Food Farmacy Grow, Gather, Prepare · Innovation Playbook (Please work with the System Innovation...

Food Farmacy Grow, Gather, Prepare

Author: Deborah Dobson, Gretchen Gore and Faith Kinsinger

Date: 6/4/2018

Concept

We intend to address food insecurity by providing healthy meals to the food insecure.

The St. Mary’s cohort will do this by providing the food insecure with a bag of healthy foods post

discharge and follow up with a phone call to address SNAP benefits and other social needs.

The St. Vincent’s cohort will focus on education classes and food access offered with community

partnerships.

The Lutheran cohort will run a food farmacy program for food insecure diabetics that will focus on diet

education, increasing access to community resources with the aid of a social worker, and providing a

week’s worth of healthy groceries every week for our participants over a 3 month span.

Venture Definition:

What we are working on:

We are working on closing the gap on nutrition as a social determinant to health.

The problems we are having:

The problem we are having is the ability of at-risk patients to obtain the foods they need to support

their health.

Those eligible for SNAP benefits are not enrolled. (40% in Jefferson county! The highest in the state)

Those with SNAP benefits not purchasing foods that would offer the most benefit.

People being discharged home without access to the proper nutrition needed to aid their healing

bodies.

The impact to the SCL Health community if we don’t find a solution to these

problems:

Food insecurity and healthcare costs will continue to rise.

Patients will continue to have poor health outcomes and be medicine dependent.

Clear, Compelling Goal:

Please frame in the form of a SMART Goal (Specific, Measurable, Achievable, Realistic,

Timely).

The goal of the program is to protect the health and well-being of patients and community members by

providing access to healthy food while teaching ways to prepare nutritious meals on a limited income.

Metrics:

Provide the metrics you will use to determine whether your venture is successful. The

metrics should support your clear, compelling goal.

Indicator Cohort Site

St Vincent St Mary Lutheran

# of Meals Per Patient X X X

Impact on Readmission Rates X X X

# of Patients Served X X x

HGBA1C X X

Class Attendance X `x X

SNAP Enrollments X X X

Alignment with Strategic Priorities:

Please provide an overview of which strategic priority this aligns to and how it will

contribute.

This project aligns with our strategic priority to improve clinical integration and be person focused. Our

intent is to deliver safe, reliable, high-quality care that extends to closing gaps caused by social

determinants of health. We desire to deliver a grow, gather, prepare Food Farmacy program that

provides holistic care to the patients we serve through increased food access, diet education and

support.

Scope:

Items to consider when defining the scope of your venture include (but are not limited to)

operational and technical resources, workflows, education/training, communications,

technical build

In Scope:

Hgb A1C >9

Qualify as food insecure

Willing to participate

Discharging patients

Utilizing community resources and partnerships

Partnering with local farmers

Out of Scope:

New hires

Building a new epic platform

Anticipated Venture Start Date:

July 1st

Anticipated Venture End Date:

December 30th

Innovation Playbook

(Please work with the System Innovation Team to work through this portion of the

document)

Type:

It is the goal of the program to reinvent how we respond to the whole needs of the patient through a

focus on nutritional wellbeing both in prevention as well as a broadened response to care planning.

Shift:

The primary focus of this venture is platform based

Ambition:

I would say this is radical. When people think of hospitals and health systems they think of prescriptions

for medication, therapies, surgeries... How simple and effective to start prescribing food!

Point Of View We met a group of women at a Senior Center who told us about a friend, Patricia, who had recently

passed away from complications of diabetes. We learned that food access was definitely a problem for

Patricia. We were surprised to find out a few other interesting facts as well. Patricia had health

insurance but choose to only go to her chiropractor, as her friends believe she was getting some

emotional need met there. We learned that her family support system was lacking and she would not let

others in her home. We wondered if anxiety and depression played a role in food insecurity and if we

needed to embrace a more holistic approach to our food farmacy program.

