# Bringing the Heart Back to Medicine by Addressing Social Drivers of Health

> Kristie Foster, director of Nursing Operations at Mt. Ascutney Hospital, joins GEMCast host Dr Christina Shenvi to discuss a screening programme at her critical-access ED.

About This Podcast

Every time a patient comes to the Emergency Department (ED) for care, there is an opportunity to identify and address factors in their life that may be contributing to their presentation. Social drivers of health (SDOH), including housing instability, access to transportation, economic hardship, and access to healthcare, are the non-medical aspects of a person’s life that influence their health. In today’s episode, Kristie Foster, Director of Nursing Operations at Mt. Ascutney Hospital in Vermont, joins host Dr Christina Shenvi to discuss the screening programme she implemented at her critical-access ED.

At the heart of the SDOH screening programme is Kristie’s focus on compassionate care. It starts with a personal, conversation-based approach in which ED technicians use a simple checklist to identify common needs. When a need is identified, a three-tiered approach is initiated to connect patients with resources that can address those needs. Tune in to learn more about how the screening programme works in practice and hear stories from this successful intervention.

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Key Points

An ED visit is unique. It is an unscheduled point of contact that can provide an opportunity to identify risk, connect patients with resources, and give them a greater chance of success when they return home.

Adverse social conditions are associated with poor health. To improve patient outcomes, SDOH such as food insecurity, medication access, transportation, housing, mental health, and substance use should be assessed.

Every issue included in the screening has a corresponding intervention and resource that will auto-populate in the EMR, making the process actionable, efficient and straightforward.

Resources may be delivered at various stages in care:

Immediately in the ED (e.g. food bags).

Automated discharge letters that include relevant resources. 

Through post-discharge follow-up to connect with additional community resources

Long-term success of a programme requires staff engagement. The best results come when staff understand why the work matters, see meaningful patient outcomes, and believe in the goals of the programme.

Next, listen to How to Put the 4Ms Into Practice: Age-Friendly Care in the ED with Dr. David Zodda. 

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