SHM Converge Scientific Abstract ePoster Gallery-Social Determinants Come to the Hospital: A Qi-Initiative to Address Food Insecurity on an Inpatient Pediatric Unit

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Lehigh Valley Health Network implemented a quality improvement initiative to address food insecurity among children admitted to its inpatient pediatric unit. Food insecurity is defined as limited or uncertain access to nutritionally adequate and safe food, and it is linked to poor child health outcomes and broader social determinants of health. The project was motivated by the COVID-19 pandemic, which worsened food insecurity through school meal disruptions, unemployment, and rising food costs, while hospitalization may be the only healthcare contact for some families.<br /><br />The aim was to universally screen all admitted pediatric patients using the American Academy of Pediatrics’ validated two-step “Hunger Vital Signs” questionnaire and then provide resources based on need. Stakeholders included nurses, hospitalists, case managers, social work, patients, and families.<br /><br />The team used Plan-Do-Study-Act cycles to refine the process:<br />1. Screening after rapport was established,<br />2. Screening moved to admission due to low compliance later in hospitalization,<br />3. A third question was added to better assess acuity and guide interventions,<br />4. Screening tools were embedded into the electronic nursing intake flowsheet.<br /><br />From March to June 2021, 506 of 1,041 patients (49%) were screened, and 44 (8.6%) screened positive for food insecurity. Screening was negatively affected by nursing shortages but improved after electronic integration. Food-insecure families were disproportionately Hispanic/Latino, urban, and publicly insured. Patients had a wide range of diagnoses and BMI values, reinforcing food insecurity as an “invisible” social determinant of health.<br /><br />Interventions for positive screens included referrals for grocery gift cards through an emergency fund, follow-up by population health/social work, and connections to local food pantries. The project concluded that universal screening is important, but sustainability depends on workflow support, and the impact of interventions still needs further study.

Asset Subtitle

Kayle Barndt

Meta Tag

Author List Alicia Llewellyn, Anna Folk, Claudia Busse, Kayle Barndt

Category Research

Concept Food Insecurity

Concept Universal Screening

Concept AAP Hunger Vital Signs

Concept Social Determinants of Health

Concept Quality Improvement

Distinguished Non-Finalist

Presenter Organization Lehigh Valley Health Network

Presenting Author Kayle Barndt

Track Quality Improvement

Keywords

food insecurity

pediatric inpatient

universal screening

Hunger Vital Signs

social determinants of health

quality improvement

COVID-19 pandemic

electronic health record

food pantry referrals

population health

Food Insecurity

Universal Screening

AAP Hunger Vital Signs

Social Determinants of Health

Quality Improvement