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A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Quality Improvement to Identify and Address Food Insecurity During Pediatric Hospitalizations
Cristin Q Fritz1,2, Gabrielle C Lyons2, Amber R Monaghan1
1Vanderbilt University Medical Center, Nashville, Tennessee.
Insights
Hospital food insecurity screening improved significantly for children, reaching 77% of eligible families. Automated resource provision ensured 100% of families with food insecurity received aid.
Area of Science:
- Pediatric healthcare
- Public health interventions
- Health equity
Background:
- Hospitalized children are a vulnerable group with high rates of undetected food insecurity (FI).
- Current screening methods are insufficient, leading to missed opportunities for intervention.
Purpose of the Study:
- To enhance food insecurity (FI) screening for eligible families of hospitalized children from 0% to 60%.
- To provide location-based food resources to families screening positive for FI.
Main Methods:
- A multidisciplinary team utilized the Model for Improvement for FI screening on one inpatient unit.
- Primary outcome: percentage of eligible families screened; Secondary outcome: percentage of families with FI receiving resources.
- Statistical process control charts analyzed intervention impact.
Main Results:
- Screening increased from 0% to a mean of 77% of 8850 eligible families, exceeding the goal.
- Key interventions included expanding screening to all services and making it required nursing documentation.
- Resource provision for families with FI increased from 56% to 100% via automated systems.
Conclusions:
- Integrating FI screening into nursing admission workflows is feasible for pediatric hospitalizations.
- Automated resource provision for positive screens effectively supports families experiencing food insecurity.
Objectives:
Hospitalized children represent a vulnerable population with high rates of unidentified food insecurity (FI). We aimed to improve FI screening for eligible families from 0% to 60%. Secondarily, we sought to provide location-based food resources to families that screened positive.
Methods:
In February 2021, we developed a multidisciplinary team and used the Model for Improvement to improve routine FI screening for eligible children on 1 inpatient unit at a single institution. Our primary measure was the overall percentage of eligible families screened for FI. Our secondary measure was the percentage of families with FI who received food resource information. Statistical process control charts were used to analyze the impact of our interventions.
Results:
A total of 8850 families were eligible for screening during the project period. The percentage of eligible families screened for FI increased from 0 to a mean of 77%, exceeding our goal, with special cause variation noted by 5 centerline shifts. The most impactful interventions were expansion of screening to patients admitted to all services and making FI screening questions required nursing admission documentation. Eleven percent of families screened positive for FI. Provision of resources increased from 56% with manual resource insertion into the after-visit summary to 100% with special cause variation associated with automated resource provision for positive screens.
Conclusions:
Integrating FI screening into the nursing admission workflow with automated resource provision for positive screens is a feasible approach to integrating FI screening into routine clinical practice during pediatric hospitalizations.
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