Do new quality measures for social risk screening 'measure up'?

Abstract

New social risk screening standards and quality metrics reward or penalize healthcare delivery organizations for social risk screening. After summarizing the recent literature on social risk screening in pediatric healthcare settings we consider how this evidence - and persistent evidence gaps - might inform future standards development. Reported social risk screening rates, measures, and modality differ greatly across recent work. Although many caregivers report acceptability of screening, experiences and expectations around effective follow-up vary. Likewise, although most frontline clinical providers find screening acceptable, they report significant implementation challenges related to time constraints, insufficient workforce, and availability of social services. Qualitative findings suggest opportunities to improve screening implementation. Literature examining the impacts of screening continues to focus on immediate posited impacts of assistance programs; few studies assess health outcomes. The existing literature does not clearly indicate whether, when, how, or for whom social risk screening standards focused on screening quantity will contribute to child health or health equity. Informed by studies on patient experience, quality measures focused on screening quantity (e.g. how many individuals are screened) should be paired with efforts to improve screening quality (i.e. patient/caregiver screening experience) as well as social and health outcomes.