Social Work Assessment Research Articles

Social workers' consideration of dental support for people living with dementia: Findings from interviews and care assessment documentation.

Social work assessments underpin support plans for many people living with dementia in their own homes in England, but it is unclear how they acknowledge that dementia places people at greater risk of mouth and dental problems affecting their wellbeing. We explored if and how dental needs are addressed during care assessments and social workers' perceptions of this aspect of personal care. This study analysed (a) semi-structured interviews with 14 social workers providing support to people living with dementia in their own homes, (b) data from 39 care assessments and support plans from two English local authorities. Interviews were recorded online, transcribed, and thematically analysed. Documents were analysed descriptively and presented visually. Participants acknowledged that oral care may be overlooked during assessments and reflected on various reasons, including assumptions of responsibility and role restrictions, limited training, and poor links with dental services. This was further evident in the analysis of assessment documentation. Participants identified potential strategies and practice changes to better integrate oral care in social work practice. These included increased awareness and more discussions around dental needs, skills training and streamlining of support. The findings have implications for social workers, educators, and commissioners or funders engaging with people affected by dementia in social work and beyond.

Findings Associated With Nonaccidental Trauma in Children With Isolated Femoral Diaphyseal Fractures.

Pediatric patients with isolated femoral diaphyseal fractures are difficult to assess for nonaccidental trauma (NAT). The purpose of this study was to determine (1) if there are any demographic features of isolated femoral diaphyseal fractures associated with suspected NAT and (2) if there are clinical signs associated with isolated femoral diaphyseal fractures associated with suspected NAT. All patients with femoral diaphyseal fractures from January 2010 to June 2018 were reviewed. We included patients younger than 4 years old with isolated femoral diaphyseal fractures. We excluded patients 4 years old and older, polytraumas, motor vehicle collisions, and patients with altered bone biology. Diagnosis of suspected NAT was determined by review of a documented social work assessment. We recorded fracture characteristics including location along femur as well as fracture pattern and presence of associated findings on NAT workup including the presence of retinal hemorrhage, subdural hematoma, evidence of prior fracture, or cutaneous lesions. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these associated findings were calculated. Totally, 144 patients met the inclusion criteria. Social work was consulted on 50 patients (35%). Suspected NAT was diagnosed in 27 patients (19%). The average age of patients with suspected NAT was 0.82 and 2.25 years in patients without NAT ( P <0.01). The rate and type of skin lesions present on exam were not different between the 2 groups. Patients with suspected NAT had no findings of retinal hemorrhage or subdural hematoma, but 5 of 27 patients (19%) had evidence of prior fracture on skeletal survey. The sensitivities of retinal hemorrhage, subdural, and skeletal survey were 0%, 0%, and 19% and the specificities of all were 100%. The NPVs were 39%, 27%, and 63%, respectively. The PPV of skeletal survey was 100%. Since there were no patients in this study with positive findings of retinal hemorrhage or subdural hematoma, the PPV for these could not be assessed. In the current study, signs of NAT such as skin lesions, retinal hemorrhage, subdural hematoma, and evidence of prior fracture on skeletal survey may not be helpful to diagnosis suspected NAT in patients with an isolated femoral diaphyseal fracture. Level III-diagnostic study.

Intervention Pathways following a Social Work Assessment: An Analysis of National Administrative Data for Children’s Social Care in England

Abstract The majority of children referred to social care services in England go on to receive a statutory assessment by a social worker. Research has identified consistent categories of demand based on the needs identified in assessments. However, little is known about the relationship between children’s assessed needs and their subsequent intervention pathways. To explore this relationship, secondary analysis was undertaken of a national administrative data-set including all children who received a social work assessment in England from 2015 to 2020 (n = 3.6 m). Children’s characteristics, assessed needs and intervention pathways were compared for each episode of CSC involvement. Regression analysis then explored how the proportion of children receiving different types of provision varied according to their needs as well as intersections of gender, age and ethnicity. The findings showed significant differences across twelve categories of demand, pointing to variation in the assessment and response to similar types of presenting needs. Implications are discussed for the planning and design of services.