We decided it would be game changing to create a food farmacy program that nurtured the physical,

mental and emotional health of the patient.

Alignment Assessment

This aligns with our mission to support the poor and vulnerable by addressing the social determinants of

health and finding a way to close the nutrition gap on the food insecure.

Venture Tribe

Venture Sponsor:

Innovation Partner: <From System Innovation Team>

Venture Team

Name Role Debbie Dobson St. Vincent lead

Dr. Rudolph Beverly Paul

Physician partner Diabetic educator Community outreach

Gretchen Gore St. Mary’s lead

Cindy Jeanie

Logistics Food insecurity identifier

Faith Kinsinger Lutheran Lead

Melissa Goodwin Amy Danielle Kristen Dr. Shepirdigian Mary

Innovation support/logistics Social worker Registered dietician Nutrition Physician partner Diabetic Educator

Risks

Please outline the risks that this venture may incur. These could be related to compliance,

technology, resources, adoption, etc.

Food supply

Non-compliance

Transportation

Device glitches or breaking

Attendance

Dependence on volunteers

Short term fix

Adequate space to store food

Technical Requirements

Please provide an overview of what new pieces of technology or changes to existing

technology would be needed to support this venture.

HgbA1C reports run

Epic turn on the 2 Food insecurity questions (ideal, but not mandatory)

Social Media: Use existing channels to “broadcast” the cooking segments. Potentially expand to display

segments in the clinics or lobby areas through the MarComm Popcorn or similar technology.

Innovation Challenge:

Venture Milestones and Timing

1

Venture Name

Grow‐Gather‐Prepare Food Farmacy

Date 6/4/2018

Venture Lead

Deborah, Gretchen, Sabrina, Faith

Location, St. Vincent, St. Mary and Lutheran Venture Timing: Lutheran: July‐December

Region

Start Date

July 1, 2018

Care Site/Department

Lutheran Target Completion Date

December 30, 2018

Venture Milestones, Accountability & Schedule: Please identify milestones for 3 phases of work

Phase 1: Setup and Prepare for Venture Launch Things to consider:

Contract negotiations (if needed)

Defining scope of work

Identify stakeholders and decision makers

Assess current state and gaps to address

Develop goals and metrics

Communication strategy

Training strategy

Define testing approach

List the Key Milestones and Activities If applicable, include IRB milestones, including target date for IRB approval

Responsible Lead Due Date

Sysco/Sodexo contract updates

Kristen 7/2/2018

Food partnerships with community partners

Faith 7/12/18

RD/intern roles‐create recipes, run shopping excursions, cooking class

Danielle 7/12/18

Diabetic educator‐main contact, run diabetes edu classes, follow up with participants

Mary 7/12/18

Facilities: prep room and kitchen space, refrigeration

Dwayne 8/17/18

Lab: run initial and post HgbA1C labs

Maricella, James 9/1/18

Jeffco Dept. health and human services: SNAP signups Amy 7/12/18

Obtain food insecurity screen

Faith 7/12/18

Stock shelves (hospital food drive)

Cathie 8/24/18

MH and depression screen Amy 7/12/18



2

Physician role

Dr. Sheperdigian 7/12/18

Phase 2: Launch and Testing Things to consider:

