Background: Islam is the second-largest religious tradition in the world, with approximately 3.45 million members in the United States. New York State has the third largest Muslim population and recent data estimates 20,000 to 25,000 Muslims reside in the greater Rochester area. During the month of Ramadan, all Muslims who are physically capable are obligated to fast from sunrise to sunset, as a means of personal reflection and cleansing. This posed a challenge for Muslim patients during Ramadan, as the previous University of Rochester Medical Center (URMC) meal ordering system did not adequately accommodate their religious fasting needs.
Purpose: To address this patient care gap and foster a more inclusive healthcare system and improve patient trust in our medical system through better understanding of their social and spiritual needs.
Description: The aim was to implement a dietary order set that provided individuals who observe Ramadan with the option of fasting during daytime hours, with allowances for additional calorie-enriched meals and fluids overnight. Throughout the month of Ramadan (4/2-5/2/22), nursing and nutrition staff assisted in identifying patients aged seven and older who may benefit from this order set. Providers placed a “Patient Observes Ramadan” order for these patients, when it was deemed appropriate and medically safe to do so. Hot and cold dinner and breakfast meals were provided during non-fasting hours (i.e. overnight 6pm to 6am). Recognizing that individuals may break religious fasting obligations due to certain critical illnesses, the project aim was for 30% participation rate across select URMC sites: Strong Memorial, Golisano Children’s, and Highland Hospitals. Participation rates and patient satisfaction was assessed retrospectively.
Conclusions: With this new meal ordering system in place, URMC now has the ability to offer culturally sensitive dietary options to Muslim patients during Ramadan. This initiative demonstrates how multidisciplinary QI collaborations can create institutional change to advocate for patients and improve inpatient experiences within our hospital system. Through this project, we increased our understanding of the social and spiritual needs within the Greater Rochester Region and fostered a more inclusive environment for patients to practice their personal religious beliefs within URMC. Future directions for this project could include increased focus in lower acuity settings of the hospital such as ED observation, as well as additional guidance regarding IV fluids, IV medications and diabetes management in the Ramadan order set.