618 - Champ’s Cupboard Produce Initiative: A Systematic, Community-Led Quality Improvement Initiative to Address Food Insecurity

Publication Number: 3599.618

Russell O. Stewart, Vanderbilt University School of Medicine, Nashville, TN, United States; Elizabeth Sun, Vanderbilt University School of Medicine, Nashville, TN, United States; Lucas Rehm, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Marie Holzer, Monroe Carell Jr. Children's Hospital at Vanderbilt, Madison, TN, United States; Alyssa Rohan, Monroe Carell Jr. Children's Hospital at Vanderbilt, Durham, NC, United States; Brianna Lillwitz, Monroe Carell Jr. Children's Hospital at Vanderbilt, Hermitage, TN, United States; Nyah Cade, Monroe Carell Jr. Children's Hospital at Vanderbilt, Smyrna, TN, United States; Sara Hanai, Monroe Carell Jr Children's Hosp at Vanderbilt, Nashville, TN, United States; Cristin Q. Fritz, Vanderbilt University Medical Center, Nashville, TN, United States

Background: Families served by Champ's Cupboard, a hospital-based program that provides non-perishable food to families with Food Insecurity (FI) at the time of discharge, expressed a need for fresh produce. Community Supported Agriculture (CSA) farms offer weekly shares of fresh, local produce to urban consumers, like those living around our medical center..

Objective: By rerouting unused CSA shares to families screening positive for FI, this project aimed to increase fresh produce provision from 0 to 10 families weekly between May and September 2025.

Design/Methods: During the growing season, three regenerative farms donated excess produce to our program. Produce was weighed at intake and distribution. Families with FI identified during admission through routine screening were offered produce before discharge. Our multidisciplinary team within a large, academic children's hospital met weekly to review data and identify intervention targets guided by our key drivers: community partnership, waste mitigation, staffing, and patient-guided improvement . The primary outcome was the number of families provided produce per week. The process measure was mass balance of produce intake and output. Balancing measures included the fraction of food wasted and the fraction of interested families turned away. Run charts assessed our interventions' impact on measures. Follow-up surveys evaluated participant experiences with the program and were summarized as proportions with 95% confidence intervals computed as Jeffreys interval.

Results: Over the course of 15 weeks, 2364.0 lbs of produce was distributed to families. Provision increased from 0 families to a mean of 12 families per week by Plan-Do-Study-Act (PDSA) cycle 3 (Figure 1). Waste dropped to hold near 0% by PDSA cycle 3 (Figure 3, Panel C). Three families who requested produce did not obtain it due to lack of produce availability (Figure 3, Panel B). Produce sources and distribution sites evolved to achieve our program measures (Figure 2). All surveyed (n=52) families (100%, CI 95-100%) used the food products and nearly all (94%, CI 85-94%) described the program as helpful. A majority (86%, CI 75-94%) said this program increased overall hospital stay satisfaction.

Conclusion(s): We achieved our aim of providing 10 families per week with fresh produce while minimizing waste by leveraging interdisciplinary efforts. Partnerships with mission-driven community partners and participant-guided improvement are invaluable strategies for addressing FI in healthcare systems and can improve care satisfaction.

Figure 1. Illustration of plan-do-study-act (PDSA) cycles
Abbreviations: DF: Delvin Farms, CFF: Caney Fork Farms, TWG: The Welcome Garden, OHO: One Hundred Oaks pediatric primary care clinic, VEGI: Vanderbilt Educational Garden Initiative community garden, ED: Emergency department, STC: Shade Tree student-run free clinic. PDSA cycle start dates indicated by vertical lines in subsequent panels.


Figure 2: Produce mass balance color coded with produce sources (top) and destinations (bottom) by week


Figure 3: Outcome and Balancing Measure Run Charts
A. Number of families served produce per week (blue solid); target highlighted (green dash). B. Percentage of families per week who requested produce but left the hospital without produce ("turn-away") (blue solid). Target highlighted (green dash). C. Fraction of produce wasted per week (blue line). Zero-waste target highlighted (green dash).