Testing your solution

Training those affected by the change

Cutover from old to new processes or tools

Measuring effectiveness of your change

Go‐live support

List the Key Milestones and Activities Responsible Lead Due Date

Eval weekly with team

Faith Sept‐Dec

Weekly diabetic class and shopping one day a week

Mary Sept‐Dec

Run a cooking class

RD Once a month Sept‐Dec

Send home a healthy prepared meal

RD Once a monthSept‐Dec

Lab draws

Faith/Dr. Shep Once in September and once in December

Weekly phone calls to patients

Mary Sept‐Dec

Anxiety and Depression Scale

Amy Once in September and once in December

Enroll patients in SNAP

Amy Ongoing thru pilot



3

Phase 3: Report Out

Assemble performance metric data

Summarize findings

Define pivot and/or expansion plan


Summarize lab results

Faith/Dr. Shep December 15

Calculate the new SNAP enrollments

Amy December 15

Compare Health Knowledge evaluations

Mary December 15

Compare POQ3 depression and anxiety screen

Amy December 15



1

Venture Name

Grow‐Gather‐Prepare Food Farmacy

Date 6/4/2018

Venture Lead

Deborah, Gretchen, Sabrina, Faith

Location, St. Vincent, St. Mary and Lutheran Venture Timing: Lutheran: July‐December

Region

Start Date

July 1, 2018


Lutheran, St. Mary’s noted as SMGJ Target Completion Date

December 30, 2018


Phase 1: Setup and Prepare for Venture Launch Things to consider:







Training strategy




Sysco/Sodexo contract updates

Kristen 7/2/2018


Faith Gretchen (SMGJ)

7/12/18

RD/intern roles‐create recipes, run shopping excursions, cooking class

Danielle 7/12/18

Diabetic educator‐main contact, run diabetes edu classes, follow up with participants

Mary 7/12/18

Facilities: prep room and kitchen space, refrigeration

DwayneGretchen/Nathan (SMGJ)

8/17/18



Jeffco Dept. health and human services: SNAP signupsMesa County Public Health Department: SNAP signups

AmyGretchen/Cindy (SMGJ)

7/12/18

Obtain food insecurity screen

FaithGretchen/Jeanie (SMGJ)

7/12/18

Stock shelves (hospital food drive)

Cathie

8/24/18




2

Physician role

Dr. Sheperdigian 7/12/18






Go‐live support



FaithGretchen (SMGJ)

Sept‐Dec


Mary Sept‐Dec

Run a cooking class

RD Once a month Sept‐Dec


RD Once a monthSept‐Dec

Lab draws

Faith/Dr. Shep Once in September and once in December


Mary Sept‐Dec


Amy Once in September and once in December

Enroll patients in SNAP


Ongoing thru pilot

Volunteers interviewing patients at discharge for food insecurity

Gretchen/Jeanie (SMGJ) Sept‐Dec

Volunteers gathering food bag and dispensing topatients that score positive

Gretchen/Jeanie (SMGJ) Sept‐Dec



3

Phase 3: Report Out


Summarize findings




Faith/Dr. Shep December 15



December 15


Mary December 15


Amy December 15

Total number of grocery bags dispensed

Gretchen (SMGJ) December 15



1

Venture Name Grow‐Gather‐Prepare Food Farmacy Date 6/4/2018

Venture Lead Deborah, Gretchen, Sabrina, Faith

Location, St. Vincent, St. Mary and Lutheran Venture Timing: St. Vincent: July‐December

Region Start Date July 1, 2018


St. Vincent Target Completion Date December 30, 2018


Phase 1: Setup and Prepare for Venture LaunchThings to consider:







Training strategy




Sodexo contract updates Kristin 7/2/2018


Debbie 7/12/18

Secure Diabetic educator Beverly 7/12/18

Secure facilities space for food and classes (Riverstone, Family Svc) Debbie 8/17/18



Obtain food insecurity screen Debbie 7/12/18



2

Stock shelves (hospital food drive) Paul 8/24/18


Physician role

Dr. Rudolph 7/12/18






Go‐live support



Faith Sept‐Dec


Mary Sept‐Dec

Run a cooking class

RD Once amonth Sept‐Dec


RD Once amonth Sept‐Dec

Lab draws

Faith/Dr. Shep Once inSeptember and once in December


Mary Sept‐Dec


Amy Once inSeptember and once in December

Enroll patients in SNAP Amy Ongoingthru pilot



3

Phase 3: Report Out


Summarize findings




Faith/Dr. Shep December15


Amy December15


Mary December15


Amy December15

Innovation Venture Metrics

1

Venture Name

Grow Gather Prepapre Food Farmacy

Date 6/4/2018

Venture

Location St. Mary’s Medical Center Venture Timing

Region

Western Colorado Start Date

July 1, 2018


St. Mary’s Medical Center Completion Date

December 30, 2018

Performance Metric Description Identify outcome and process measure results that address the health of the individual, the care provided and/or the reduction in cost of care. Identify the target, the quarter the target will be achieved and any baseline measurement currently available

