TOTB-06: IMPROVING NUTRITION IN PERIOPERATIVE PATIENTS
Ryan Macht, MD, MS; Boston Medical Center
What problem in education is addressed by this work?:Food insecurity affects a disproportionately high number of patients at safety-net hospitals, and malnutrition is an increasingly prevalent problem in our society in both underweight and overweight individuals. Perioperative malnutrition is associated with worse surgical outcomes thus access to nutrition is a high priority intervention. Despite provider knowledge of the importance of nutrition, screening for food insecurity as one of the critical social determinants of health is not standard practice and thus resources that target malnutrition and food insecurity remain underutilized.
Describe the intervention:
During this year-long Socially Responsible Surgery Nutrition Project, all surgical providers receive a standardized educational intervention on the importance of nutrition, how to screen for food insecurity, and how to refer patients to one of the local resources including Boston Medical Centerâs in-house food pantry. Additionally, this project is working to create a culture of screening for food insecurity by integrating screening practices into daily rounds, incorporating medical students in the process, and including nutritional resource handouts to patients at discharge. Changes in provider practices are monitored with pre- and post-education surveys and by tracking the number of referrals made to the food pantry by surgical providers.
Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome:
We believe that screening for food insecurity should be part of the standard of care for all surgical providers, and thus education on the importance of nutrition should be a standard part of surgical training in all programs. A simple educational intervention such as this one to establish a culture of screening surgical patients for food insecurity specifically, and social determinants of health more generally, is a low cost, high impact way to improve patient care. Barriers that may exist at other institutions include lack of an in-house food pantry, although many of our referrals are to local food pantries or low cost grocery suppliers which exist in all parts of the country.