"We ask because we care": Lived experience of social determinants of health screening among social workers and nurse case managers

Introduction/Objectives: SDOH screening is increasingly required, yet is often operationalized as EHR documentation. The objective of this project was to explore how social workers and nurse case managers experience SDOH screening and how care settings shape its meaning and practice. 

Methods: We conducted semi-structured interviews with 10 staff members (6 social workers, 4 nurse case managers) across inpatient and outpatient follow-up contexts in a large academic health system and analyzed transcripts using Colaizzi's phenomenological method.

Results: Five themes emerged: negotiating patient autonomy, conversational personalization, technological and systemic frustrations, staff expertise, and interprofessional collaboration. Participants reported time pressure, emotional labor, and moral distress when needs were identified without reliable pathways to assistance, and they described contrasting inpatient urgency and outpatient continuity that influenced disclosure, trust, and follow-up.

Conclusions: SDOH screening was experienced as relationship-centered work that depends on supportive workflows and response capacity; implementation should pair screening mandates with training, streamlined documentation, and closed-loop referral processes.