The Highland Health Advocates: a preliminary evaluation of a novel programme addressing the social needs of emergency department patients

Abstract

Health-related social needs are common in this US safety net ED. Our help desk is one possible model for addressing social needs.

Material Needs of Emergency Department Patients: A Systematic Review

“…Further, no studies in this review examined the effects of interventions to address ED patient material needs, and therefore we do not know if or how such interventions may be effective in improving health and other outcomes. One quasi‐experimental study published subsequent to our literature search found that ED patients at a safety‐net California hospital who received a “help desk” intervention designed to assist with their material needs were more likely than a control group to be aware of and have made contact with agencies that could assist them with their needs 1 month later, but did not have changed self‐reported health or ED use . This study, however, suffered from several methodologic limitations.…”

“…Finally, as interest in SDOH increases, new studies meeting our eligibility criteria have continued to be published after our last database search in January 2017, such as the intervention study mentioned earlier . Another study examined malnutrition and food insecurity among elderly adults across three EDs in the Northeast, Midwest, and Southern United States, finding an overall malnutrition prevalence of 12.3% .…”

Achieving the Quadruple Aim: Treating Patients as People by Screening for and Addressing the Social Determinants of Health

“…Examples include the Health Advocates of Alameda Health System, the Health Advocates at Zuckerberg San Francisco General Hospital, and the FIND Desk at UCSF Benioff Children's Hospital in Oakland. 27,28 However, just as an ED should provide episodic care and not continuing care, the resource navigators should link not only emergency providers but also primary care providers. This allows for continuity and ongoing advocacy for social concerns through the patientcentered medical home.…”

Volunteer contributions in the emergency department: A scoping review

“…15,[49][50][51][52][53][54][55][56][57] The majority (n=52; 59.8%) of described programs had general volunteers in the ED, while 35 (40.2%) had volunteers targeting a specific patient population, including pediatrics, 17,42,[64][65][66][67][68][69][70][71][72][73][74][75][76] geriatrics, 25,[38][39][49][50][51][52]77 patients with mental health and addiction issues 18,[22][23][24]35,40,78 and other vulnerable populations. 10,[79][80] Table 3 contains examples of some of these targeted programs.…”

“…12 programs used quantitative methods, including a number of randomized clinical trials, 18,19,24,26,37,40,42,50,52,53,77,79 four programs used qualitative methods 12,13,20,25 and two programs did not specify the type of evaluation used 23,31 . Of those that reported a focus on particular outcomes, patient satisfaction, 12,13,20,31 follow-up and referral rates, 25,40,79 ED and hospital costs and length of stay, 19,42,77 subsequent ED visits, 26,37 medical complications, 50,52 mental health , 18,23,24 and malnutrition 53 in the hospital were all reported to be positively affected by volunteers in the ED. Many of the evaluations of programs took the form of surveys and questionnaires from the perspectives of patients and hospital staff.…”