P2.283: Improving Social Determinants of Health Identification and Intervention Among Pediatric Inpatients: A Comparison of Written Questionnaire and Verbal Screening Strategies

Purpose/Objectives: To determine if written screening identified social risk factors more consistently than verbal screening, resulted in increased rates of screening, and led to improved referral for positive screens.

Design/Methods: A retrospective review was conducted, of verbal SDOH screening data from January to February 2024 to establish baseline rates. Nurses performed verbal screenings at intake, documented them in the Epic SDOH template. In April 2024, written SDOH screening forms were introduced for patients admitted under the pediatrics service, though some were missed due to logistical constraints. We analyzed the percentage of children screened, positive screens, and patients with identified risks who received interventions. From April 2024 to February 2025, bimonthly Plan-Do-Study-Act (PDSA) cycles were conducted, with run charts tracking trends. Key interventions included structured questionnaires, standardized workflows, EMR modifications, and resident education with feedback.

Results: Review of baseline data indicated that 2% of patients screened positive through verbal screening. Following the implementation of a written questionnaire, the percentage of positive screens increased to approximately 18%. When comparing factors such as housing, food insecurity, and transportation, families were more likely to disclose challenges on a written questionnaire, as evidenced by consistently higher positive responses. Additional concerns identified included immigration and insurance-related issues, as well as caregiver mental health and substance use. During high-volume months, resident-led written screening decreased due to clinical demands, whereas nurse-led verbal screening remained more consistent. However, written screenings, even when infrequent, identified a higher rate of positive responses compared to verbal screenings. This demonstrates the enhanced sensitivity and effectiveness of written screening tools in identifying a broader range of social needs.

Conclusion/Discussion: Written SDOH screening forms were more likely to be positive than verbal screening assessments. Reviewing screening forms as part of the team workflow enabled us to provide appropriate referrals and resources. The consistency of written screenings, even during high-demand periods, emphasizes the importance of integrating sustainable and streamlined screening processes into routine clinical practice. Future studies should evaluate long-term impacts on outcomes and healthcare utilization.