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. 2021 Oct;10(4):e001540.
doi: 10.1136/bmjoq-2021-001540.

Opportunity to inform social needs within a hospital setting using data-driven patient engagement

Shoshana Hahn-Goldberg  1   2 , Pauline Pariser  3   4 , Colton Schwenk  5 , Andrew Boozary  3
Affiliations

Opportunity to inform social needs within a hospital setting using data-driven patient engagement

Shoshana Hahn-Goldberg et al. BMJ Open Qual. 2021 Oct.

Abstract

Background: High-risk patients account for a disproportionate amount of healthcare use, necessitating the development of care delivery solutions aimed specifically at reducing this use. These interventions have largely been unsuccessful, perhaps due to a lack of attention to patients' social needs and engagement of patients in developing solutions.

Methods: The project team used a combination of administrative data, information culled from charts and interviews with high-risk patients to understand social needs, the current experience of addressing social needs in the hospital, and patient preferences and identified opportunities for improvement. Interviews were conducted in March and April 2020, and patients were asked to reflect on their experiences both before and during the COVID-19 pandemic.

Results: A total of 4579 patients with 26 168 visits to the emergency department and 2904 inpatient admissions in the previous year were identified. Qualitative analysis resulted in three themes: (1) the interaction between social needs, demographics, and health; (2) the hospital's role in addressing social needs; and (3) the impact of social needs on experiences of care. Themes related to experiences before and during COVID-19 did not differ. Three opportunities were identified: (1) training for staff related to stigma and trauma, (2) improved documentation of social needs and (3) creation of navigation programmes.

Discussion: Certain demographic factors were clearly associated with an increased need for social support. Unfortunately, many factors identified by patients as mediating their need for such support were not consistently captured. Going forward, high-risk patients should be included in the development of quality improvement initiatives and programmes to address social needs.

Keywords: health equity; health services research; healthcare quality improvement; hospital medicine; patient-centred care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Guiding questions for patient interviews.
Figure 2
Figure 2
Patient interview inclusion flowchart.
See this image and copyright information in PMC

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