Our ED's Discharge Center (EDDC) facilitates appointments and paper-based social determinants of health (SDoH) screening. No criteria guide EDDC utilization. The ED's provider-administrator-run, patient-satisfying follow-up call program contacts only ~25% of discharges. We describe Learning Organization-principle-guided evaluation of EDDC efficiency, aiming to create EDDC time to expand the follow-up program. We reviewed appointment-making, SDoH-screening, and follow-up program data. We surveyed patients to determine whether adopting SHOUT tool criteria (no home, no primary care physician, or insurance) might yield more-judicious EDDC utilization. EDDC staff's 20 minutes/patient yielded fewer ED returns and admissions. Most patients improved post-discharge and made appointments themselves; 6% met SHOUT criteria for EDDC assistance; 4.5% would benefit from SDoH screening. Adopting SHOUT criteria would create significant time for EDDC-staffed follow-up program expansion. QR-code-accessible SDoH surveys would screen thousands more patients, minimizing EDDC staff involvement, saving 95% of the effort while retaining 100% of the benefit.

The authors have declared no competing interest.

This study did not receive any funding.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study was deemed exempt by Northwell Health's Human Subject Protection Program - Institutional Review Board (IRB) as a quality improvement project.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors.