751 - Quality Improvement to Identify and Address Food Insecurity During Inpatient Admissions

We aimed to improve FI screening for English, Spanish, and Arabic-speaking families on our Pediatric Hospital Medicine (PHM) teams from 0% to 60% and provide location-based food resource information to >80% of families with a positive FI screen.   


Design/Methods: Our multi-disciplinary team within a large academic children’s hospital created a key driver diagram targeted at our aims (Figure 1). In February 2021 we implemented routine FI screening among a subset of PHM patients, which was not previously done. Our process measure was the overall percentage of eligible families screened for FI. To monitor for inequity in the screening process we also followed the percentage of eligible families screened by language. Our primary measure was the percentage of families with FI who received food resource information. To monitor for a substantial increase in social work consults due to the desired consult for high-risk screens the balancing measure was the percentage of screened patients with a social work consult. Statistical process control charts were used to analyze the impact of our interventions on our measures.

Results: The percentage of eligible families screened for FI increased from 0 to 27.8% in association with this initiative, with special cause variation noted on a p-chart (Figure 2). There was no statistical difference in screening rate by language (data not shown). 12.7% of families screened positive for FI. Provision of resources increased from 56% to 100% with special cause variation noted on a p-chart in association with automated EHR resource provision for positive screens (Figure 3). There was no significant impact on volume of social work consults among screened patients (data not shown).

Conclusion(s): Small tests of change, starting with a single nursing role on a single unit, were used to establish a process for routine FI screening without significantly increasing social work consults. Automation of the resource provision process based on patient answers increased provision of appropriate food resource information. Building on this foundation, work is ongoing to spread screening more broadly across the hospital while also working to equitably increase the percentage of families screened.