TY  - JOUR
AU  - Wallace, Andrea S.
AU  - Luther, Brenda
AU  - Guo, Jia-Wen
AU  - Wang, Ching-Yu
AU  - Sisler, Shawna
AU  - Wong, Bob
PY  - 2020
TI  - Implementing a Social Determinants Screening and Referral Infrastructure During Routine Emergency Department Visits, Utah, 2017-2018
T2  - Preventing Chronic Disease
JO  - Prev Chronic Dis
SP  - E45
VL  - 17
CY  - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2  - PURPOSE AND OBJECTIVES  Emergency departments see a disproportionate share of low-income and uninsured patients. We developed and evaluated a process for identifying social needs among emergency department patients, for facilitating access to community-based resources, and for integrating clinical and community-based data. INTERVENTION APPROACH  We leveraged an academic-community partnership to develop a social needs screening tool and referral process. EVALUATION METHODS  In a 25-day feasibility trial incorporating rapid improvement cycles, emergency department staff screened 210 patients for social needs. Observational and interview notes were analyzed, and data were linked from patient screenings, the United Way of Salt Lake 2-1-1 consumer information system, and electronic health records. RESULTS  Domains uncovered during pilot testing included screening based on appearance or insurance; discomfort asking stigmatizing questions; and lack of clarity regarding the screening's purpose. During the trial, 61% (n = 129) of patients reported 1 or more need, 52% (n = 67) of whom wanted follow-up. Of the 65 patients with complete data who wanted referrals, 49% (n = 32) were ultimately reached by 2-1-1, which provided an average of 4 community referrals (eg, pharmacy programs, utility assistance). Service usage 3 months before versus 3 months after emergency department index dates demonstrated that patients with social needs experienced a significant increase in emergency department use compared with those without needs (1.07 vs 1.36, P = .03), while patients with no needs experienced increases in primary care visits compared with those patients with unmet needs (0.24 vs 0.56, P = .03). IMPLICATIONS FOR PUBLIC HEALTH  We demonstrated the ability to systematically screen and refer for emergency department patients' unmet social needs by using existing resources and to link screening results, service referral details, and health service data. However, our experiences demonstrate that widespread implementation efforts should thoughtfully address staff perceptions and patient communication challenges.
SN  - 1545-1151
UR  - https://doi.org/10.5888/pcd17.190339
DO  - 10.5888/pcd17.190339
ER  - 
<a href="http://www.cy118119.com/">国产精品久久久久久一级毛片</a>
<script>
(function(){
    var bp = document.createElement('script');
    var curProtocol = window.location.protocol.split(':')[0];
    if (curProtocol === 'https') {
        bp.src = 'https://zz.bdstatic.com/linksubmit/push.js';
    }
    else {
        bp.src = 'http://push.zhanzhang.baidu.com/push.js';
    }
    var s = document.getElementsByTagName("script")[0];
    s.parentNode.insertBefore(bp, s);
})();
</script>
</body>