Background: Various Social Determinants of Health (SDoH) are implicated in ophthalmic diseases, with food insecurity being of particular importance given the link between food and conditions such as diabetic and hypertensive retinopathy. While prior quality improvement (QI) initiatives addressing food insecurity screening exist, they are limited in the ophthalmic clinical setting.

Purpose: We implemented a Health Equity (HE) Quality Improvement fellowship project to improve screening for food insecurity in an urban ophthalmology outpatient clinic that sees adult and pediatric patients.

Methods: Several initiatives were implemented in an attempt to reach a goal of 80% of patients screened for food insecurity. Project initiatives included improving the patient visit flow to incorporate screening and training clinic staff and providers on this new process as well as introducing an on-site food pantry. Various Quality Improvement tools, such as a current state process map, a Cause-and-Effect Diagram, a Key Driver Diagram, and infographics for patient education, were utilized.

Results: Weekly data reports indicate that the team reached the goal of 80% after having consistently screened in the 60-70% range since the project started. Since this project is ongoing, improvements and refinements will continue to be made until special cause variation is reached.

Conclusion: This HE-QI project serves as a model for improving SDoH screening in ophthalmologic settings and also as a model for work that can be done through HE-QI fellowships.