GERI ‐ RISK : A Quality Improvement Initiative to Screen for Social Risk in a Geriatric Care Clinic

BACKGROUND: Unmet social determinant of health (SDOH) needs can impede access to healthcare and increase morbidity and mortality for older adults. Screening for SDOH takes time, and primary care clinicians often have competing demands. METHODS: Using a quality improvement (QI) approach, we created a systematic method to screen for SDOH needs as well as perceived health, activities of daily living, instrumental activities of daily living, and internet use among patients seen in a geriatric medicine clinic. Patients screened were from one physician's panel with scheduled primary care appointments in the upcoming 6 months. Epic electronic medical record system and REDCap were used for documentation. We used the plan-do-study-act (PDSA) methodology to improve the screening. RESULTS: Of the 368 patients contacted, 224 (61%) completed screening, with 210 (94%) of those patients identifying at least one unmet SDOH need. Excluding screening for tobacco use and depression (which were already screened at a high rate), screening increased by 2%-33% for most SDOH. CONCLUSION: Telephone screening is a feasible method to identify patients' SDOH needs. Next steps include expanding the screening to additional physicians' patient panels, conducting additional PDSA cycles to further improve screening rates, and integrating these methods into the standard clinic workflow.