Addressing Food Insecurity in Pediatric Primary Care: Implementation of a Fresh Produce Delivery Pilot.

Introduction: Food insecurity negatively impacts young children's health and development. Our pediatric primary care practice partnered with a local food bank to connect families experiencing food insecurity to a fresh produce home delivery program, using quality improvement (QI) methodology. Methods: Our multidisciplinary team developed a referral pathway from the pediatric practice to the food bank's produce delivery program. The medical team and the food bank completed a QI training course. Our key driver diagram informed interventions, including electronic health record referrals, clinical staff educational initiatives, office signage promoting the program, and refinement of the produce delivery program by the food bank. Our primary outcome measure was referring more than 3% of all patients aged 5 years or younger seen in primary care to the produce delivery program, with a goal of 200 families within 6 months. Our process measure (the food bank's primary outcome measure) was the number of days from referral to first delivery. Results: Over 6 months, we referred 192 families to the produce delivery program. Our initial outcome measure referral rate was 5% of all patients seen in primary care each week, which later adjusted to a sustainability rate of 3.5%. The food bank improved its delivery approach, reducing the mean days to first delivery from a peak of 74 days to 21 days. Conclusions: Addressing food insecurity in outpatient pediatrics requires a multifaceted approach, including connecting families to community-based resources. A shared commitment to QI by the primary care practice and the partner food bank ensured the success of this fresh produce home delivery pilot program.