VA OIG: Opportunities Exist to Better Integrate Health-Related Social Needs and Social Determinants of Health into Discharge Assessment and Planning

The VA Office of Inspector General (OIG) conducted a review to evaluate (1) VHA and medical center leaders’ awareness and incorporation of social determinants of health (SDOH) and health-related social needs (HRSN) into inpatient medical unit discharge assessments, planning, policies, and templates; and (2) VHA’s efforts to address SDOH/HRSN with tools and community resources.

The OIG determined there were no national policies or procedures that integrated SDOH/HRSN into discharge assessment and planning. Although the OIG found three national reference documents incorporating SDOH/HRSN, these documents were not considered formal guidance and were largely unknown to leaders responsible for discharge assessment and planning within inpatient units. Most medical center staff developed their own discharge policies and procedures addressing SDOH/HRSN, according to an OIG survey.

The OIG also identified national templates incorporating SDOH/HRSN for primary care social workers but no template for discharge planning within medical …

The OIG made five recommendations to the Under Secretary for Health regarding the development of national policy on incorporating SDOH/HRSN into discharge assessment and planning, implementation of a standardized template, evaluation of barriers to assessing SDOH/HRSN at discharge, use of health equity tools, and establishment of community resource partnerships to address SDOH.

1. The Under Secretary for Health considers the need for a national policy establishing the inclusion of social determinants of health/health-related social needs into discharge assessment and planning.
2. The Under Secretary for Health considers the implementation of a standardized electronic health record template, such as the Assessing Circumstances and Offering Resources for Needs tool, that includes the assessment of social determinants of health/health-related social needs of hospitalized patients.
3. The Under Secretary for Health evaluates barriers to assessing social determinants of health/health-related social needs when patients are discharged from VA medical centers.
4. The Under Secretary for Health promotes the use of health equity tools across VA medical centers
5. The Under Secretary for Health promotes the establishment of partnerships of VA medical centers with community resources to address social determinants of health/health-related social needs.

Read the report here.

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