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Reducing Caregiver Hunger During Pediatric Hospitalization
Katherine A Auger1,2,3, Brenda Demeritt4, Andrew F Beck1,5,3
1Division of Hospital Medicine.
Insights
Caregiver hunger during pediatric hospitalization decreased from 86% to 15.5% through a quality improvement initiative providing meal access. This ensures families receive adequate food support during stressful hospital stays.
Area of Science:
- Healthcare Quality Improvement
- Pediatric Health Services Research
- Health Equity
Background:
- Pediatric hospitalizations present significant financial and emotional burdens for families.
- Caregivers, particularly those with lower incomes, frequently experience food insecurity during their child's hospital stay.
- A high baseline of 86% of caregivers reported hunger, necessitating targeted interventions.
Purpose of the Study:
- To reduce the incidence of caregiver hunger during pediatric hospitalizations.
- To decrease the percentage of hungry caregivers of Medicaid-insured and uninsured children from 86% to below 24%.
Main Methods:
- A quality improvement project was conducted on a 41-bed inpatient unit at an urban academic hospital.
- A multidisciplinary team utilized plan-do-study-act cycles to address food access barriers.
- Caregiver-reported hunger was the primary outcome measure, tracked over time using statistical process control charts.
Main Results:
- Caregiver hunger was significantly reduced from 86% to 15.5%.
- A temporary intervention of meal vouchers demonstrated a notable decrease in reported hunger.
- Secured hospital funding for meal cards resulted in sustained improvements in food access.
Conclusions:
- Implemented a data-driven quality improvement initiative to effectively decrease caregiver hunger.
- Established a sustainable system for improving food access for families during pediatric hospitalizations.
- Ensured caregivers could access sufficient food, alleviating a critical stressor during their child's care.
Background And Objectives:
Pediatric hospitalizations are costly, stressful events for families. Many caregivers, especially those with lower incomes, struggle to afford food while their child is hospitalized. We sought to decrease the mean percentage of caregivers of Medicaid-insured and uninsured children who reported being hungry during their child's hospitalization from 86% to <24%.
Methods:
Our quality improvement efforts took place on a 41-bed inpatient unit at our large, urban academic hospital. Our multidisciplinary team included physicians, nurses, social workers, and food services leadership. Our primary outcome measure was caregiver-reported hunger; we asked caregivers near to the time of discharge if they experienced hunger during their child's hospitalization. Plan-do-study-act cycles addressed key drivers: awareness of how to obtain food, safe environment for families to seek help, and access to affordable food. An annotated statistical process control chart tracked our outcome over time. Data collection was interrupted because of the COVID-19 pandemic; we used that time to advocate for hospital-funded support for optimal and sustainable changes to caregiver meal access.
Results:
We decreased caregiver hunger from 86% to 15.5%. A temporary test of change, 2 meal vouchers per caregiver per day, resulted in a special cause decrease in the percentage of caregivers reporting hunger. Permanent hospital funding was secured to provide cards to purchase 2 meals per caregiver per hospital day, resulting in a sustained decrease in rates of caregiver hunger.
Conclusions:
We decreased caregivers' hunger during their child's hospitalization. Through a data-driven quality improvement effort, we implemented a sustainable change allowing families to access enough food.
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