诊科(ED)是筛查未满足的社会需求并将患者与社会服务联系起来的合适场所。这项质量改进研究纳入了定性和定量数据,以检查ED患者和计划实施中未满足的社会需求。
UNASSIGNED:从2020年9月至2021年12月,城市安全网医院成人ED实施了一项社会需求筛查和转诊计划。训练有素的急救人员筛选了符合条件的患者的5种社会需求(住房,食物,交通运输,公用事业,employment),为筛查阳性的患者提供资源指南(THRIVE+)。我们从电子健康记录中收集筛查数据,对THRIVE+患者和临床工作人员进行了半结构化访谈,并直接观察到放电相互作用。
UNASSIGNED:急救人员对58.5%的符合条件的患者进行了社会风险筛查。在接受筛查的患者中,27.0%的人报告至少有1个社会需求未得到满足。其中,74.8%请求援助。接受筛查的患者报告说,住房不安全(16.3%)是最普遍的未满足的社会需求,其次是粮食不安全(13.3%)和失业(8.7%)。在接受采访的患者中,57.1%的人被筛查,但只有24.5%的人回忆起收到资源指南。接受指南的患者报告说,与资源联系并支持通用指南传播收效甚微。工作人员表示倾向于向社会服务进行温暖的交接。在13个观察到的放电相互作用中,临床工作人员仅与2名患者讨论指南,在任何观察到的互动中没有对指南的积极认可。
UNASSIGNED:ED社会需求筛查计划可以适度可行并被接受。我们认为住房是最普遍的需求。筛查和转诊之间存在显著差距,很少有患者接受资源。进一步的培训和工作流程优化正在进行中。
UNASSIGNED: The emergency department (ED) is an opportune venue to screen for unmet social needs and connect patients with social services. This quality improvement study incorporates both qualitative and quantitative data to examine unmet social needs among ED patients and program implementation.
UNASSIGNED: From September 2020 to December 2021, an urban safety-net hospital adult ED implemented a social needs screening and referral program. Trained emergency staff screened eligible patients for 5 social needs (housing, food, transportation, utilities, employment), giving resource guides to patients who screened positive (THRIVE+). We collected screening data from the electronic health record, conducted semi-structured interviews with THRIVE+ patients and clinical staff, and directly observed discharge interactions.
UNASSIGNED: Emergency staff screened 58.5% of eligible patients for social risk. Of the screened patients, 27.0% reported at least 1 unmet social need. Of those, 74.8% requested assistance. Screened patients reported housing insecurity (16.3%) as the most prevalent unmet social need followed by food insecurity (13.3%) and unemployment (8.7%). Among interviewed patients, 57.1% recalled being screened, but only 24.5% recalled receiving resource guides. Patients who received guides reported little success connecting with resources and supported universal guide dissemination. Staff expressed preference for warm handoff to social services. Of 13 observed discharge interactions, clinical staff only discussed guides with 2 patients, with no positive endorsement of the guides in any observed interactions.
UNASSIGNED: An ED social needs screening program can be moderately feasible and accepted. We identified housing as the most prevalent need. Significant gaps exist between screening and referral, with few patients receiving resources. Further training and workflow optimization are underway.