430 - Assessment of an Electronic Health Record-Based Social Needs Screening Tool and Referral Workflow in a Pediatric Emergency Department

Publication Number: 4421.430

Joseph Y. Liao, Boston University School of Medicine, boston, MA, United States; Lauren Ameden, Boston Medical Center, Wellesley, MA, United States; Sorraya Jaiprasert, Boston Medical Center, Boston, MA, United States; Rebecca Levin, Boston University School of Medicine, Boston, MA, United States; Pablo Buitron de la Vega, Boston University School of Medicine, Roxbury, MA, United States; Deborah A.. Frank, Boston University School of Medicine, Brookline, MA, United States

Background: Unmet social needs are prevalent in patients presenting to Pediatric Emergency Departments (PEDs) and associated with adverse child health outcomes. Our hospital implemented an electronic health record (EHR)-based social needs screening and referral workflow in the PED, in which a printed resource guide is automatically included in the discharge summary. It is unknown whether the referral process helps families connect to services.

Objective: To determine the rate at which families requesting resources attempt to contact and successfully connect with services based on the referral workflow.

Design/Methods: Contact was attempted 1-2 months post visit with caregivers of patients 0-17 years and patients >17 years who presented to the PED between March and August 2025, endorsed at least one unmet social need on their screen, and requested to be connected to resources. A research team member administered surveys via phone assessing: (1) comfort with screening, (2) helpfulness of the resource guide, (3) attempt to contact and ability to connect with services, and (4) barriers encountered at each stage. Demographic information was obtained via the EHR. Descriptive statistics were calculated for patients' reported race, ethnicity, language preference, and insurance type to assess potential disparities in connection rates. Chi-squared and T-tests were conducted between groups.

Results: Of 228 total caregivers or patients, 101 completed follow-up surveys (44.3%). Of those who completed the survey, the majority requested resources for food (54.5%). Most reported being neutral (5.0%) or comfortable (60.4%) with or not remembering being screened (27.7%). 46.5% of those surveyed remembered receiving a resource guide, and 25.8% reported the resource guide was somewhat or very helpful. Regarding service connection, 35.6% (n=36) attempted to contact services, while 64.4% (n=65) never attempted contact. Overall, 22.8% successfully connected with a service. Among those who never attempted contact (n=65), the primary barrier was losing contact information (n=36). Among those who attempted but failed to connect (n=13), the primary barrier was having a bad experience with the service (n=8). There was no association between race, ethnicity, preferred language, or insurance type in attempt to contact or ability to connect with services.

Conclusion(s): Almost 1 in 4 families who completed follow-up surveys were successfully able to connect with services through an automated EHR-based referral workflow in the PED. Further studies should evaluate strategies to improve rates of initial contact attempts and successful connections.

Table 1
Demographic information of those who completed follow-up surveys

Table 2
Follow-up survey results

Table 3
Association between demographic information and attempt to contact or successfully connect with a service