Case Study: Temple Health 2023 Achievement Award

Social Determinants of Health: A Comprehensive Health System Approach to Screening and Response 
Living the Vision Award

The Goal

To improve health outcomes and health equity by identifying and addressing barriers to patients’ health.

Intervention

Temple Health undertook a comprehensive multi-year program to systematically identify and respond to social determinants of health (SDOH) among our patients and community. Our systematic approach follows an iterative process of 1) launching SDOH screening to understand the needs of patients in a particular care setting, 2) partnering with community-based organizations to develop and deliver interventions for the SDOH identified by screening, especially those overrepresented among Black and Hispanic patients, 3) creating innovative internal programs to address SDOH in our highest risk patients, and 4) expanding to additional care settings.

Results

Our SDOH screening and response program was successfully rolled out to all of our primary care practices, emergency departments, nurse navigation programs, burn unit, and cancer center from 2019 through 2022. More than 170,000 screenings have been completed health system-wide. An innovative community health worker program responds to positive screenings, and patients are connected to a robust array of community partnerships and innovative SDOH-related programs. Through these programs, we have reduced hospitalizations and emergency department visits for patients with complex SDOH-related needs.

 

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Topics: Population Health, Quality Initiatives

Revision Date: 2/28/2023

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