3-minute case study: Prescriptions for groceries
What innovations drive success in population health? Here's a tactic from a leading healthcare system.
Although staff at Boston Medical Center (BMC) were eager to address nutrition-related illness, they recognized that simply advising patients to eat better was … bananas.
The majority of the 487-bed academic medical center's patients are from low-income underserved populations. Not only can many not afford healthy food, they often live in food deserts without access to affordable, nutritious ingredients. In order to promote patients' health, prevent illness, and support recovery, BMC needed a way to make picking up healthy food as easy as picking up a prescription.
That's exactly what staff did. All BMC patients are screened for food insecurity and, if found eligible, are written a prescription to pick up free groceries at the on-site Preventive Food Pantry.
Just don't call it hospital food. “We're a therapeutic food pantry, so about half of our food is perishable, and we give foods that are medically appropriate for each patient's condition," says Latchman Hiralall, manager of the pantry.
Hiralall is one of four full-time staff at the pantry, which has grown into a hospital-wide program that feeds between 7,000 and 8,000 patients — and their families — each month. With a $300,000 annual operating budget (underwritten by benefactors), the small staff relies on local volunteers to help manage and distribute the 15,000 pounds of donated food each week.
“It's convenient, since patients may be at the hospital anyway, or anyone in the family can pick up it up," says Hiralall. And now that the prescriptions are tracked in patients' electronic health records, providers can see if individual prescriptions are filled, and the pantry can track how many people use the service by clinical area.
The data were especially helpful in revealing that geriatric patients weren't filling their prescriptions. “It turned out it was a pride issue, and they didn't want to be seen standing in line," says Hiralall. When BMC created a private area where patients wait for their food orders, they saw an immediate uptick in usage. “They feel comfortable coming now."
Patient feedback has been resoundingly positive, especially for the fresh fruits and vegetables, which are in short supply at most food pantries. Hiralall estimates that the pantry gets 10 new referrals every day from clinicians, nutritionists and social workers.
Recently, BMC expanded the service by adding a demonstration kitchen. Here, dieticians teach classes on preparing healthy meals using simple, cost-effective recipes, as well as offering condition-specific nutrition education for weight-management, diabetes, cardiac health, and cancer care.
For Hiralall, the proof is in the pudding. “I've seen patients scheduled for gastric bypass surgery cancel it because they lost so much weight from eating our healthy food."
Erin Graham is a frequent contributor to athenaInsight.