Emergency Risk Assessments in Child Welfare Services: Developing Structured Support to Professional Assessments

ABSTRACTThe article presents a study on structured support for the professional assessment of emergent domestic violence in families with children. Data are presented on the development and study of a new structured support called iRiSk emergency, which was developed jointly by the authors of this article, and an emergency social work unit in Stockholm, Sweden. The model was developed from the iRiSk model, which, translated from Swedish, stands for ‘Interventions and Risk and Protection Assessments for children exposed to violence’. Structured support for emergency risk assessments is rare as existing instruments mainly focus on screening for violence and are not designed to guide professionals in situations of identified violence. The purpose of the research project is elaborated through two research questions: (1) Which information is needed for emergency assessments, and how can it be collected? (2) What are the specific preconditions of the child welfare service emergency work to be taken into account in terms of emergency risk assessments? The feedback from the social workers was that iRiSk emergency was flexible to use, decreased the risk of missing important risk factors and made the assessments more child‐centred. The model appears to be a viable approach for enhancing the systematic evaluation and testing of structured support for emergency risk assessment in social work, surpassing the limitations of the current study.

Psychosocial Distress Screening Among Interprofessional Palliative Care Teams: A Narrative Review

With increased need for palliative care and limited staffing resources, non-social workers are increasingly responsible for screening for urgent psychosocial distress. The National Consensus Project guidelines call for all palliative care team members to be competent in screening across domains. Yet, in contrast to an abundance of evidence-informed tools for palliative social work assessments, standardization for interprofessional psychosocial screening is lacking. This lack of standardized practice may lead to harmful disparities in care delivery. The purpose of this narrative review is to examine current literature on evidence-informed practices for psychosocial screening within palliative care. Google Scholar, a university Summon library search engine, and prominent palliative care journals were searched using the same phrases to locate articles for inclusion. Each article was reviewed and synthesized across common themes. Although an abundance of validated screening tools exists for outpatient oncology-specific settings, there is minimal guidance on psychosocial screening tools intended for specialty palliative care. The most oft-cited tools have been met with concern for validity across diverse palliative care populations and settings. Additional research is needed to operationalize and measure brief psychosocial screening tools that can be validated for use by interprofessional palliative care teams, a stepping-stone for increased equity in palliative care practice.

Exploring Social Work professionals' Experiences of the Mindfulness-Based Social Work and Self-Care Programme: A Focus Group Study.

The evidence for the potential of mindfulness-based programmes to support improved social work practice and self-care is growing. The aim of this focus group study was to explore social workers' (n = 13) experiences of the Mindfulness-based Social Work and Self-care programme (MBSWSC). Thematic analysis highlighted two superordinate themes: benefits to direct social work practice and coping with the social work role. Four subordinate themes highlighted the different social work practice components that were enhanced through MBSWSC participation: social work assessment, service user engagement and team working, working to social work values, and social work skills. Three subordinate themes identified improvements in individual processes which supported enhanced stress coping: moving from avoidant to approach coping, improved boundaries, increased emotional awareness and reduced negative thinking. Our findings indicate that the MBSWSC programme can have a multi-faceted positive effect on social work practice, and on social work professional's capacity to cope with their role.

Head injury and associated disability in adults undergoing pre-sentencing assessment by criminal justice social work

Although evidence indicates that head injury (HI) is prevalent in prisoners, little is known about HI in defendants during the Court process. This study assesses history of HI and persisting sequelae in defendants undergoing Criminal Justice Social Work (CJSW) assessment for Court.A cross sectional, between subjects design was used. HI history was assessed using the Ohio State University TBI Identification-Method and disability with the Glasgow Outcome Scale-Extended in 46 adult defendants undergoing a CJSW assessment in Scotland. Assessments of mental health, cognitive function, effort on tests and dysexecutive behaviour were also carried out. Comparisons were made between defendants with and without significant HI.Significant HI (SHI) was found in 33/46 (72%) participants and 39% (13/33) of these had persisting disability. Those with SHI were more likely to have moderate-severe mental health difficulties, problematic alcohol or drug use and impairment on the Dysexecutive Questionnaire. Group differences were not found on cognitive tests or in offending history. No CJSW report identified HI.Disability, psychological distress, dysexecutive behaviour and potentially harmful substance use are more common in defendants with SHI. Training and a screening process for HI in CJSW assessments is needed to inform Court disposals and interventions.

Variability in Occult Injury Screening Among Siblings/Household Contacts of Physical Abuse Victims.

