• Article
  • April 25, 2018

3 Steps for Implementing Social Needs Screenings to Detect Child Health Risk Factors

Screening for social determinants can be challenging for children's hospitals. Here are three things to consider.

Medical care can only go so far without addressing other risk factors that affect a child's overall health. Unmet social needs such as homelessness, unsafe housing conditions and unemployment are major contributors to poor health outcomes. But screening for social determinants of health (SDOH) is a challenging process for children's hospitals.

A new report, Screening for Social Determinants of Health: Children's Hospitals Respond, shares strategies and tools children's hospitals have used to implement SDOH screenings. Here are three steps to help your hospital implement a screening tool.

Identify and build community connections

To have a successful screening tool, you need to know how to address social needs. Start by establishing community relationships outside your hospital. Learn who the community resource providers are; identify the resources available from community and social service organizations and their capacity for referrals.

Work to build relationships with these resources. One hospital partnered with a university's pre-medicine program to build a family resource database and social needs training. In some cases, children's hospitals can bring the right parties together.

Find the right screening tool

One common question across hospitals is, "What SDOH screening tools are my peers using?" Some hospitals use hybrid, customizable tools to fit the needs of their patients and providers, but the efficacy is unknown. Other tools may not be appropriate for pediatrics or contain questions organizations aren't prepared to address.

Screening tools for children require a different approach. In this report, children's hospitals can review a list of 16 tools and platforms frequently used in pediatric health care settings.

Start small

There are many logistical concerns when adding a screening tool to the health evaluation process. Some organizations cite buy-in as a barrier to implementation. But children's hospitals have started small to make progress, advancing their programs by first screening in primary care clinics, requesting advance input from providers in different areas of the hospital, and increasing the number or social workers to better serve patient and family needs.

Once a tool is in place, process improvements may be needed to ensure screenings work correctly, as was the case for one hospital that found primary care physicians were referring patients with social needs to the hospital's emergency department.

While it's not simple to add social needs screenings to existing patient assessments, children's hospitals are finding a way to make it work. Thoughtful planning and buy-in from the entire care team are critical to addressing a child's whole health.

Want to learn more? Additional insights on SDOH screenings are available in the June 5 Social Needs Screenings: The Tale of Two Hospitals webinar and Context Counts: How Social Determinants of Health Impact Care Delivery whitepaper, part of the Essentials of Population Health education series.

Send questions or comments to magazine@childrenshospitals.org.