Implementing a Process for Screening Hospitalized Adults for Food Insecurity at a Tertiary Care Center.

Area of Science:

• Public Health
• Healthcare Management
• Social Determinants of Health

Background:

• Food insecurity is linked to chronic conditions and increased healthcare costs.
• Screening for food insecurity in hospitals is less common than for other social determinants of health.
• A high prevalence of food insecurity exists in the hospital's patient population, yet no universal screening process was in place.

Purpose of the Study:

• To develop and implement a universal screening process for food insecurity in hospitalized adults.
• To integrate food insecurity screening into the electronic health record (EHR) nursing admission workflow.
• To connect identified food-insecure patients with appropriate food resources.

Main Methods:

• A validated 2-item food insecurity screen was integrated into the EHR nursing admission workflow.
• Two weeks of nursing education preceded the process implementation.
• The process was piloted on a 26-bed hospital medicine unit, with weekly adherence monitoring and adjustments using plan-do-study-act cycles.

Main Results:

• After 28 weeks, screening adherence increased from a baseline of 2.2% to 61.5% (361/587 encounters).
• The average weekly screening rate was 61.1%.
• 5.8% of screened patients (21/361) were identified as food insecure.

Conclusions:

• Implementing an EHR-based food insecurity screening process significantly increased patient identification.
• Integration into existing nursing workflows and ongoing education are key to sustained success.
• The process demonstrated resilience despite challenges like staff turnover and shortages during the COVID-19 pandemic.