When using screening tools, make sure you are actually at the point where this is necessary/appropriate.
What is a screening tool? It's exactly that. It's something that's meant to be administered to broad populations in order to flag undetected conditions that might otherwise go unnoticed, so these can be addressed. The tool is administered, and if it is positive for certain things, it then creates a record that the person has a previously undetected/currently unmet need.
If you are in a setting that uses these, make sure you understand this, and only administer screening tools to people who need to be screened, i.e., people who don't know if they have any conditions for which the tool screens.
If you are doing hearing screenings, don't administer these to people with known hearing loss. Ask everyone if they've been previously identified, because medical/school records are often inaccurate (no need to ask someone who you do know is Deaf/hard of hearing). Just document that it was deferred due to already being identified. If you administer a screener, this create a records at the individual and population level showing they have a previously undetected/currently unmet need, which they don't. It skews data on how many people are going around with undetected conditions, and it enters into the person's individual medical or school record that they are experiencing medical neglect that they are actually not.
If you are doing screenings to detect emotional/behavioral concerns in children, don't administer these to youth/families who report their child has a diagnosed psychiatric disability for which they are receiving treatment. It still may be appropriate to administer other brief tools that look at social functioning, mood, etc. over time, but not the tools that are intended to flag undetected concerns.
Also, with the tools that are based on self-report, most are unclear whether the person is to answer them based on how they function with their accommodations (medication, learned strategies, loved ones who are aware and support appropriately, accommodations in place at work or school) or how they would function without these. If we fill them out based on current functioning, we create a medical record showing that a person with an ongoing disability has no functional impairment. This creates problems. If we fill them out based on how the person would function with no intervention, we create a medical record that someone is functioning poorly and has unmet needs. This also creates problems.
If you work somewhere that has no way to indicate that you deferred a screening for a valid clinical reason, or which returns metrics that the provider or facility are out of compliance for not administering a tool, this is not patient-centered and is poor practice. Aside from the clinical reasons I discussed, any person should be able to decline any procedure without any context of pressure or resentment around this. Aside from rare true imminent risk situations, health care and social services participation should be no different from going to the hairdresser or auto mechanic in terms of how the professional explains the pros and cons of something, the customer decides what they would like, and that's the end of it. Insurance sometimes complicates this, but dealing with the insurance companies is something we as providers have chosen to take on, and should not be passing on to the patient.