Metric Process (P) or Outcome (O) Measure

Triple Aim MetricsImprove health (H) Improve care (C) Reduce costs (RC)

Baseline Performance and Measurement

Period

TargetPerformance

FrequencyMeasured

Goal Date for Achieving Target

Food Insecurity Survey

P H, C, RC September‐December

Identify need Once per admisstion

December 31st

Number of Grocery bags provided

O H, C, RC September‐December

1 bag per patient

Once per admission

December 31st

Snap enrollments P H September‐December

Once per admission

December 31st


1

Venture Name

Grow Gather Prepapre Food Farmacy

Date 6/4/2018

Venture

Location Lutheran Venture Timing

Region

Start Date

July 1, 2018


Lutheran Completion Date

December 30, 2018




Baseline Performance and Measurement

Period

TargetPerformance

FrequencyMeasured

Goal Date for Achieving Target

Example: 30 Day Readmission rate

Example: 90 Day Readmission rate

Hgb A1C

O H, RC SeptemberAnd December

A drop of 2 points in HgB A1C

2x December 15th

Snap enrollments P H Throughout pilot once December 15th

Health knowledge survey

O H September and December

Increase in health knowledge

2x December 15th

Number of participants (direct and indirect)

O H, RC Throughout pilot 6 direct participants plus their family members

once December 15th

Number of meals provided

P H, C Throughout pilot 5‐7meals/week weekly December 15th

POQ3 anxiety and depression scale

O H, C September and December

Decrease in anxiety and depression

2x December 15th


1

Venture Name Growth Gather Prepare Food Pharmacy Date 6/4/2018

Venture

Location St Vincent Venture Timing



St Vincent/Physician Clinics Completion Date December 30, 2018




BaselinePerformance

and Measurement

Period

TargetPerformance

FrequencyMeasured

Goal Date forAchieving Target

Hgb A1C (>9)

O H, RC SeptemberAnd December

A drop of 2 points in HgB A1C

2x December15th

Attendance in education sessions

P H Throughoutpilot

Min 3 classes attended pp

Monthly December15th

Health knowledge survey

O H September andDecember

Increase in health knowledge

2x December15th

Number of participants (direct and indirect)

O H, RC Throughoutpilot

6 directparticipants plus their family members

once December15th

Number of meals provided

P H, C Throughoutpilot

5‐7meals/week

weekly December15th

POQ3 anxiety and depression scale

O H, C September andDecember

Decrease in anxiety and depression

2x December15th

Innovation Venture: Pilot Risks

1

Venture Name

Grow, Gather, Prepare

Date 6/4/18

Location St. Mary’s Medical Center Venture Timing

Region

Western Colorado Start Date

July 1, 2018


St. Mary’s Medical Center Target Completion Date

December 30, 2018

Risks

Describe Risk

What Would Be the Potential Impact on the Project & SCL Health if the risk became an

issue?

Probability of Happening(Low, Med, High)

MitigationStrategies

Need is greater than what we can provide

Program would not be sustainable

Medium Collaborate with other community food partners to meet need.

Providing one bag of groceries is not a long term solution

Readmission rates would not change

Medium Connect patients with other resources (Food Banks, Cooking Matters Classes, Food For Life Classes, SNAP/WIC)

Space for Food Pantry at Hospital

Would not be able to launch pilot

Low Creative solutions to space issue

Volunteer capacity Higher cost to program in having to use associates

Low Reaching out to RSVP, Meals on Wheels, Senior Companion Volunteers to help during launch.


