Social Emergency Medicine

Social Emergency Medicine

Overview

Social emergency medicine (Social EM) examines the intersection of emergency care and the social factors that influence health outcomes. The program started with a focus on suicide prevention and mental health emergencies, with projects such as the ED Safety Assessment & Follow-up Evaluation (ED-Safe), and has now expanded its focus to include disparities in emergency care, and adverse social determinants of health.

Major Research Themes
  • Language
  • Literacy
  • Adverse social determinants of health (aSDoH)
  • Screening and linkage
  • Healthcare disparities
  • COVID-19
  • Race/ethnicity/gender
  • Health literacy


Active Projects

The MOLAR Study (Mapping Oral Health and Local Area Resources) is a randomized controlled trial of an adverse social determinants of health (aSDoH) screening and resource linkage intervention for Emergency Department (ED) patients. The aim of the study is to screen ED patients to identify unmet oral health needs or aSDoH risks/needs and provide geographically targeted resources to address them. Participants will be randomized into one of three intervention arms 1) standard care aSDoH and dental resources 2) geographically specific aSDoH and dental resources 3) geographically specific aSDoH and dental resources with navigational assistance. Participants will be followed for 12 months with the primary outcome being successful linkage to care and healthcare utilization.

For more information, please contact Dr. Maggie Samuels-Kalow.

While the Medication Education for Dosing Safety (MEDS) intervention is efficacious when delivered by a research assistant, we lack data on its effectiveness in routine clinical practice. The goals of MEDS 2 are to establish the effectiveness of the MEDS intervention as delivered by ED staff and determine the factors associated with successful implementation of the intervention.

For more information, please contact Dr. Maggie Samuels-Kalow

Adverse social determinants of health (aSDoH), such as housing and food insecurity, are strongly associated with healthcare utilization and health outcomes.  The goal of our work is to identify and address aSDoH in an efficient and scalable way to address social needs, reduce disparities in care, and improve health outcomes. We have ongoing additional work around understanding neighborhood and spatial risk, evaluating and developing directories of community resources, and identification of social risk and social need.

Various projects are aimed at (1) determining the utility of the ED as a screening site for patients who are missed by existing screening pathways within an integrated health system, (2) establishing the prevalence of screening for aSDoH in a nationally representative sample, and (3) identifying barriers and facilitators among EDs that are successfully screening for aSDoH.

For more information about an ongoing national survey to assess current aSDoH screening practices, click here.

For more information about any aSDoH projects, please contact Dr. Maggie Samuels-Kalow.

The COVID-19 Disparities project aims to identify disparities in measured prevalence and outcomes of COVID-19 patients based on factors such as demographics, individual socioeconomic status, and neighborhood socioeconomic status.

For more information, please contact Dr. Maggie Samuels-Kalow


Past Initiatives

Medication Education for Dosing Safety (MEDS) aimed to determine whether a brief intervention at the time of emergency department (ED) discharge can improve safe dosing of liquid acetaminophen and ibuprofen by parents/guardians. We performed a randomized controlled trial of a teaching intervention combining lay language, simplified handouts, provision of an unmarked dosing syringe, and teach-back to confirm correct dosing. A multi-faceted intervention at the time of ED discharge – consisting of a simplified dosing handout, a teaching session, teach-back, and provision of a standardized dosing device – can improve parents’ knowledge of safe dosing of liquid medications at 48-72 hours.

For more information, please contact Dr. Maggie Samuels-Kalow.

Primary publication:
Naureckas Li C, Camargo CA Jr, Faridi M, Espinola JA, Hayes BD, Porter S, Cohen A, Samuels-Kalow M. Medication Education for Dosing Safety: A Randomized Controlled Trial. Ann Emerg Med. 2020 Nov;76(5):637-645. doi: 10.1016/j.annemergmed.2020.07.007. Epub 2020 Aug 15. PMID: 32807539; PMCID: PMC7857015.

Visualization Linking Emergency Needs and Services (VLENS) aimed to enable the visualization of community resources, hospital utilization, and social determinants of health/predicted need. Click here to view a video overview of the project. 

For more information, please contact Dr. Maggie Samuels-Kalow

The goal of this study was to pilot TEACH, a text-message based questionnaire to identify adverse social determinants of health (aSDoH) and automatically provide resources.

For more information, please contact Dr. Maggie Samuels-Kalow

ECOCH was a comparative examination of two social need and risk screening strategies in the ED. Using a mixed-methods approach, ED patients were recruited at a large urban academic medical center and randomized to verbal vs. electronic modalities following informed consent.

Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) was a multicenter study of suicide prevention. For more information, click here.

Please contact Drs. Ed Boudreaux, Carlos Camargo or Van Miller if you would like additional details.