Addressing food insecurity: a paediatric academic advocacy collaborative quality initiative
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2025-04
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<jats:sec> <jats:title>Objective</jats:title> <jats:p>This quality improvement (QI) initiative aimed to address food insecurity (FI) by improving FI identification and referral to food assistance programmes for the families served by the eight paediatric academic institutions in North and South Carolina.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The primary process measures were screening 80% of eligible families for FI and coding for FI. The outcome measure was referring 80% of families identified with FI to appropriate resources. The balancing measure was maintaining a rate below 20% of missed opportunities for referral. Change ideas were organised into four main key drivers. The eight teaching clinics of the Carolinas Collaborative completed monthly chart audits using the Quality Improvement Data Aggregator (QIDA). Baseline was December 2020 and implementation occurred January 2021�May 2022. Creation of run charts was later transferred to statistical process control charts. Standard probability or Montgomery rules were used to identify special cause variation. Sites used individual QIDA data to conduct Plan-Do-Study-Act cycles; aggregated data were shared during bimonthly meetings.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 4270 eligible charts were audited, 3430 patients screened and 525 identified as having FI. The rate of FI screening shifted from 68.5% to 86%. The rate of FI identified remained at 15%, and food referrals were consistently offered 90% of the time. While FI diagnostic coding did not reach the 80% goal, there was a shift from 38.3% to 70.5%. The balancing measure remained well below the goal of less than 20% of missed opportunities to discuss positive FI (centreline of 9.5%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>A paediatric academic collaborative QI initiative focused on FI demonstrated collective improvement and allowed for rapid implementation, dissemination and spread.</jats:p> </jats:sec>
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Amati, J Blakely Andrews, Shivani Mehta, Talia Buitrago Mogollon, Lizmarie Maldonado, Kerry K Sease, Debra Best, Kimberly Montez, Emily Vander Schaaf, et al. (2025). Addressing food insecurity: a paediatric academic advocacy collaborative quality initiative. BMJ Open Quality, 14(2). pp. e003083–e003083. 10.1136/bmjoq-2024-003083 Retrieved from https://hdl.handle.net/10161/32406.
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Debra Lynn Best
The tenets of advocacy have been intentionally woven into my work in all domains from clinical service to education to scholarship. Defined broadly by Earnest, et.al., advocacy is “activity that promotes the social, economic, educational, and political changes that ameliorate threats to human health and advance the well-being of people”. Under that umbrella, the foci that I have pursued through the years have been varied, ranging from childhood obesity prevention to teen parenting to universal newborn home visiting. Currently, my area of focus is in supporting early relational health and social emotional development. Throughout each endeavor, I have focused on lifting the voices of those in marginalized populations and intentionally partnering with the community to provide holistic approaches to meet both medical and psychosocial needs of individuals.
Carolyn Sears Avery
Academic interests in health-related social needs, health care value, alternative payment models, resident education
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