The objective of this study is to examine radiologic occult injury screening performance/yield among contacts presenting for precautionary medical assessments and assess factors associated with deferred screening. Data were collected retrospectively from charts of contacts younger than 8 years presenting for precautionary evaluation to a level 1 pediatric emergency department January 1, 2018 to March 31, 2023. Demographics, radiologic performance/yield, physical examination, social work-based psychosocial assessment, reasons for deferred imaging, and diagnostic codes were abstracted. Descriptive statistics and χ 2 analysis are reported. Three hundred ninety contacts were identified; 364 (93.3%) were biological siblings. Most (276, 70.8%) were 2 to 8 years old. Statistically significant relationships were identified with age, insurance, and hospital social work assessment and screening. Thirty-four infants (54%) underwent neuroimaging; no studies were abnormal. Of 114 contacts, <2 years old, 97 (85%) underwent skeletal survey (SS); 9 (9%) SS were abnormal. Twenty-seven (24%) returned for follow-up SS; 4 (14.8%) were abnormal. For 2 contacts, an abnormal initial SS was refuted by follow-up imaging. Physical examinations were abnormal for 11% of contacts. Reasons for deferred imaging included contact well appearance, caregiver concerns, and clinician disagreement with indications. Encounter International Classification of Diseases codes varied, commonly reflecting nonspecific screening assessments. Despite national clinical practice guidelines, studies of abusive injury prevalence and radiologic yield among at-risk contacts exposed to unsafe environments are few. Screening evaluations inclusive of physical examination and radiologic studies identify abuse concerns among at-risk contacts. Further study of factors impacting radiologic screening decisions is needed. Considerations to advance epidemiologic research include standardized diagnostic coding and prospective assessment of radiologic yield.

Factors Impacting Maltreatment Evaluation and Reports to Child Protective Services in Pediatric Substance Exposures.

The objective of this study was to assess demographic, clinical, and psychosocial factors associated with pediatric substance exposures, describe the medical evaluation, and identify factors associated with social work (SW) and hospital-based child protection team (CPT) safety assessments and reports to child protective services (CPS). We retrospectively reviewed charts of electronic medical records for children ages 0 to 72 months presenting for accidental ingestion evaluated May 1, 2015 to May 1, 2021 at a level 1 pediatric trauma center. Cases of environmental exposures, iatrogenic medication errors, dosing errors, and allergies/adverse reactions were excluded. Data were analyzed using descriptive statistics; χ 2 and multivariable logistic regression analysis assessed factors associated with two primary outcomes of interest, SW/CPT assessment and CPS report. Among 773 total cases of substance exposures during the studied time frame, 27% were referred to SW/CPT for further safety assessments and 15.4% were reported to CPS. Being admitted to the hospital, prescription medication or recreational/illegal/illicit substance exposures, and increasing psychosocial risk factors were found to be significantly associated with referrals. Age, race, and insurance status were not found to be associated. Toxicology screening was performed in only 24.7% of cases. Of those eligible for further imaging per hospital protocol, skeletal surveys were obtained in 5.5% of cases and head imaging was obtained in 9% of cases. There is significant variability in pediatric substance exposure assessment practices. Disparities based on demographic characteristics are uncommon. Perceived severity of condition, exposures involving recreational/illegal/illicit substances, and greater prevalence of family psychosocial adversities are associated with higher rates of SW/CPT assessment and CPS reports.

Integrating social care into gynecologic oncology: Identifying and addressing patient's social needs

ObjectiveWe aimed to identify social needs of gynecologic oncology patients using a self-administered social needs assessment tool (SNAT), compare the SNAT to a formal social work assessment performed by cancer care navigators (CCN), and provide SNAT-informed community resources. MethodsWe analyzed prospectively collected data from a performance improvement initiative in a safety-net gynecologic oncology clinic between October 2021 and July 2022. We screened for eight social needs domains, health literacy, desire for social work, and presence of urgent needs. Clinicodemographic data were abstracted from the electronic medical record. Univariate descriptive statistics were used. Inter-rater reliability for social needs domains was assessed using percent agreement. Results1010 unique patients were seen over this study period. 488 (48%) patients completed the SNAT, of which 265 (54%) screened positive for ≥1 social need. 83 (31%) patients were actively receiving cancer treatment, 140 (53%) were in post-treatment surveillance, and 42 (16%) had benign gynecologic diagnoses. Transportation (19% vs 25%), housing insecurity (18% vs 19%), and desire to speak with a social worker (16% vs 27%) were the 3 most common needs in both the entire cohort and among patients actively receiving cancer treatment. 78% patients in active treatment were seen by a CCN and received SNAT informed community resources. The percent agreement between the SNAT and formal CCN assessment ranged from 72%–94%. ConclusionsThe self-administered SNAT identified many unmet social needs among gynecologic oncology patients, corresponded well with the formal social work CCN assessment, and informed the provision of community resources.

