J Healthc Qual. 2022;44(5):305-312. doi: 10.1097/JHQ.0000000000000350.
Food insecurity has been linked to numerous chronic conditions and higher healthcare costs; however, screening for food insecurity lags behind screening for other social determinants of health, particularly in the hospital setting. Although our hospital serves a population with a high prevalence of food insecurity, no process previously existed to universally screen patients. Our multidisciplinary team developed and implemented a process to screen hospitalized adults for food insecurity and connect them with food resources, which we piloted on a 26-bed hospital medicine unit. We integrated a validated 2-item screen into the electronic health record (EHR) nursing admission workflow, and provided 2 weeks of nursing education before process implementation. Adherence to screening was monitored weekly and adjustments were made using plan-do-study-act cycles. After 28 weeks, 361/587 (61.5%; weekly average 61.1%) encounters were screened (compared with a baseline of 2.2%), with 21/361 (5.8%) identified as food insecure. The implementation of an EHR-based food insecurity screening process in the hospital setting increased screening and identification of food insecure patients. Through improved integration of screening questions into the existing nursing workflow and continued education, success was sustained despite challenges with nursing staff turnover and staff shortages during the COVID-19 pandemic.
食物不安全与许多慢性疾病和更高的医疗保健费用有关；然而，与其他健康决定因素的筛查相比，食物不安全的筛查滞后，尤其是在医院环境中。尽管我们的医院服务的人群中食物不安全的发生率很高，但以前没有普遍筛查患者的流程。我们的多学科团队开发并实施了一个对住院成年人进行食物不安全筛查并为他们提供食物资源的流程，我们在一个 26 张病床的医院内科病房进行了试点。我们将经过验证的 2 项筛查纳入电子健康记录 (EHR) 护理入院工作流程，并在实施流程前提供了 2 周的护理教育。每周监测筛查的依从性，并使用计划-执行-研究-行动循环进行调整。在 28 周后，对 587 次就诊中的 361 次（61.5%；每周平均 61.1%）进行了筛查（与基线的 2.2%相比），其中 21/361（5.8%）被确定为食物不安全。在医院环境中实施基于 EHR 的食物不安全筛查流程增加了对食物不安全患者的筛查和识别。通过将筛查问题更好地整合到现有的护理工作流程中，并持续进行教育，尽管在 COVID-19 大流行期间护理人员流动和人员短缺带来了挑战，但仍取得了成功。
