Abstract
Background:
The CHNA for HonorHealth Osborn identified food insecurity as a significant health disparity within our community. The USDA defines food insecurity as “a state in which consistent access to adequate food is limited by a lack of money and other resources at times during the year.” Overall, 15.9% of all Maricopa County households are food insecure, including 25.4% of Maricopa County children. The Desert Mission (DM) program (established in 1927) began under the John C. Lincoln (JCL) Health Network to help underserved families meet their health and social needs. With the newly merged HonorHealth (Scottsdale Healthcare and JCL), DM expanded its services into a new geographic area.
Methods:
We used a 2-question screening tool to identify those with food insecurity at Heuser Family Medicine Center. (1) Within the past 12 months, we worried whether our food would run out before we got money to buy more. This was true “often,” “sometimes,” “never.” (2) Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more. This was true “often,” “sometimes,” “never.”
Results:
Overall, 1 in 3 patients screened positive for food insecurity. In November, 33.33% of patients screened positive; in December, 31.44% of patients screened positive; and in January, 35% of patients screened positive. Patients meeting criteria were offered services, including emergency food supplies, and were administered a risk assessment to better define their overall social needs.
Conclusion:
Implementation of a 2-question screening tool is a rapid, easily reproducible way to identify a previously unseen portion of our patient population that is food insecure. Partnering with community food banks and using their resources can help this vulnerable population address this health inequity. Future efforts targeting EHR integration will make it easier to follow these patients and improve screening efficiency.
PROJECT MANAGEMENT PLAN – Utilization of Community Resources to Address Food Insecurity in a Federally Qualified Health Center.
| Vision Statement | Our vision is to have a diverse community outreach program that will reduce food insecurity while being a model that others can emulate. |
| Team Objectives | Our team objectives were as follows:
Our project assumptions were as follows:
Our measures of success were as follows:
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| Success Factors | The most successful part of our work was implementing a simple tool that has uncovered a significant healthcare disparity in our patient population (food insecurity). We were inspired by the alarming number of individuals who are food insecure in our community. |
| Barriers | The largest barrier encountered was engaging patients and physicians to consistently complete the 2-question food insecurity screening tool at every office visit. We worked to overcome this challenge by integrating this screening tool into our EHR to identify patients who have already been screened. We decreased the frequency of screening to every 6 months and will continue to reevaluate the process and make adjustments to the workflow. |
| Lessons Learned | The most important advice to provide another team embarking on a similar initiative is (1) to have an established form of documentation of screening questions prior to starting the initiative, preferably embedded into each patient’s EHR; (2) to try to collaborate with a food distributor prior to kicking off your food insecurity screening tool so that resources will be available for those in need at the time of diagnosis; (3) to find creative methods to consistently engage providers and patients to complete the questionnaire while also identifying EHR tools to mainstream and standardize the questionnaire. |