Misner Nicole, Panagos-Billiris Patoula, Yavelow Michelle, Chaphalkar Chaitanya, Tsalatsanis Athanasios, Khalaf Racha T
Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
J Pediatr Gastroenterol Nutr. 2025 May;80(5):776-782. doi: 10.1002/jpn3.70010. Epub 2025 Feb 10.
Food insecurity (FI), limited or uncertain access to adequate food, impacts every state, county, and community in the United States. The goals of this quality improvement (QI) initiative were to first achieve greater than 90% compliance with FI screening for patients seen at pediatric GI clinics within 1 year and second increase the proportion of families identified as FI connected with resources to 50% at follow-up visits.
Using plan-do-study-act cycles, interventions were implemented to (1) educate, (2) create a screening process, (3) optimize communication with EMR utilization, and (4) connect families to resources. Descriptive statistics on all variables collected were performed. Differences between the FI and food secure groups were assessed using the Mann-Whitney test for continuous variables and the Chi-squared test for categorical variables. QIMacros® Quality Improvement/SPC Software for Excel was used to create process control charts to show improvement.
During the timeframe from August 29, 2022, to February 29, 2024, 2946 visits were completed in the GI clinic, and 58% (1731 patients) were screened for FI. Of the patients that were screened for FI, 13% screened positive. Compliance with FI screening improved to 90%, and connection to resources improved to 75%. Race, ethnicity, preferred language, and insurance were all significantly associated with FI, p < 0.001 CONCLUSIONS: This QI initiative demonstrates standardized FI screening improves FI identification and connection to resources.
粮食不安全（FI），即获得充足食物的机会有限或不确定，影响着美国的每个州、县和社区。这项质量改进（QI）计划的目标，一是在1年内使儿科胃肠病诊所就诊的患者中，FI筛查的依从率超过90%；二是在随访时，将被确定为粮食不安全且与资源建立联系的家庭比例提高到50%。
采用计划-执行-研究-行动循环，实施干预措施，包括（1）开展教育，（2）建立筛查流程，（3）优化电子病历使用中的沟通，以及（4）帮助家庭获取资源。对收集的所有变量进行描述性统计。对于连续变量，使用曼-惠特尼检验评估粮食不安全组和粮食安全组之间的差异；对于分类变量，使用卡方检验进行评估。使用QIMacros® Excel质量改进/统计过程控制软件创建过程控制图以显示改进情况。
在2022年8月29日至2024年2月29日期间，胃肠病诊所共完成2946次就诊，其中58%（1731名患者）接受了FI筛查。在接受FI筛查的患者中，13%筛查呈阳性。FI筛查的依从率提高到90%，与资源建立联系的比例提高到75%。种族、民族、首选语言和保险都与FI显著相关，p < 0.001。结论：这项QI计划表明，标准化的FI筛查可提高FI的识别率以及与资源的联系。
