Quality Improvement to Identify and Address Food Insecurity During Pediatric Hospitalizations

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.