Background: Social Determinants of Health (SDOH) refer to the circumstances present in the surroundings where individuals are born, reside, acquire knowledge, engage in employment, participate in leisure activities, practice religion, and grow old, which have an impact on a diverse array of health-related outcomes, functioning, and risks that affect the quality of life. The presence of disparities based on race/ethnicity, socioeconomic status, and geographic location is notably evident in the incidence of mortality and/or morbidity associated with cardiovascular disease, cancer, diabetes, COPD, HIV/AIDS, homicide, psychological distress, hypertension, smoking, obesity, and the availability of high-quality healthcare services. Methods: The Plan Do Study Act method of quality improvement was used for this project. Data of initial screening and referral from November 2022 to January of 2023 were retrieved. Baseline assessment included reviewing the Athena electronic health records of patient's medical records within the Midwestern Academic Internal Medicine Clinic. This review will consist of new patients and annual physical patients that were screened for SDOH between April 2023 to December 2023. Intervention: Newly retrieved data from April 2023 to December 2023 will be compared to the original SDOH screening and referral data from November 2022 to January 2023. With this data, quality improvement opportunities will be formulated with the staff at a Midwestern Academic Internal Medicine Clinic. Internal Medicine staff: Providers- academic faculty physicians or nurse practitioners Staff- RN, case/clinical managers, social workers, medical assistants, and medical receptionists Results: The previous studies assessment following the implementation of the SDOH process map (see Appendix C) and screening tool (see Appendix B), between November 2022 to January 2023, showed 73% of eligible patients were screened (see Appendix E). The current data from April 2023 to December 2023 revealed an 83% completion rate (see Appendix E). Conclusions: The data collected demonstrated an increase of 11% in completion of SDOH screenings in comparison to the initial data. The results suggest that having an SDOH screening process in place, educating, and training staff regarding the screening process can improve the screening rates. It's important to note that despite the increase of percentage of SDOH screening, continued education, monitoring and growth is required to sustain the initiative. SDOH screening sustainability requires continuous monitoring, educating, and training for the staff and newly hired staff involved in the screening process (Zhang & Fornilli, 2023).
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