Workforce Models to Screen for and Address Patients’ Unmet Social Needs in the Clinic Setting: A Scoping Review

• Published in: Journal of primary care & community health Vol. 12; p. 21501327211021021
• Main Authors: Sandhu, Sahil, Xu, Jacqueline, Eisenson, Howard, Prvu Bettger, Janet
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 2021; SAGE PUBLICATIONS, INC; SAGE Publishing
• Subjects: Ambulatory health care; Clinical trials; Clinics; Community resources; Delivery of Health Care; Health care industry; Health services; Humans; Literature reviews; Medical personnel; Medical screening; Medicine; Needs assessment; Observational studies; Observational Studies as Topic; Organizational effectiveness; Original Research; Patients; Primary care; Professional development; Social Determinants of Health; Social education; Social factors; Social services; Social Support; Social Workers; Systematic review; Teams; Tests; Volunteers; Workforce; social determinants of health; screening; workforce; ambulatory care; scoping review
• ISSN: 2150-1319; 2150-1327
• DOI: 10.1177/21501327211021021

Objectives While healthcare organizations increasingly aim to address the social determinants of health (SDOH) in the clinic setting, there is little guidance on which staff are best equipped to assume this role. The present study is a scoping review of the peer-reviewed literature to characterize workforce models used to screen for and respond to patients’ unmet social needs in ambulatory settings. Methods Four online databases were used to identify papers published until February 2021. Eligible articles were original research studies or systematic reviews that described the implementation of a standardized assessment for multiple SDOH domains and resulting activities to respond to individual patient needs (eg, referral to community resources) in ambulatory care settings. Results Of the 1569 articles identified, 65 met study eligibility criteria. Majority of studies had observational study designs (11% were randomized control trials). For screening-related activities, more articles reported using traditional healthcare staff (51%), such as medical providers, medical assistants, and front-desk staff, than social care staff (32%), such as social workers and student volunteers. In contrast, for response-related activities, more articles reported using social care staff (88%) than traditional healthcare staff (60%). While we found wide variations in specific team configurations and training for the roles, social care staff generally provided more intensive forms of assistance than traditional healthcare staff. Conclusion While this review demonstrates the breadth of models for building or deploying a workforce to integrate health and social care, it also identifies the need for rigorous research on workforce development, implementation, and effectiveness.