One of our most important directives at MedStar Southern Maryland Hospital Center is to improve health in our community. From the Community Health Needs Assessment, we know that there are great disparities in health among those we serve, and that they are often linked to socioeconomic factors such as housing instability, unemployment, hunger, domestic violence and lack of transportation. Such factors can lead families to avoid preventive and routine care, instead using the Emergency Department (ED) only when an illness or condition becomes more severe.
To address health disparities that stem from socioeconomic factors, MedStar Health has chosen three sites to pilot a program designed to identify the most important problems interfering with patients’ health and connect the patients with existing aid programs. We were chosen as a pilot site, along with the MedStar Harbor Hospital Obstetrics Department and the MedStar Franklin Square Family Health Center.
The Emergency Department links patients to appropriate community services, and conducting follow-up resource counseling to patients who screen positive for unmet needs. The pilot is largely based on use of an online tool called Aunt Bertha, a database that makes it easy to find need-based social service programs in a specific geographic area.
“It’s about meeting patients where they’re at,” says Octavia Peterson, who is our hospital’s health lead for the project, as well as community outreach coordinator for Cardiac Care Management. She says the goal is to not only give these patients the emergency care they need, but to try to help them with other needs that could be affecting their health.
When the pilot begins on July 1, Emergency Department nurses will start screening every ED patient. Patients who have an identified need for services will be referred to our case management department. There, a case manager will use Aunt Bertha to search for appropriate social program for each individual and will later follow up to make sure the patient has actually contacted those programs.
Key questions that MedStar Health hopes to answer with this pilot include what social needs face our patients, the feasibility of screening for social needs at the point of care, the effectiveness of Aunt Bertha in linking patients to services, and whether the program actually affects patient behaviors.