A Multicenter Quality Improvement Initiative to Address Food Insecurity in the Carolinas

Problem: Food insecurity (FI) increased during the pandemic from 1 in 7 to 1 in 4 children nationally. The American Academy of Pediatrics (AAP) recommends addressing FI; however, only 60% of pediatricians screen and fewer assist families with FI. North and South Carolina pediatric FI rates are 19.3% and 16.2%, respectively.

Measurement: The Carolinas Collaborative (CC), including the eight pediatric residencies in the Carolinas, implemented a QI project in December 2020 to increase FI screening in clinics and referral to food assistance programs to 80%. Monthly chart audits were entered into the AAP’s QIDA system and aggregate run charts were reviewed.

Analysis: If FI was identified using a validated tool, patients were eligible for resources. Each site completed 30 random chart audits monthly, collecting data on response, referrals and demographics. Data was entered into QIDA to generate run charts for individual clinical sites and for collaborative review.

Implementation: FI screening was optimized by 1). utilizing multi-stakeholder teams to ensure adequate support, 2). establishing flow diagrams to design screening and intervention processes, identify potential barriers and address positive screens, 3). applying multi-institutional knowledge about previous successes, 4). utilizing resident champions to promote screening. All institutions collected data through QIDA.

Results/Discussion: CC demonstrated collective improvement in all measures, each sustaining above goal for at least 8 months despite a new academic year. Screening increased from a 72% to 82% median, referral for +FI exceeded the 80% goal, and the balancing measure was maintained below 20% missed opportunities to discuss +FI.

Speakers
Assistant Professor of Pediatrics
Assistant Professor of Pediatrics – Prisma Health / UofSC SOM-Greenville

Speaker Type: Poster Presentations On-Demand

  • Performance and Process Improvement IconPerformance and Process Improvement
Assistant Professor
Assistant Professor – Atrium Health

Speaker Type: Poster Presentations On-Demand

  • Performance and Process Improvement IconPerformance and Process Improvement
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