300 Identification of Social Determinants of Health in a Pediatric Emergency Department

Abstract

The primary aim of this study is to implement a screening system within pediatric emergency department to better identify families with unmet basic needs. The secondary aim is to improve connection of families to community resources to address the identified areas of need. The study was conducted between February and March 2019 at a community hospital pediatric emergency department with an annual census of 13000 visits. A convenience sample of families presenting to the ED were given the survey instrument to complete voluntarily. The survey instrument used was the “We Care Survey,” a well validated tool to determine social determinants of health. Surveys were done predominantly between 10AM to 4 PM when the study team was available in the ED. When any unmet need was identified, trained research personnel offered to provide or direct them to the appropriate relevant resources. A resource booklet compiled by the social work department and study team was also provided to the participating family. Statistical analysis using SPSS for Windows was done to explore associations between families with any unmet need and other variables. Inclusion criteria for study participants are families with patients presenting for ED visits from 10am to 4pm. Families will be excluded if they are not English speaking. Of the 200 families that completed the survey, 175 (88%) families identified at least one unmet need. Needs indicated on the survey included 65 (32.5%) caregivers identified needing help finding a job, 32 (16%) identified needing help obtaining a high school diploma, 29 (14.5%) identified housing insecurity and another 9 (14.5%) identified food insecurity as an unmet need. Other identified areas of unmet need were 19 (9.5%) for with smoking cessation, 4 (2%) for drug use, 9 people (4.5%) for help with their depression, 6 (3%) with domestic abuse and 15 (7.5%) for daycare help for their child. From this study, we were able to better identify patients’ psychosocial problems and help improve our means of addressing the problems. By doing this study, we were able to help at risk families and children obtain resources that they need. Additionally, we are able to better serve the population seen in our pediatric emergency department. We are currently in the process of using the results of this study to formally and permanently implement a means of addressing social determinants of health in the pediatric emergency department. This study has allowed us to better refine the way the pediatric emergency department addresses the needs of its patients and their families.