Learning through simulation: A systematic literature review of the use of virtual reality and augmented reality in social work education

The use of virtual reality as a learning tool is becoming increasingly prevalent in social work education. This systematic review aims to analyse the findings of studies that have applied virtual reality to social work training through thematic and content analyses. Our results show that the main advantages of virtual reality for social work training cited in the literature include improvements in motivation, and the acquisition of competencies and skills specific to the discipline of social work (assessment, diagnosis and intervention), among others. The main limitations include temporal constraints in the application of virtual reality, as well as perceived dehumanisation.

Towards a ‘Social Model’ of Mental Capacity for Social Work

Abstract The statutory social work role in England and Wales regularly involves assessment and ‘best interests’ decision making under the Mental Capacity Act (MCA) 2005. Legal frameworks that permit substitute decision making have, however, been challenged as a contravention of the human rights of people with disabilities. This article aims to answer the question: ‘Can mental capacity be theorised for social work assessment in England and Wales in a way that is compatible with social work ethics and values?’ Findings are that mental capacity is a complex and disputed concept best described using a constructivist ‘social model’ which situates it as a property of an individual’s relationships. Such a model suggests that assessments are a joint endeavour and that the quality of the relationship between assessor and assessed is crucial. The present legal framework disincentivises but does not prevent capacity assessment based on a social model. The existing literature suggests that further research might identify ways in which social work capacity assessment could enhance rather than diminish the autonomy of the people involved. These findings have implications for social work research, education and post qualification training.

Capability approach to evaluate real-world effectiveness of social services

Abstract Background The capability approach offers a comprehensive framework for the evaluation of conditions for wellbeing in terms of how well society promotes equal opportunities, skills, and the ability to lead a good life. The aim of this study was to utilize the capability approach to evaluate the real-world effectiveness of health social work among those with experienced negative life-events. Methods “Evidencing the effectiveness of health social work assessment and intervention” (Terva, 2021-2023) quasi-experimental data with mixed methods collected in real-world conditions across three hospital districts. The baseline data (intervention=266 and comparison=255) is collected and 6 months follow-up study is lasting until June 2023. Questionnaire data among participants included validated measures of perceived capabilities and background variables (age, gender, education, income) and among social workers (the evaluation of needs). Analysis of covariance (ANCOVA) while adjusting background variables at baseline and qualitative analyses will be applied. Results People with negative life-events perceived their capabilities as being lower than general adult population. These differences were especially reflected to live a healthy life and form satisfying social relationships. In baseline, the intervention group also demonstrated significantly lower capabilities compared to the comparison group. The detailed results of the real-world effectiveness of health social work on capabilities within and between intervention and comparison groups will be presented at the conference. Conclusions Our study is one of the first ones to utilize capability approach to examine real-world effectiveness of social services among those negative life events. Future studies should also include the commodities, converting factors and individual agency into the analyses and try to capture the dynamic process of the realization of capabilities and agency with a longer follow-up up to 24 months. Key messages • Capability Approach (CA) provides useful tool for evaluating effectiveness of social services in terms of promoting health and wellbeing of the customers. • CA could be utilized for developing more empowering and effective wellbeing policies targeted to the specific customer-centered needs.

Use of case studies in social work assessments – ChatGPT’s kryptonite?

ABSTRACT The launch of ChatGPT sent ripples across higher education, particularly in attempts to detect its use by students using it to complete assignments. This paper reflects on the past semester of ‘life with ChatGPT’, starting with a narrative of current practices in assessment writing at the Singapore University of Social Sciences, before embarking on a test of the response generated by ChatGPT in answering a case study-based exam question. Taken together with the author’s experiences grading assignments that had been at least partially generated by artificial intelligence (AI) but not known at that time, it is surmised that case studies tend not to lend themselves well to having good-quality responses being generated by AI tools such as ChatGPT, at this current stage of their development. However, implications for assessment writing involving case studies include the need for sufficient details, both essential and peripheral, so that students have to ‘separate the wheat from the chaff’, and decipher how best to apply the concepts being examined based on the unique circumstances of the case scenario. At this point in time, the use of complex, detailed, and well-written case studies in assessment questions appears to be ChatGPT’s kryptonite and could ensure authentic assessments.

