Continuous quality improvement in social needs screening: Evaluation of an intervention in bariatric specialty care

INTRODUCTION: With growing recognition of the influence that social risks, such as food insecurity and housing instability, have on individual and population health, social risk screening and social care interventions have proliferated across the health system. Social needs intervention research on screening and referral in specialty care is limited, despite evidence that social needs influence access to and outcomes of surgical and specialty care. 

METHODS: This study is a qualitative, formative evaluation of a quality improvement-oriented social needs screening and referral pilot program implemented in a bariatric surgery practice and aims to share lessons related to the structure and process components of a quality improvement (QI) framework. 

RESULTS: Semistructured interviews revealed variation in patient eligibility for resources and highlighted the need for enhanced staff capacity and data system integration. In addition, process-related themes including patient hesitation toward referrals, variability in screening pathways, and uncertainty surrounding communication practices emerged in qualitative analyses. 

CONCLUSIONS: Implementation of social needs screening and referral programs in specialty care setting is feasible but requires unique structure and process-related considerations. Incorporating QI infrastructure into these programs allows for continuous evaluation of program processes and can be used to evaluate the impact of these programs on health outcomes.