A year in review: Quality improvement of a new food insecurity team at a student-run free clinic
Poster #: 156
Session/Time: A
Author:
Gautam C. Ramanathan, BA
Mentor:
Ellen V. Pudney, PhD RDN
Research Type: Public Health
Abstract
INTRODUCTION:
In 2024, a food insecurity (FI) team was founded to assess and address FI as part of routine clinic operations at the HOPES student-run free clinic. During appointment check-ins, all patients were asked to complete the two-item Hunger Vital Sign screener and those who screened positive were seen by the FI team during their appointment. Based on patient needs and comorbid conditions, patients were provided resources that included local food assistance information and cost sensitive nutrition guides for chronic disease management. Clinicians on the FI team documented each patient's food insecurity status, a summary of counseling provided, and a record of educational handouts shared. The current project assessed the quality and consistency of the FI team operations during its first year of implementation.
METHODS:
This is a retrospective chart review of patients who attended HOPES primary care appointments between June 1, 2024, and May 31, 2025. We inputted the following information from patient charts into REDCap: age, sex, prior medical history of and number of medications for hypertension, diabetes, or dyslipidemia, the educational handouts provided by the FI Team, and the assessment and plan notes relevant to the FI discussion. Data were analyzed using SPSS (version 21, IBM Inc.). Descriptive statistics (means and standard deviations) were used to summarize patient characteristics.
RESULTS:
During the first year of implementing the FI team, 115 patients were seen at the primary and chronic care clinics at HOPES with 100% filling out the FI screener. Thirty-five patients (30%) screened positive for FI (average age of 43.9 ± 15.9 and 32% male). Among FI positive patients, 17 had hypertension (49%), 13 (37%) had dyslipidemia, and 11 (31%) had diabetes. According to chart notes by the FI team, 25 (71%) of the patients with FI were given the Bridge2Resources handout and 13 (37%) were given the Eat Right When Money's Tight handout. Of those with hypertension, three (18%) were given the nutrition for reducing blood pressure handout. Of those with dyslipidemia, three (23%) were provided a nutrition for reducing cholesterol handout. Of those with diabetes, two (18%) were provided a nutrition for reducing blood sugar handout.
CONCLUSION:
Overall, this quality improvement project was successful in screening all clinic patients for FI as part of routine clinic flow and all patients who screened positive for FI were visited by the FI team during their appointment. However, distribution of educational handouts, especially the disease-specific handouts, was lower than hoped for. The FI team intake process did not include a review of patient charts for chronic conditions, and if patients did not volunteer that information, condition specific handouts were not provided. Going forward, we will do additional training to standardize the method of providing patients with resources and improving documentation in the chart notes.
In 2024, a food insecurity (FI) team was founded to assess and address FI as part of routine clinic operations at the HOPES student-run free clinic. During appointment check-ins, all patients were asked to complete the two-item Hunger Vital Sign screener and those who screened positive were seen by the FI team during their appointment. Based on patient needs and comorbid conditions, patients were provided resources that included local food assistance information and cost sensitive nutrition guides for chronic disease management. Clinicians on the FI team documented each patient's food insecurity status, a summary of counseling provided, and a record of educational handouts shared. The current project assessed the quality and consistency of the FI team operations during its first year of implementation.
METHODS:
This is a retrospective chart review of patients who attended HOPES primary care appointments between June 1, 2024, and May 31, 2025. We inputted the following information from patient charts into REDCap: age, sex, prior medical history of and number of medications for hypertension, diabetes, or dyslipidemia, the educational handouts provided by the FI Team, and the assessment and plan notes relevant to the FI discussion. Data were analyzed using SPSS (version 21, IBM Inc.). Descriptive statistics (means and standard deviations) were used to summarize patient characteristics.
RESULTS:
During the first year of implementing the FI team, 115 patients were seen at the primary and chronic care clinics at HOPES with 100% filling out the FI screener. Thirty-five patients (30%) screened positive for FI (average age of 43.9 ± 15.9 and 32% male). Among FI positive patients, 17 had hypertension (49%), 13 (37%) had dyslipidemia, and 11 (31%) had diabetes. According to chart notes by the FI team, 25 (71%) of the patients with FI were given the Bridge2Resources handout and 13 (37%) were given the Eat Right When Money's Tight handout. Of those with hypertension, three (18%) were given the nutrition for reducing blood pressure handout. Of those with dyslipidemia, three (23%) were provided a nutrition for reducing cholesterol handout. Of those with diabetes, two (18%) were provided a nutrition for reducing blood sugar handout.
CONCLUSION:
Overall, this quality improvement project was successful in screening all clinic patients for FI as part of routine clinic flow and all patients who screened positive for FI were visited by the FI team during their appointment. However, distribution of educational handouts, especially the disease-specific handouts, was lower than hoped for. The FI team intake process did not include a review of patient charts for chronic conditions, and if patients did not volunteer that information, condition specific handouts were not provided. Going forward, we will do additional training to standardize the method of providing patients with resources and improving documentation in the chart notes.