About two years ago, NHRMC started providing some patients with food boxes when they left the hospital to help them in the days following their discharge.
Patients who were clinically malnourished and experienced food insecurity received excellent care for their conditions during their hospital stay. But when they left to go home, it was often difficult for them to continue eating healthy – or eating at all.
The boxes contained items like milk, brown rice, cheese, cans of low-sodium vegetables, and pasta with sauce – as well as information about resources in the community that could provide them with food long-term.
Patients were flabbergasted – and grateful.
“They don’t come to the hospital expecting to get food. They come expecting to get medicine or crutches,” said Corey Yingling, LEAN project lead who also helps coordinate NHRMC’s food boxes. “We believe food is medicine.”
The boxes have now grown into a full-fledged food pharmacy program. NHRMC case managers, social workers, and dietitians screen patients in the hospital and some outpatient locations for food insecurity and provide them a box of food when they leave.
Pictured: Anechia Wiggins, RN, is a case manager with the New Hanover Regional Medical Center Surgery Navigation Center. She holds a food box from NHRMC's food pharmacy program that supports patients facing food insecurity. Case managers, social workers and dietitians screen patients in the hospital and some outpatient locations and provide eligible patients with a box of food when they leave.
The History of the Boxes
Angela Lago, manager of clinical nutrition, said her team of registered dietitians originally began thinking about how to get food to patients who needed it in 2016. They focused their work on patients who were food insecure and clinically malnourished, which means they met at least two of six clinical characteristics for malnutrition, which include losing weight without trying or having a poor appetite.
Malnourishment can often overlap with food insecurity, which happens when a person can’t regularly get affordable, healthy food. About 15 percent of people in New Hanover County are food insecure, according to the Food Bank of Central and Eastern North Carolina.
Lago and Scott Whisnant, NHRMC’s administrator of community engagement, combined their work on malnutrition and food insecurity to earn a grant from The Duke Endowment. That helped them hire Skip Allen, NHRMC’s first Clinical Outreach Dietitian.
Allen follows up on nutritional concerns that dietitians originally spot in the hospital when they confirm a patient has malnutrition and often food insecurity. He visits patients’ homes (either in person or virtually) and looks holistically at the factors that affect their ability to get and eat food. Do they have reliable transportation to a well-stocked grocery store? Are they battling depression or cancer, which can affect appetites? Do they understand their nutrition plan of care to continue the healing process?
Sometimes the patient’s issues can be solved after just a few visits from Allen, and sometimes they need more resources.
“Our goal is to help prevent patients from having to return to the hospital unnecessarily,” Lago said. “We want patients to thrive after they leave our facility.”
Since its inception, the malnutrition food boxes and the food pharmacy combined have distributed more than 900 boxes, Lago and Yingling said.
NHRMC’s food pharmacy gives out about 60 boxes a month, and Yingling expects to exceed 100 boxes next month.
The food pharmacy isn’t a replacement for a traditional food bank or food pantry, said Yingling. Patients can’t shop the pharmacy on their own and only receive a food box if the screening determines they are food insecure. Instead, the food boxes patients receive through the food pharmacy program are “a bridge to get them to a more secure, sustained source of food in the community,” Yingling said.
Some of those sources have created long-term partnerships with the food pharmacy. Wilmington Green, which has community gardens throughout New Hanover County, brings fresh produce to NHRMC - Coastal Family Medicine to include in those patients’ food boxes. Some food boxes also now include a $20 voucher for fresh produce from Feast Down East, a mobile food market that visits neighborhoods whose residents don’t have easy access to grocery stores. NourishNC and the Food Bank of Central and Eastern North Carolina are also key partners in the program.
The food pharmacy has helped change the NHRMC health system’s perspective on food insecurity and how eating well affects our health, Yingling said.
“This is an opportunity to help our patients,” she said. “We need to look at all the different components of somebody’s life along with their health care if we really want to take care of that person.”