Implementation Resources

Below are guides, toolkits, and reports that provide recommendations and guidance about how to implement social needs screening and interventions in clinical settings. Additional information to inform implementation efforts, including peer-reviewed research articles, can also be found in our Evidence Library.

National Surveys Gauging Prevalence of Social Care-Related Activities in the Health Care Sector

Yuri CartierMatt PantellEmilia De MarchisLaura Gottlieb
In 2018, SIREN researchers reviewed the findings from 23 different national surveys collected through September 2018 that included questions about health care-based social care assessment and intervention activities. We've developed a table divided into six sections reflecting the health care...

Compendium of Medical Terminology Codes for Social Risk Factors

A. Arons, S. DeSilvey, C. Fichtenberg, & L. Gottlieb
This spreadsheet contains codes related to social risk factors that we extracted in a systematic search of four medical vocabularies ( LOINC, SNOMED CT, ICD-10-CM, and CPT). The spreadsheet is intended to help interested stakeholders (including from clinical and social service providers, measure...

Characteristics of Social Prescribing Statements by Professional Medical Associations

G. GusoffC. FichtenbergL. Gottlieb
A table linking to professional medical association (PMA) clinical guidelines and policy statements that feature themes related to assessing for and/or addressing social risk/resilience in health care delivery settings. The statements were collected from 42 different PMAs, including the American...

Food Insecurity Screening Toolkit

HumanaFeeding America
Humana partnered with Feeding America to develop a toolkit to raise awareness and to offer suggestions for how health care professionals might treat food insecurity in their patients. This resource is intended to support health care providers as they identify patients who are food insecure and to...

Blueprint for Complex Care: A Strategic Plan for Advancing the Field

M. HumowieckiT. KurunaR. SaxM. HawthorneA. HamblinS. TurnerK. MateC. SevinK. Cullen
The Blueprint for Complex Care is a strategic plan to support multidisciplinary innovations and accelerate opportunities to improve care for individuals with complex health and social needs. Input was gathered from consumers, providers, administrators, executives, and more to outline the goals,...

HealthBegins Webinar: Designing and Financing Sustainable Community Health Investments

Rishi Manchanda, MD, MPHJason HelgersonBill Pinakiewicz
National experts describe operational and financing strategies and best practices to establish sustainable partnerships with community organizations. Watch now .

Social Determinants of Health Series: Transportation and the Role of Hospitals

Health Research & Educational Trust
This guide explains the link between transportation and health and discusses the role of hospitals and health systems in addressing transportation issues, improving access and helping design and support better transportation options. Although hospitals and health systems traditionally have not...

Social Determinants of Health Series: Food insecurity and the role of hospitals

Health Research & Educational Trust
This guide discusses the link between food insecurity and health issues, including chronic illness and child development, and the role of hospitals in identifying food-insecure individuals and households to help address this determinant of health. Access the Guide >

Social Determinants of Health Series: Housing and the role of hospitals

Health Research & Educational Trust
This guide is the second guide in a series of resources from the Health Research & Educational Trust (HRET) and Association for Community Health Improvement (ACHI) on how hospitals can address the social determinants of health— such as adequate housing, quality education and access to...

Screening and interventions for food insecurity in health care settings state strategies to increase an underutilized practice in California

M. Cannon
Despite a growing body of evidence suggesting that food insecurity has significant consequences for the health of low-income Californians, very few hospitals and health clinics in our state are routinely screening for food insecurity. In this paper we examine how food insecurity screening tools can...