Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University School of Medicine, Nashville, Tennessee.
Hosp Pediatr. 2024 Dec 1;14(12):963-972. doi: 10.1542/hpeds.2024-007926.
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.
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.
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.
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.
住院儿童是一个弱势群体，其食物不安全（FI）的发生率很高，但却有很多未被识别出来。我们的目标是将有资格的家庭的 FI 筛查率从 0%提高到 60%。其次，我们希望为筛查阳性的家庭提供基于位置的食物资源。
2021 年 2 月，我们成立了一个多学科团队，并使用改进模型来提高单家机构 1 个住院病房中符合条件的儿童的常规 FI 筛查率。我们的主要衡量标准是接受 FI 筛查的有资格家庭的总体百分比。我们的次要衡量标准是接受 FI 筛查的家庭中获得食物资源信息的百分比。统计过程控制图用于分析我们干预措施的影响。
在项目期间，共有 8850 个家庭有资格接受筛查。接受 FI 筛查的有资格家庭的百分比从 0 增加到平均 77%，超过了我们的目标，并且注意到了 5 个中心线偏移的特殊原因变化。最具影响力的干预措施是将筛查扩展到所有服务部门的入院患者，并将 FI 筛查问题纳入护理入院文件要求。有 11%的家庭筛查出 FI 阳性。资源提供从手动将资源插入随访摘要中的 56%增加到与阳性筛查相关的特殊原因变化导致的 100%自动化资源提供。
将 FI 筛查整合到护理入院工作流程中，并为阳性筛查自动提供资源，是将 FI 筛查整合到儿科住院期间常规临床实践中的一种可行方法。