1

Venture Name

Grow, Gather, Prepare

Date 6/4/18

Location Lutheran Venture Timing

Region

Start Date

July 1, 2018


Lutheran Target Completion Date

December30, 2018

Risks

Describe Risk

What Would Be the Potential Impact on the Project & SCL Health if the risk became an

issue?

Probability of Happening (Low, Med, High)


Not having enough food supply

Failed venture, dissatisfied patients

Low Coordinating with Sysco during the pilot phase, as well as doing an adopt‐a‐shelf drive thru Wellness, and gardens at West Pines

Non‐compliant participants

Lower N. Medium Interview pt.’s prior to enrolling in the program to determine feasibility

Education classes not conducive to patients schedule

Lower N Medium Interview pt.’s prior to enrolling in the program to determine feasibility

Transportation

Lower N. Disruption of class and shopping if pt.’s show up late

Medium Utilize hospital lyft contract

Selling food for other purchases

Inaccurate results. low Education alongside free food.


1

Venture Name Grow, Gather, Prepare

Date 6/4/18

Location St. Vincent Venture Timing



St. Vincent Target Completion Date December 30, 2018

Risks

Describe Risk

What Would Be the PotentialImpact on the Project & SCL Health if the risk became an

issue?

Probability of Happening (Low, Med, High)


Not having enough food supply

Failed venture, dissatisfiedpatients

Low Coordinating with Syscoduring the pilot phase, as well as doing an adopt‐a‐shelf drive thru Wellness

Non‐compliant participants

Lower N. Medium Interview pt.’s prior toenrolling in the program to determine feasibility

Education classes not conducive to patients schedule

Lower N Medium Interview pt.’s prior toenrolling in the program to determine feasibility

Transportation

Lower N. Disruption of class and shopping if pt.’s show up late

Medium Utilize hospital lyft contract

Selling food for other purchases

Inaccurate results. low Education alongside freefood.

Glitch with continuous monitoring device

Inaccurate results Low Insure back up deviceavailable. Lab draw


2

Lost continuous monitoring device

$700 per device low Device covered byinsurance

BUDGET TEMPLATE FOR INNOVATION CHALLENGEFood Farmacy

Debbie Dobson St. Vincent

6/4/2018

Total funding requested by innovation

venture

Phase 1 ‐ Secure

Materials

September October November December January February Total

INNOVATION CHALLENGE

Operating Expenses

Wages and Benefits $3,200 $3,200 $3,200 $3,200 $3,200 $1,600 $1,600 $19,200

Office Supplies $100 $250 $250 $250 $250 $250 $100 $1,450

Office Expenses $0

Medical Supplies $600 $600 $600 $600 $600 $600 $3,600

Training, Training Materials $100 $250 $250 $250 $250 $250 $1,350

Contract Labor $0

Food $2,000 $2,400 $4,800 $4,800 $4,800 $18,800

Operating Expense Subtotal $44,400

$1,200

Capital Expenses

Equipment $4,800 $4,800

Hardware $0

Labor (ex: IT) $0

Software $0

Capital Expense Subtotal $0 $4,800

Total Funding $49,200

Manager wage $40/hr .25 FTE

RD wage $40/hr .25FTE

Food; $50/bag with room to expand cohort based on results

Office Supplies: paper survey ($100 month) and grocery bags $150 month)

Equipment: CMD for cohort ($800 per device)

Phase 3 ‐ Wrap Up and Report Phase 2 ‐ Live Pilot

Identify a detailed budget indicating how funds will be spent each quarter for the grant period.

