Developing a Reliable and Valid Scale to Measure Psychosocial Acuity

Abstract

This tool is a unique comprehensive scale and methodology to measure the psychosocial acuity of patients and families across a health care continuum. Coupled with other measures, psychosocial acuity can tell a complete and compelling story of social work contributions and aid in resource alignment. Accurately conveying the full scope of social work value to anyone, especially health system leadership, requires that the psychosocial acuity of the patient and family be measured and factored into the equation, along with productivity, time spent, and services provided. The development and utilization of the Psychosocial Acuity Tool is the focus of this publication.

Association Between Psychosocial Acuity and Glycemic Control in a Pediatric Type 1 Diabetes Clinic

“…Psychosocial acuity was measured by the Psychosocial Acuity Scale (PAS), a clinician-administered assessment of psychosocial acuity across 7 domains: transportation/lodging, insurance/finances, housing, coping/mental health, cognitive function/mental status, social/community/school support, and functional status/discharge follow-up. 12 Each domain includes 4 levels of acuity: 1 = low/no concern, 2 = medium concern, 3 = high concern, 4 = critical concern. For example, for the PAS domain of insurance and finances, low or no concern could reflect a patient who presents at a clinical encounter with adequate insurance, the ability to obtain prescriptions, and other financial resources.…”

“…Psychosocial acuity is not summative 12 ; instead, psychosocial acuity at each encounter was determined numerically as selecting the maximum number of any of the 7 acuity domains (e.g., if there was an assessed value of 3 for transport/lodging and 2 for housing, the assigned acuity value for that encounter would be 3). In addition, patients with a score of 2 or greater in any of the social risk domains were coded "high acuity," whereas patients whose highest assessed score was 1 (low/no concern) were coded "low acuity."…”

“…One such way to categorize patients' psychosocial needs within clinical settings is using psychosocial acuity, or the severity of a patient's psychosocial condition and related need for intervention at a given time. 12 The Psychosocial Acuity Scale (PAS) has previously been validated as a way to quantify the level of service provided by clinical social workers to address patient and family psychosocial needs. 12 The scale consists of 7 domains that may influence the health of patients and families, including transportation/lodging, insurance/finances, housing, mental health and coping, cognitive function, social support, and functional status.…”

“…12 The Psychosocial Acuity Scale (PAS) has previously been validated as a way to quantify the level of service provided by clinical social workers to address patient and family psychosocial needs. 12 The scale consists of 7 domains that may influence the health of patients and families, including transportation/lodging, insurance/finances, housing, mental health and coping, cognitive function, social support, and functional status. Psychosocial acuity has been measured across health care settings to evaluate the daily contributions of social workers through patient and family needs on a given day and thereby, resource allocation and intervention delivery to care for the psychosocial needs of patients and families.…”

“…Psychosocial acuity has been measured across health care settings to evaluate the daily contributions of social workers through patient and family needs on a given day and thereby, resource allocation and intervention delivery to care for the psychosocial needs of patients and families. [12][13][14] In addition, acuity has been previously used to describe the number of psychosocial needs present in a clinic population. 15 Although studies have looked at the association of social risk with glycemic outcomes from broader, high-level variables, such as socioeconomic status, insurance status, or neighborhood adversity, studies that have looked at individual-level clinical risk variables assessed by trained social service professionals as part of routine clinical pediatric T1D care are limited.…”