The Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) is a validated social needs screening tool widely used in primary care but rarely adapted for the emergency department (ED). We evaluated the feasibility of implementing an abridged PRAPARE tool in a high-volume ED using an operational model designed to minimize burden on clinical staff.

From October 2021 to October 2023, trained student volunteers administered an 11-item abridged PRAPARE survey to adult ED patients during waiting-room time, parallel to routine clinical workflows. This retrospective quality improvement analysis evaluated deidentified data from these encounters. Items were selected via multidisciplinary consensus based on local resource alignment and analyzed descriptively.

Of 6,931 patients approached, 683 (9.8%) completed screening. Most identified as non-Hispanic Black (62%) and female (61%). Nearly all (94%) reported at least one unmet social need, and 56% reported three or more. The most common were food insecurity (47%), medication access (39%), and utility insecurity (37%). Substantial proportions also reported transportation barriers (28%), housing instability (27%), unemployment (26%), and feeling unsafe at home (15%). Black patients were overrepresented relative to the ED census (62% vs 40%). Among those with unmet needs, 96% expressed willingness to engage with assistance.

An abridged PRAPARE tool was successfully implemented using a low-burden, volunteer-driven model and identified a high prevalence of unmet social needs. These findings support streamlined screening delivered outside the clinical workflow and offer operational lessons on volunteer staffing, workflow integration, and referral infrastructure.

Social determinants of health (SDOH) can contribute to disparities that negatively impact health outcomes and healthcare utilization. Comprehensive screening is frequently overlooked during inpatient clinical care. This pilot aimed to evaluate the capturability of a multi-domain SDOH screening tool during hospitalization, as well as correlation of SDOH needs to readmissions.

The Protocol for Responding to and Assessing Patients’ Assets, Risks and Experiences (PRAPARE) screening tool was implemented on admission with adult inpatients at an academic tertiary medical center in central Pennsylvania. A total of 80 patients were screened over an 8-week period using the PRAPARE tool.

43.7% of participants were identified as having at least one SDOH need and 21.2% were identified as having two or more needs. Of the participants identified as having at least one SDOH need through PRAPARE screening, 42.5% experienced a readmission within 30 days, compared to 15% readmissions among participants with no identified SDOH needs. For each additional SDOH need a patient had, the odds they experienced a readmission increased by 2.2 times.

The study findings suggest that utilization of the PRAPARE screening tool has the ability to capture significant SDOH needs among hospitalized patients. This study also suggests that higher SDOH needs correlate to increased odds of experiencing a hospital readmission.