Andrea Wallace, PhD, RN, FAAN, Associate Dean for Research at the University of Utah College of Nursing, delivered the May 7 National Institutes of Health (NIH) Clinical Center Grand Rounds lecture hosted by the National Institute of Nursing Research (NINR). The lecture series covers a variety of topics for physicians, clinicians, biomedical researchers, nurses, and other health care professionals to remain current on the latest advancements in clinical care.
This year marks the 40th anniversary of the National Institute of Nursing Research (NINR), one of 27 institutes and centers at the NIH, which leads nursing research to solve pressing health challenges and inform practice and policy. Wallace’s invitation to speak recognizes her as a nationally respected researcher whose work focuses on designing and testing practical evidence-based interventions to improve patient outcomes.
The focus of Wallace’s lecture surrounded her team’s long-standing efforts to integrate social care into fast-paced clinical environments such as emergency departments and inpatient units. Citing the College of Nursing’s work on the SINCERE social needs screener, developed in collaboration with Utah 211 and supported by NINR and the Agency for Healthcare Research and Quality, she explained how nurses and care teams have identified critical gaps in access to food, housing, transportation, and caregiving support.
Since 2017, more than 70,000 patients have been screened through the SINCERE social needs screener. “Nearly half of those who complete screening report at least one unmet need, with the most reported needs being for utilities, rent, household items, and food. Still, only 44% made contact with the resource navigator and fewer than 1/3 ultimately connected with the community service, showing just how much can be lost between screening and support.” Wallace stressed that screening alone isn’t enough. Without follow up systems and a way to act on information, needs remain unmet.
To encourage successful adoption and results beyond social needs screening, Wallace pointed out that “systems should be designed to foster relational trust and psychological safety. If staff don’t feel safe raising concerns or deviating from task lists, these relational moments often get skipped.” Systems, Wallace mentioned, should also be intentionally designed for spread and sustainability from the start. “We need more than just good evidence. We need infrastructure to support the transition from promising social needs to real world practice across systems. When we talk about integrating social needs into care, it’s not just about building a better workflow, it’s about making sure health care meets people where they are and reflects what they actually need to live well.”
Wallace closed her lecture with a clear call for deeper investment in nurse scientists and the training that enables them to lead system level change. She emphasized the growing importance of skills such as community engagement, which fosters trust and ensures interventions are grounded in lived experience; pragmatic trial design in real world settings; and fluency in multi-level, cross sector data, which is essential for evaluating complex interventions that span health and social care. This work, Wallace explained, generates the kind of evidence needed to build health systems that are scalable, sustainable, and responsive to the realities patients face.