P2.E085: Infant Supply Insecurity Screening and Infant Supply Distribution in the Pediatric Emergency Department

Background: Infant supplies (diapers and formula) are examples of necessities that families with young children struggle to afford. In Chicago, it is estimated that 1 in 3 families face diaper poverty. In the pediatric emergency department (ED), healthcare providers are likely to interface with families experiencing social need and are in a unique position to assess for and intervene on infant supply needs. We developed an initiative to screen caregivers of infants and young children presenting to the Lurie Children’s ED for infant supply insecurity and to distribute diapers and formula to families in need.

Project Description: The infant supply screening and infant supply distribution initiative aims to screen caregivers of patients presenting to the pediatric ED under 12 months for formula insecurity and under 36 months for diaper insecurity. Nurses screened for infant supply insecurity during triage and documented results in the electronic medical record (EMR). If a caregiver screened positive for infant supply insecurity, the EMR prompted nurses to place an order in the EMR that paged the social worker. The social worker met with the caregiver to offer infant supplies and information on community resources. We describe the first four months of the initiative, including rate of infant supply screening, infant supply need, resources offered, and patient encounter characteristics including sex, age in months, race and ethnicity, interpreter requirement, Emergency Severity Index (ESI), and disposition.

Discussion: From 8/1/2023-11/30/2023, 7015 patients under 36 months presented to the pediatric ED, 3206 of which were under 12 months. Of the patients under 36 months, 3852 (54.9%) were screened for diaper insecurity (Table 1). Of those screened, 242 (6.3%) screened positive for diaper insecurity; and of these, 68 (28.1%) received diapers and resources. Of the patients under 12 months, 1825 (56.9%) were screened for formula insecurity (Table 2). Of those screened, 117 (6.4%) screened positive for formula insecurity; and of these, 27 (23.1%) received formula and resources. Of the 242 patients who screened positive for diaper insecurity, mean age was 12.5 months, 190 (78.5%) identified as Hispanic/Latinx, and 161 (66.5%) required an interpreter. Of those 117 screened positive for formula insecurity, mean age was 4.4 months, 88 (75.2%) identified as Hispanic/Latinx, and 87 (74.4%) required an interpreter.

Conclusion: The preliminary outcomes of this intervention demonstrate that infant supply needs among caregivers presenting to the pediatric ED are common. Further longitudinal data is needed to better characterize the severity of infant supply needs in the ED and may be used to support long-term policy interventions that support caregiver access to diapers and formula. These preliminary outcomes also suggest opportunity for quality improvement initiatives aimed to improve rates of infant supply screening and connection with resources.