Linking administrative data on children's social care to investigate the outcomes of provision

ObjectivesThis paper will present findings from a study of linked administrative data on children’s social care (CSC) services in England. Its objectives were to identify and profile the underlying categories of demand for CSC services in England and compare the outcomes of provision between these categories, using a range of measures.&#x0D; MethodsAn anonymised longitudinal dataset was assembled for children in need and children in care who received services in England between 2015-21. Latent Class Analysis (LCA) was used to identify mutually exclusive categories of demand for all children subject to a statutory social work assessment within that period, based on the factors identified at assessment. Descriptive profiles of these categories were constructed using demographic data as well as children’s intervention pathway following assessment. Survival analysis using adjusted Cox regression models was then undertaken to compare rates of re-referrals, repeat child protection plans, and re-entries to care, for children receiving services within each category.&#x0D; ResultsThe latent class analysis found twelve distinct categories of demand for children’s social care services, which were consistent across local authorities. Conditional probabilities were used to interpret the demand represented by each category, in consultation with stakeholders. The most prevalent category was domestic abuse and violence (19.7%), followed by complexities around parental mental health (18.4%). Other categories included disability, child mental health, risks outside the home, complex domestic abuse, and concerns about another person in the family or household. The profile of children varied across these categories, including age, gender, ethnicity, the level of risk identified by services, and the type of provision received. Significant differences were also found in the outcomes of provision across categories, especially in re-referrals and re-entries to care.&#x0D; ConclusionThe categories create an evidence-based typology of demand to supplement conventional performance measures. Local profiling of these categories can be support designing and planning services and aligning the textual information gathered in assessments with the statistical data used for audit and inspection.

Social work virtual: preparing social work students for a digital future

ABSTRACT During the pandemic, social workers have faced increasingly complex client needs, and are simultaneously undergoing transformative changes in practice with the rapid uptake of digital technologies. To make the best use of these technologies, practitioners require new knowledge, skills, and competencies, yet to date, the development of digital competencies has not formed a curriculum priority in social work higher education. To address this gap, we developed the 8-week simulation learning experience Social Work Virtual. Combining the principles of best pedagogical practice in both face-to-face and online education, Social Work Virtual is specifically tailored to develop digital social work competencies under the mentorship of practicing clinicians. In this paper, we describe the challenges in higher education and healthcare service provision that prompted the development of this learning simulation, and the opportunities it provided for students to develop skills in social work assessment and intervention using digital technologies. We include a reflective account by a practice mentor in Social Work Virtual. The reflection offers insights into how this simulation experience addressed student learning needs amid a rapidly changing social and professional landscape. We then consider how educators may adopt similar pedagogical strategies to integrate digital competencies within their professional programs.

Disparities in Maternal-Infant Drug Testing, Social Work Assessment, and Custody at 5 Hospitals.

To evaluate for disparities in peripartum toxicology testing among maternal-infant dyads across a hospital network and subsequent child protective services (CPS) involvement. Retrospective chart review of 59,425 deliveries at 5 hospitals in Massachusetts between 2016 and 2020. We evaluated associations between maternal characteristics, toxicology testing, and child welfare involvement with disproportionality risk ratios and hierarchical logistical regression. Toxicology testing was performed on 1959 (3.3%) dyads. Younger individuals and individuals of color were more likely to be tested for cannabis use or maternal medical complications compared to white non-Hispanic individuals. Among those without a substance use disorder, age <25 (adjusted odds ratio [aOR] 2.81; 95% confidence interval [CI], 2.43-3.26), race and ethnicity (non-Hispanic Black (aOR 1.80; 95% CI, 1.52-2.13), Hispanic (aOR 1.23; 95% CI, 1.05-1.45), mixed race/other (aOR 1.40; 95% CI, 1.04, 1.87), unavailable race (aOR 1.92; 95% CI, 1.32-2.79), and public insurance (Medicaid [aOR 2.61; 95% CI, 2.27-3.00], Medicare [aOR 13.76; 95% CI, 9.99-18.91]) had increased odds of toxicology testing compared to older, white non-Hispanic, and privately insured individuals. The disproportionality ratios in testing were greater than 1.0 for individuals under 25 years old (3.8), Hispanic individuals (1.6), non-Hispanic Black individuals (1.8), individuals of other race (1.2), unavailable race (1.8), and individuals with public insurance (Medicaid 2.6; Medicare 10.6). Among dyads tested, race and ethnicity was not associated with CPS involvement. Peripartum toxicology testing is disproportionately performed on non-white, younger, and poorer individuals and their infants, with cannabis use and medical complications prompting testing more often for patients of color than for white non-Hispanic individuals.

