Creating healing-centered health systems by reimagining social needs screening and supports

Athough the impact of health-related social needs (HRSNs) on children’s health is well documented, there has been a recent fervor to implement HRSN screenings broadly in pediatric health care organizations, catalyzed by health equity–focused changes in the health care industry. These include Joint Commission requirements, Centers for Medicare and Medicaid quality measures, US News and World Reports hospital rankings, and efforts to incorporate screening into value-based reimbursement systems. As HRSN screening becomes standard of care, there are several implications for pediatric health care organizations as they transition from a care model that was once fully under the purview of families and frontline clinicians/staff to an approach overseen by systems-level leaders and administrators. Although likely beneficial, such an expansive approach creates a complex array of institutional decision makers who have varied skills sets, motivations, and experience, thereby potentially leading to divergent, and perhaps contradictory, goals for screening. The rapidity of implementation without centering the voices of key partners or prioritizing resource provision and supports is concerning and may lead to harm.