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Case Study

How Rush Incorporated SDOH into Patient Care

10 Minute Read


The challenge

Nurses often feel uncomfortable and ill-equipped to identify and address their patients’ social determinants of health (SDOH). This discomfort can stem from:

  • Discomfort discussing patients’ personal issues
  • Lack of education and/or fluency around social determinants of health
  • Lack of tools or standardized process to screen for SDOH

The organization

Rush University Medical Center (RUMC) is an academic medical center that includes a 671-bed hospital, the 61-bed Johnston R. Bowman Health Center, and Rush University.

The approach

Nurse leaders at RUMC created a tailored SDOH education strategy, based on staff strengths and areas of development. They then designed an SDOH screening tool to help nurses feel confident and comfortable discussing social needs with patients.

The result

Nearly all nurses participated in the education sessions and demonstrated increased knowledge and confidence in identifying and addressing SDOH.



RUMC recognized need to address SDOH

On the West Side of Chicago, where RUMC is located, patients are more likely to have serious health challenges and less likely to access and afford the care they need. Compared with primarily white downtown Chicago neighborhoods, such as the Loop, West Side residents are:

4x more likely to die from diabetes

3x more likely to die as an infant

2x more likely to die from cancer

To reduce these health inequities caused by social, economic, and structural determinants of health, RUMC recognized the importance of identifying and addressing the SDOH needs of their patients. RUMC collaborated with nurses across the system to implement this initiative. As patient advocates on the front lines providing direct patient care, nurses were well positioned to screen RUMC patients for SDOH.


The three steps

To support nurses in their efforts to screen for and address social needs, nurse leaders at RUMC took three steps:

  • Step

    Assess RNs’ knowledge and confidence in discussing SDOH with patients

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  • Step

    Equip RNs to screen for SDOH through tailored education

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  • Step

    Implement an SDOH screening tool to standardize the process

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Nurses who participated in the food insecurity education sessions had greater knowledge about food insecurity and patients’ social needs. Nearly all (97%) nurses participated in the sessions and demonstrated increased knowledge and confidence (p< .001). This increase in nurses’ knowledge and confidence improved their ability to discuss access to affordable and nutritious food with patients.

To further nursing’s efforts to address SDOH and promote health equity, Angelique Richard, SVP COO/CNO at Rush University Medical Center, and Dr. Janice Phillips, Director of Nursing Research and Health Equity, established the Rush System Nursing Health Equity Council (Rush System NHEC). Dr. Phillips is the Chair for the Council, which meets periodically to address how nurses can further advance health equity across the Rush Health System. The council includes representation from most of the hospital’s service lines. These representatives serve as ambassadors on their units and support their coworkers in making SDOH an integral part of their nursing practice. Council members also sit on other committees throughout the hospital, bringing a nursing perspective to the health equity work done across the health system.

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