SHM Converge Scientific Abstract ePoster Gallery-Examining Discrepencies in Health-Related Social Needs Screening in Hospitals

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This study examined implementation of CMS-mandated health-related social needs (HRSN) screening at Jefferson Health and compared results from nurses versus community health workers (CHWs), sometimes paired with medical students. Using a retrospective sample of 152 hospitalized patients discharged from Jefferson’s Hospital Medicine service between January 1 and June 30, 2024, the authors reviewed documented screening in six overlapping social need domains.<br /><br />Screening rates increased after the mandate, with nurses completing HRSN screens in 69% of cases and CHWs/medical students in 85%. Nearly all patients (95%) had at least one positive social need identified. Housing instability was the most common concern (36.2%), while utility needs were least common (15.1%). CHW-based screens identified more positive needs overall, especially for housing instability.<br /><br />However, the study found substantial discordance between screeners. Overall agreement on screening outcomes was low, with 22% discordance and a Cohen’s kappa of 0.25. Positive screen percent agreement was only 28%, while negative agreement was higher at 76%. These findings suggest that different screeners may identify different patient needs even when using the same general domains.<br /><br />The authors conclude that HRSN screening increased after CMS implementation, but the consistency of screening remains poor across healthcare workers. They recommend standardizing screening methods and defining best practices. Potential improvements include targeted screener training, team-based screening models, and more patient-centered screening strategies. Limitations include reliance on electronic documentation and a small sample that may not reflect the broader patient population. Further research is needed to validate and standardize HRSN screening.

Asset Subtitle

Nolan P. Chiles

Meta Tag

Author List Alyssa Yeager, Christine Shusted, Nolan P. Chiles, Rebecca C. Jaffe

Category Research

Concept Health-Related Social Needs Screening

Concept CMS Mandate

Concept Discordance

Concept Kappa Coefficient

Concept Patient Outcomes

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College at Thomas Jefferson University

Presenting Author Nolan P. Chiles

Track Quality Improvement

Keywords

HRSN screening

CMS mandate

Jefferson Health

nurses

community health workers

medical students

housing instability

utility needs

screening discordance

Cohen's kappa

Health-Related Social Needs Screening

CMS Mandate

Discordance

Kappa Coefficient

Patient Outcomes