Hunger: A Missed Opportunity for Screening in the Pediatric Emergency Department

2018 ◽  
Vol 57 (11) ◽  
pp. 1318-1325 ◽  
Author(s):  
Tamar Robinson ◽  
Leah Bryan ◽  
Veda Johnson ◽  
Terri McFadden ◽  
Sarah Lazarus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Emergency Department ◽  
Food Insecurity ◽  
Hospital Staff ◽  
Social Needs ◽  
Social Risk ◽  
Care Hospital ◽  
Social Risk Factors ◽  
Primary Care Hospital

Background. The American Academy of Pediatrics and pediatric community recognize the importance of addressing social determinants of health. There are limited data on the prevalence of food insecurity or literature establishing protocols assessing food insecurity in the emergency department (ED). Methods. Two anonymous surveys were administered, one to families during their ED visit and another to ED staff to assess perceptions on the ED’s role in providing social support. Results. Thirty-three of 214 respondents (15.4%) reported food insecurity and are associated with economic risk factors ( P < .0001) and a lack of primary care ( P = .008). Overall, 83.2% of the ED staff believed knowing information about families’ social risk factors would help patient care and 77.6% believed that the ED staff should address families’ social needs. Conclusions. Food insecurity affects a significant portion of ED families across income ranges. Screening for food insecurity in the ED is important given association with lack of primary care. Hospital staff supports screening and intervention.

scholarly journals A Screening and Referral Intervention for Food Insecurity Among Older Emergency Department Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Aileen Aylward ◽  
Timothy Platts-Mills ◽  
Liane Wardlow ◽  
Conor Sullivan ◽  
Jessa Engelberg Anderson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Food Insecurity ◽  
Local Area ◽  
Social Risk ◽  
Social Risk Factors ◽  
Community Based ◽  
Community Based Services ◽  
Satisfaction With Services

Abstract Food insecurity is prevalent among older adults, negatively impacts health, and may increase healthcare utilization. Risk factors include poverty, lack of transportation, and social isolation. Community-based services may mitigate food insecurity and other social risk factors. However, identifying those at risk and connecting them to services can be challenging. We implemented a screening and referral program in an Emergency Department (ED) to identify older adults facing food insecurity and connect them to a local Area Agency on Aging (AAA), which arranged and tracked delivery of community-based services. ED nursing assistants used the Hunger Vital Sign screener to assess food insecurity in patients aged 60 years and older. ED Care Managers (CMs) saw all who screened positive and made referrals to the AAA. The AAA conducted an intake assessment and arranged services. Patients were contacted three months after their ED visit to evaluate health, quality of life, and satisfaction with services. Of 423 patients screened over 7 months, 45 (11%) reported food insecurity. Of those, 25 were referred to the AAA. Patients were not referred to the AAA due to CM inability to make a referral (7), declining services (4), or other reasons (11). The AAA reached 21 patients and 9 received at least one service. Of those, 5 were reached for follow-up and reported satisfaction with services. The most frequently requested service was Meals on Wheels (10). Food insecurity is common among older ED patients. An ED-AAA partnership is feasible and connects older adults to beneficial services in their communities.

scholarly journals Social Determinants and Frailty in High-Need, High-Risk Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 179-179
Author(s):  
Kiranmayee Muralidhar ◽  
Willy Marcos Valencia ◽  
Fei Tang ◽  
Stuti Dang
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
High Risk ◽  
Frailty Index ◽  
Univariate Analysis ◽  
Ordinal Logistic Regression ◽  
Social Needs ◽  
Social Risk ◽  
Social Risk Factors ◽  
Ordinal Logistic Regression Analysis

Abstract The VA Geriatrics and Extended Care Data Analysis Center uses national predictive modelling to identify High-Need High-Risk (HNHR) Veterans, to provide targeted services and reduce hospitalization and institutionalization risk. To learn the needs of Miami VA HNHR Veterans, we mailed a needs-assessment survey to 2124 Veterans, of whom 634 responded (29.8% response rate). The average respondent age was 70.5±9.2. Among them, 127(20%) were &lt;65 years old, 326(51.4%) were 65-74, and 179(28.2%) were ≥75; 389(61.4%) White, 225(35.5%) Black/African Americans; 515(81.2%) were Non-Hispanic, 111(17.5%) Hispanic/Latino; 173(27.3%) were high school graduates, 350(55.2%) had at least some college credit, 39(6.2%) had a master’s degree or more and 536(84.5%) were health literate. As per Morley’s FRAIL scale, 266(42%) were frail, 242(38.2%) were pre-frail and 87(13.7%) were robust. Social risk factors possibly associated with frailty were analyzed using ordinal logistic regression. Univariate analysis showed significant association with poor health literacy, having a caregiver, social isolation, transportation trouble, delayed or missed doctors’ appointments due to transportation, a negative perception of aging, likelihood of depression, being homebound, inability to use the internet, lack of technology for video conferencing and lack of email use (p≤0.01). Through multivariate ordinal logistic regression analysis, adjusting for patients’ age and Jen Frailty Index, we found that the same social risk factors other than internet use showed significant association with frailty (p≤0.01). HNHR Veterans have complex social needs with a limited ability to manage their chronic conditions, necessitating interventions that address not only their medical issues but also their access barriers and social support.

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

2021 ◽  
Vol 10 (3) ◽  
pp. e001362
Author(s):  
Alison Bradywood ◽  
Treasa "Susie" Leming-Lee ◽  
Richard Watters ◽  
Craig Blackmore
Keyword(s):  
Risk Factors ◽  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Screening Tool ◽  
Social Needs ◽  
Social Risk ◽  
Social Risk Factors ◽  
Risk Screening ◽  
The Core

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.

scholarly journals Broad-based SARS-CoV-2 Testing Program for Healthcare Workers in a Primary Care Hospital In France

2021 ◽  
Author(s):  
Julie Chas ◽  
Marine Nadal ◽  
Martin Siguier ◽  
Anne Fajac ◽  
Michel Denis ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare Workers ◽  
Care Hospital ◽  
Testing Program ◽  
Primary Care Hospital

An Approach to Selecting Single or Multiple Social Risk Factors for Clinic-Based Screening

2021 ◽  
Author(s):  
John F. Steiner ◽  
Glenn K. Goodrich ◽  
Kelly R. Moore ◽  
Spero M. Manson ◽  
Laura M. Gottlieb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Risk ◽  
Social Risk Factors
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