Detailed Funding Sources and Budget

1


Gretchen Gore St. Mary's Medical Center

6/4/2018


venture

Phase 1 ‐ Secure

Materials

Oct Nov Dec Jan Feb March Total


Operating Expenses

Wages and Benefits $1,600 $1,600 $1,600 $1,600 $1,600 $1,600 $1,600 $11,200

Office Supplies $100 $250 $250 $250 $250 $250 $100 $1,450

Office Expenses $0

Medical Supplies $0

Training, Training Materials $0

Contract Labor $0

Food $7,000 $7,000 $7,000 $7,000 $7,000 $35,000

Operating Expense Subtotal $47,650

Capital Expenses

Equipment $2,000 $2,000

Detailed Funding Sources and BudgetIdentify a detailed budget indicating how funds will be spent each quarter for the grant period.

Phase 2 ‐ Live Pilot Phase 3 ‐ Wrap Up and Report


Faith Kinsinger at Lutheran Medical Center

6/4/2018


venture

Phase 1 ‐ Secure

Materials

Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Total


Operating Expenses

Wages and Benefits $1,760 $960 $1,120 $1,440 $1,440 $1,440 $800 $8,960

Office Supplies $1,000 $400 $100 $100 $100 $100 $200 $2,000

Office Expenses $0 $0 $0 $0 $0 $0 $0 $0

Medical Supplies $0 $0 $0 $2,500 $0 $0 $2,500 $5,000

Training, Training Materials $0 $0 $0 $125 $125 $125 $125 $500

Contract Labor $0 $0 $5,000 $0 $0 $0 $0 $5,000

Food $0 $0 $0 $3,600 $3,600 $3,600 $3,600 $14,400

Operating Expense Subtotal $2,760 $1,360 $6,220 $7,765 $5,265 $0 $0 $35,860

Capital Expenses

Equipment $10,000 $0 $0 $0 $0 $0 $0 $10,000

Detailed Funding Sources and BudgetIdentify a detailed budget indicating how funds will be spent each quarter for the grant period.

Phase 2 ‐ Live Pilot Phase 3 ‐ Wrap Up and Report

Innovation Challenge Semi‐Finalists Submission

Please fill out this submission form and return to Peter Kung ([email protected]) by end of day on April 7th, 2018. Submissions received after the deadline will not be considered and will not move forward in the challenge.

Innovation Venture Lead(s): Faith Kinsinger, Deborah Dobson, Gretchen Gore, Sabrina Suazo Team Member Names: Cindy Ortiz‐SMGJ Location (SMGJ, LMC, SVH): Email: Phone Number: Innovation Venture Title: Food Pharmacy: Grow, Gather, Prepare Program Innovation Intent: This is a concise articulation of your venture’s goal. Consider these two questions as you frame your intent: 1. How is this innovation different? Assess what others have already focused on and use this to

identify types of innovation to focus on those things that are distinctive and create a shift in the patient journey.

2. How ambitious is this venture? How much will you be able to move the needle on your goal?

The grow-gather-prepare program helps close the gap on nutrition as a social determinant to health. The goal of the program is to protect the health and well-being of patients and community members by providing access to healthy food while teaching ways to prepare nutritious meals on a limited income.

Food is a major player of health and wellness. Healthcare has always placed a high value on diet-from food pyramids in public health to specific diet plans at hospital discharge. This innovation attempts to meld these two; public health in an acute care setting. The patients and community members who are touched by the Grow-Gather-Prepare Program have the capability to make life long changes to their health. Not only will their lives be changed, but evidence shows those with increased food access improve the lives of those in their home and community. This innovation can not only move the needle, but with a long game view, the impact will have exponential growth. Innovation Shift: What is the primary focus of the change you want to create with your venture? Choose from one of the following three options and provide a short narrative of how your venture fits that option: Business Model: configuring assets, capabilities, and other elements of the value chain to serve our

customers and generate revenue differently

Platform: Focus on reinventing, recombining, or finding fresh connections across capabilities and offerings to create new value for customers.

Customer Experience: Connects, serves, and engages customers in distinctive ways, influencing their interactions with SCL health and our offerings.

