Implementing screening for social determinants of health using the Core 5 screening tool

Abstract

Social determinants of health (SDOH) have been documented to underpin 80% of overall health and are being increasingly recognised as key factors in addressing tertiary health outcomes. Yet, despite the widespread acceptance of the association of SDOH with health outcomes, more than two-thirds of hospitals do not screen for social risk factors that indicate individual-level adverse SDOH. Such screening for social risk factors represents the first step in connecting patients with resources and documents the prevalence of social needs. The aim of this project was to implement the Core 5 social risk screening tool and evaluate its efficacy and usability in identifying social risk factors in a presurgical spine population. Prior to this implementation, screening for social risk had not been performed. The Model for Improvement provided a framework for implementing and evaluating the Core 5 social risk screening tool. Methods included implementation of a patient self-report social risk screening tool, referral workflow to connect patients with needed resources and evaluation of staff feasibility in using the Core 5 tool. The results indicated that the screening tool identified patients with social risk factors and staff reported perceptions of efficacy and usability in clinical workflow. Overall, 52 of 88 (59%) of subjects in the presurgical spine population were effectively screened. Of these, five patients (10%) had identified social needs that needed to be addressed prior to surgery. The staff usability survey for the Core 5 tool demonstrated high acceptance and usability, with an average score of 4.4 (out of 5). Future work should evaluate the efficacy of the screening tool in other ambulatory and tertiary settings.

Utilizing a Tailored Approach to Standardized Screening of Health-Related Social Needs

“…However, the reviewed studies lacked comprehensive descriptions of personalized social needs screening and referral procedures. [10][11][12][13][14][15][16][17][18][19] The findings of this project add to the existing body of evidence showing the impact of standardized screening on social needs identification and referrals to community resources.…”

“…The state of the evidence in SDoH does not describe individualized social needs screening and referral processes. However, previous studies have employed various tools, methods, and interventions in different clinical settings, offering compelling evidence that tailored screening processes can be effectively and sustainably implemented 10-19. In addition, there was consensus regarding the essential components of best clinical practice to increase social needs identification and referrals: (1) conducting universal screening, (2) utilizing an established referral process, (3) integrating screening tools as a normal part of the encounter, (4) integrating interdisciplinary teamwork, and (5) providing social needs education and training 10-19.…”

A qualitative analysis of perceptions of and reactions to COVID‐19

“…Importantly, public health nurses are in a unique and advantageous position regarding the intersection between public prevention and clinical care. For example, it has been recommended that nurses conduct a SDOH screening with patients (Bradywood et al., 2021 ), yet currently, only one‐third of hospitals conduct SDOH screenings (Bradywood et al., 2021 ). Implementing this screening more widely may provide a more illuminating picture of the factors intersecting with COVID‐19 risk, and its implications.…”

Social determinants of health in multiple sclerosis

“…The Core-5 screening tool 105 was developed to identify individuals with poor social determinants of health in health-care settings, and is way to identify those at greatest need of input. The tool was independently tested within both inpatient and outpatient settings; staff survey data indicated high acceptance and usability 106 . In Box 1, we suggest a short screening questionnaire, based on the Core-5 screening tool, that can be used to assess social determinants of health in people living with MS.…”