Nashville General Takes Multi-Pronged Approach to Chronic Disease Management
xBy FORD SANDERS
Nashville General Hospital is filling prescriptions for improved outcomes with their unique Food Pharmacy, which provides patients with access to nutritious dietary options. The program offers free-of-charge food totes with fresh produce and shelf-stable items that are specifically tailored to the patient's needs to optimize health and manage chronic disease.
"We felt that it was our responsibility to do whatever we can to help our patients here. With food insecurity being such a big issue, the Food Pharmacy was started," explained Mike Venters, MS, RDI, director of Food and Nutrition Services for Nashville General Hospital (NGH).
With so many patients striving to manage chronic conditions from diabetes to heart disease, NGH has looked for innovative ways to increase patient education and engagement, along with services to address barriers to optimal care. The Food Pharmacy is much more than just a quick visit to grab groceries. The process starts in the doctor's office when looking at ways to improve diet and keep patients healthy.
Chief Ambulatory Services Officer Dorothy Bennett noted it works much like a regular pharmacy in that a provider writes a prescription for the Food Pharmacy. "We give them food that equates to their chronic disease," she said. "If they're hypertensive, we are going to give them low sodium. If they are cancer patients, we are going to give them high caloric foods so they can stay on their treatment plan," Bennett added.
Patients at NGH also become educated about the food they are eating and the effects on the body and their specific condition. They are taught how to read the labels on items and make sure it matches up with the nutritional requirements to better manage their chronic disease.
In addition to the Food Pharmacy, NGH works to keep patients educated and engaged in all aspects of self-care. Andrew Pierre, DPM, AACFAS, a podiatrist and fellowship-trained foot and ankle surgeon with NGH, said the most common chronic disease they see is diabetes, which can easily lead to an increased risk of infections, difficult-to-treat wounds and a higher rate of amputations. Diet and nutrition are key factors in managing diabetes, but Pierre said counseling also plays a critical role in care management. NGH deploys an entire counseling team - their Care Management Team - to make sure patients truly understand what it takes to stay healthy and keep their diabetes in control.
"One of the things that I tell my patients is that food is medicine. It's really all about education and making sure they understand their disease process," said Pierre. "Once the patients understand the disease process and the complications that can happen with it, they are less susceptible to developing wounds and amputations."
As 2020's coronavirus pandemic set in, the NGH team knew they would have to address new barriers to keeping their patients and community safe. During the public health emergency, the Food Pharmacy has expanded their efforts by supplying help to those who are food insecure throughout Nashville, whether they are patients with NGH or not.
Venters said they have started a new, temporary program that is delivering thousands of bags of food to those in need right now. Since March 1, the NGH Foundation, which runs the Food Pharmacy, has distributed more than 5,930 food bags, provided over 26,000 days of food and supplied 96,000 meals.
"We have an outreach program that started when the pandemic started. We have a lot of volunteers that are delivering food to people that basically have no way of getting food to themselves or have money to do that," said Venters.
Funding for the Food Pharmacy comes from grants, community donations and the NGH Foundation with shelf-stable food purchases through Second Harvest Food Bank of Middle Tennessee. This collaborative effort helps keep the shelves stocked with those important items to optimize patient health. While the Food Pharmacy is primarily staffed with trained volunteers, clinical specialists on the team are on site to offer education about what the patient is consuming and why it is so important. The program also has an agreement with Lipscomb University where students come volunteer for weeks at a time and receive class credit for their efforts.
While NGH spans many disciplines and specialties, chronic disease management is among the most important ways to optimize outcomes and provide secondary prevention for complications and comorbid conditions. By introducing programs like the Food Pharmacy and engaging patients through education, NGH removes barriers and affords patients the opportunity to fuel their bodies and their minds in order to focus on regaining and maintaining their health.