The primary focus of this venture is platform based. It is the goal of the program to reinvent how we respond to the whole needs of the patient through a focus on nutritional wellbeing both in prevention as well as a broadened response to care planning. Background: Identify if and how a similar solution has been tested or implemented before in either another healthcare organization or another industry. If so, identify when, where and the results that were achieved. Salem Health in Oregon implemented “The Food Farmacy” in 2016. According to Sharon Heuer, Director of Community Health Improvement it works like this: When a Dietitian recognizes that a patient is nutritionally compromised and has few resources to purchase food, they can now refer them to the Food Farmacy for help. Like many food banks, the Food Farmacy is run by hospital Volunteers and the project is funded by the Salem Health Foundation. The generous donations of hospital employees and community members ensure that their shelves are well stocked for their patients in need. When patients are referred to the Food Farmacy, a Volunteer visits with them before they go home. The volunteer helps the patient select groceries and delivers the selections to their room before hospital discharge. RN Discharge callers touch base with patients a few days after they go home to make sure that they have on‐going access to healthy food. The nurses often help patients connect with food pantries in their area and meals on wheels programs. The Food Farmacy ensures that patients in need have healthy food when they go home. Arkansas Children’s Hospital (ACH) began screening for food insecurity in the summer of 2015, and has reported that about 20% of families describe problems with food or access to food. In response, ACH has partnered with the USDA and a local food pantry to serve free meals to children identified as being in urgent need during hospital and clinic visits throughout the year. The hospital also fights food insecurity through their Cooking Matters program, which provides tours of grocery stores to help teach how to purchase healthy foods on a budget, and coordinates a course on preparing nutritious meals. Assistance in applying for federal nutrition programs is also available to patients and their families. They serve anywhere from 1,250 to 1,500 meals per week on average. The San Francisco General Hospital Therapeutic Food Pantry is a clinically based prescription food program implemented to increase access to healthy food, promote healthy eating, provide unique nutrition education, and address food insecurity. It began in light of research done directly at the hospital, suggesting a clear relationship between food insecurity and disease. Physicians are able to write a prescription for healthy food items to patients who are “food insecure,” and they can pick the food up that same day at the pantry. It is staffed by a dietitian that helps patients decide what foods to eat or avoid for certain conditions, and it also offers classes for

healthy cooking techniques and strategies for shopping on a budget. Patients will also receive referrals to local food resources. To test the impact of the pantry, they will be tracking health changes in pregnant women with diabetes and obese children using a quarterly survey and data from their medical records. In January of 2017 it had completed its pilot phase and planned to expand on an ongoing basis to 5 clinic sites throughout the city. Community gardens have been implemented at other hospital sites and shown to provide educational opportunities and provide local fresh produce for hospital meals. Homestead hospital in Florida created a community garden in 2014 and has already hosted over 750 students for educational purposes with plans to expand its student reach this year. https://baptisthealth.net/baptist‐health‐news/grow2heal‐homestead‐hospitals‐community‐garden/ The food pharmacy is an idea that has been implemented in Pennsylvania at Geisinger Health Systems in 2016. The pilot proved to be successful in diabetic patients, with an average HbgA1C drop of 2 points. The Geisinger food pharmacy project now serves over 250 patients and their families. Geisinger interview NPR article Cooking Matters, a program that teaches how to shop and prepare nutritionally balanced meals on low income budgets found that families were cooking more often and more confident that they would be able to afford enough food. Over a six month period, families were eating more vegetables, including non‐fried options and green salad. Before the program, families “sometimes” worried that food might run out each month; six months post attending a cooking matters course, they “rarely” worried about this. Benefits: Identify potential patient experience, health, or financial benefits associated with the solution. Include the benefits to the patients, care givers and providers within and outside our four walls. How can those benefits be measured? Are you already measuring those benefits?

What do we want to propose from here? Are there any other ways to measure the benefits we should capture?

