A Quality Improvement Initiative to improve food access in pediatric patients with food allergy and food insecurity.

Abstract

BackgroundFood allergy affects 8% of US children and is a risk factor for food insecurity. ObjectiveOur aim was to increase screening for unmet food needs among families presenting for food allergy follow-up at our Allergy clinic from 0% to ≥70% and to increase same-visit resource referrals from 0% to ≥90%, by June 2025. MethodsWe integrated a screening and resource referral process in the electronic health record (EHR). Resources included: referrals to registered dietitian (RD) or social work (SW), help finding food banks/pantries, help enrolling in nutritional assistance programs, and a website of local resources. Families could indicate that they had no unmet food needs. We analyzed the weekly percentage of eligible patients with completed screeners (process measure) and percentage of requests with resource referrals occurring during the visit (outcome measure) using statistical process control charts. ResultsOf 11,857 visits, 59.5% patients were male; the average age was 7.9 years (SD=5.4). For most visits (98.3%), families were enrolled in the patient portal. Screener completion reached 73.1% and resource referrals reached 100%, with multiple centerline shifts indicating statistically significant improvement. Resources were requested at 5.5% (344/6,244) of visits with completed screeners: RD (40.2%), SW (9.0%), food banks (14.7%), nutritional assistance programs (12.2%), and website (23.9%). Thirteen families requesting RD referrals also selected "I have no needs." ConclusionAn EHR-based screener coupled with automated referrals is accepted by families and can streamline referrals to food resources. All patients with food allergy may benefit from dietician support.