Developing an Approach to Health-Related Social Needs Screening Across Settings in a Pediatric Health System

Increasingly, health-related social needs (HRSNs) screening is being implemented across multiple settings within a single hospital or across health care systems, including outpatient clinics, emergency departments, and inpatient units. This rise in HRSN screening is driven in part by the Centers for Medicare & Medicaid Services' and The Joint Commission's health equity regulatory and accreditation requirements, effective January 1, 2023. These requirements necessitate intentionality in the development and coordination of hospital and health care system-wide processes to meaningfully implement screening and address reported HRSNs. Guidelines for organizational alignment of HRSN screening and response across pediatric health care systems are not described in the literature but could provide an opportunity to enhance patient experience, avoid duplication of effort, and strengthen services delivered to patients who report HRSNs. We present our pediatric academic medical center's approach to achieving organizational alignment of HRSN screening and response developed by a multidisciplinary team of experts in pediatrics, health equity, social work, nursing, case management, and health care leadership. Building on experience from our primary care practices that began screening in 2019, a multidisciplinary team reviewed existing evidence, completed an inventory of HRSN screening and response across our health care system, and identified opportunities for alignment in screening and response. The implementation strategy generated from this process includes fundamental screening and response strategies and workflow and training guidance and can provide other hospitals and health care systems with a roadmap for aligning their own organization's HRSN screening and response processes to assist with the implementation of new health equity HRSN regulatory and accreditation requirements.