Initial participants can be selected from our CPC+ patient community with opportunity to expand the program to community partners. Not only will this program provide 360 degrees of Caring, it will be a natural opportunity to leverage and strengthen the SCL Health brand through earned media. Additional value will come from increased compliance and clinical outcomes associated with eating a healthier diet. Participants will complete pre and post program surveys and testing (lab panels) to measure the program's effectiveness.

Comparison of the costs to treat an acute health issue, like low blood sugar, with medical attention ($19,345) versus addressing it with long-term nutrition ($657). (Hilary Seligman) Hospital-level examples demonstrate the success of healthy food programs to decrease the need for medical care. Geisinger Health System in Central Pennsylvania recently opened the Fresh Food Pharmacy which

offers food insecure, diabetic patients a “prescription” for free foods that will help them manage their diabetes. The fresh food is accompanied by education on nutrition and meal preparation, along with one-on-one meetings with health providers like registered dietitians. The annual cost per patient is $1,000 and preliminary data shows that participants in the Fresh Food Pharmacy improve their hemoglobin A1C (indicating improved management of diabetes) by an average of three points or the equivalent of a $24,000 reduction in medical expenses.

Measuring the benefits of these programs can simply be done by documenting the number of people involved in these programs. (Grow) The gardens benefits can be measured by the number of community members owning a plot and by the weight of food grown and donated to the hospital or local food banks.

(Gather)The food pharmacy benefits can be measured by the amount of people given food bags upon discharge. Follow up calls to these patients could also provide valuable information as to how the program has impacted their health. We will also measure the number of patients with chronic disease and food insecurity who are a part of the food pharmacy program that entails free shopping with a registered dietician.

(Prepare)The food pharmacy preparation will be measured by the number of people we do one-on-one food prep with and the number of community members who are educated on food prep using SNAP dollars. The initial goal will be to conduct cooking preparation classes by 12/31/2018

Technology: Describe the technology that will be needed to implement the solution. Identify if the technology already exists or needs to be created. If the technology already exists describe what will be tested that is unique to this solution. Explain how the new technology will enable providers or patients to create or enhance services. Ideal – Epic: Turn on the option to identify Social Determinants of Health to more easily identify patients who should be triggered into the program. Epic: Create reporting capabilities to measure expected outcomes Social Media: Use existing channels to “broadcast” the cooking segments. Potentially expand to display segments in the clinics or lobby areas through the MarComm Popcorn or similar technology. Funding/Resources: 1. Describe the time required to secure resources and launch the venture. 2. Describe the investment needed for this solution (people, roles, technology). 3. Lastly, ‘guessimate’ and circle budget needed (the innovation project funding will not exceed a

6 month period pilot). A) $10,000‐$25,000

B) $25,000‐$50,000 C) $50,000‐$75,000 D) $75,000‐$100,000 E) $100,000‐$150,000

Lead time to secure resources and launch the venture

Grow: 8 weeks

Gather: 8 weeks

Prepare: 4-6 weeks

Resources needed

a. Grow-containers, raised beds, soil, seeds, plants, water access, gravel, gardening tools, hoses. People that would need to be involved include: community garden lead, nutrition services, dieticians, and community partners.

b. Gather-food pantry space, healthy food to stock the shelves, reusable grocery bags, screening tool to identify eligible discharging patients for food prescription. Involvement for the gather piece of this project includes epic technology to assist in identification of those at risk for food insecurity and volunteers to prepare food bags for the identified patients.

c. Prepare-kitchen access, kitchen tools, technology to stream cooking class, guest chefs. People needed to support this project include epic technology, guest chefs, registered dieticians and nutrition services.

Food Farmacy Grow, Gather, Prepare · Innovation Playbook (Please work with the System Innovation...

Documents

Transcript of Food Farmacy Grow, Gather, Prepare · Innovation Playbook (Please work with the System Innovation...