Developing and Evaluating a Social Work Assessment Model based on Co-production Methods

Abstract Building Better Futures (BBF) is a structured and systematic model developed in Northern Ireland for assessing parenting capacity when there are childcare concerns. This article focuses on the iterative development of the model, through a social work, practitioner–academic, research collaboration. BBF was developed using a mixed method, flexible and multi-modal, iterative design embracing a collaborative approach between social work academics and practitioners. Five senior practitioners (SPs) were appointed for a three-year period to work on the project. The formative implementation and evaluation of the model consisted of a series of co-produced, in-depth mixed-method evaluation studies across the region. The project outcomes confirmed the utility of the model for social work practitioners and the benefits to families. An evaluation of the co-production methodologies identified the importance of building an inclusive, collaborative team with shared trust. The importance of managing power between the groups was identified, and the absence of parents as part of the collaboration was acknowledged. Engagement in research can enhance professional identity and job satisfaction for social workers and develop social work tools and processes which are ‘fit for purpose’ because they have been influenced by the views of the end users.

Categorising Demand for Child Welfare Services Using Latent Class Analysis: A Study of the National Data-sets on Children in Need in England

Abstract In England, administrative data on children’s needs are recorded following a social work assessment. These data are typically used to understand prevalence of individual risk factors and to inform processes, such as the work of local safeguarding partners and multi-agency services. However, reporting individual factors at assessment cannot capture the complexity and heterogeneity of multiple and overlapping needs. This study aimed to identify common types of demand, via a limited number of clusters, using the factors recorded in a national data-set of over 4.2 million assessments carried out between 2014 and 2021, of which 3.6 million had at least one factor recorded. Latent class analysis was used to identify twelve distinct categories of demand for children’s social care services, which were consistent across local authorities. Conditional probabilities were used to interpret the demand represented by each category, in consultation with stakeholders. The most prevalent category was domestic abuse and violence (19.7 per cent), followed by complexities around parental mental health (18.4 per cent). Other categories included disability, child mental health, risks outside the home, complex domestic abuse and concerns about another person in the family or household. This article examines some of the operational and planning implications of categorising demand in this way.

Identification of healthcare vulnerabilities associated with unplanned hospital care in Black patients with pancreas cancer.

e18572 Background: Black patients with pancreatic cancer are underrepresented in clinical trials and have worse outcomes than other patients. A retrospective analysis we conducted of 658 patients with pancreatic cancer identified that Black patients are 2.8x more likely to have recurrent ED visits than non-Black patients. This finding motivated this study of Black patients with pancreas cancer who had ED visits over a two-month period to better understand the causal factors that predispose this population to higher rates of unplanned hospital care. Methods: A quality improvement pilot study of Black patients with pancreas cancer who had ED visits between 12/06/22-02/06/23 was conducted. Computational identification of this cohort was performed using a novel Power BI dashboard that tracks health system encounters by patients with pancreas cancer using ICD10 C25 as a cohort identifier in daily updates. Each ED visit then prompted a phone call to the patient from an African American oncology nurse practitioner who served as a cultural translator to evaluate their healthcare vulnerabilities. Demographic and clinical features were recorded from the EMR. Median household income was extrapolated by zip code using data from the US Census Bureau. Results: During this two-month period, 14 Black patients had at least 1 ED visit. Of these, 50% had ≥2 ED visits during this timeframe. Through retrospective review, we found that patients in this cohort had an average of 4.4 ED visits in the past year. The cohort was 50% male with a mean age of 65.5 years and median household income of $67,032. 21% have commercial insurance, 36% have Medicaid, and 43% have Medicare. 86% established care with a primary care physician and 71% established care with a medical oncologist. 79% of patients did not have a social work assessment in their charts. We were unable to reach 50% of patients in this cohort at their preferred phone numbers. Of the patients we connected with: 71% note their highest level of education as high school, 29% do not feel safe in their communities, 14% lack a reliable support system, and 57% experience financial insecurity. Conclusions: We observed a substantial burden of ED visits among Black patients. Remarkably, half of the patients already required a second ED visit during the two-month span of this project. Given these intriguing results, we intend to pursue a prospective study using a validated questionnaire to better understand and address the factors that lead to these ED visits.