Learning Collaborative

February 28, 2018

The Dish

The Dish provides a monthly update to participating sites enrolling in the MQii Learning Collaborative.

Spotlight: Emerging Impact of Malnutrition on Surgical Patients

In a recent analysis published in the Journal of Urology, urologists at the University of Iowa, including Kenneth Nepple, MD, 2016 Learning Collaborative participant, evaluated available literature to understand the prevalence and impact of malnutrition on surgical patients, particularly those with bladder cancer, and the implications for urologists. After reviewing 20 studies targeting at-risk surgical patients, intensive care unit patients, and the geriatric population, they determined malnutrition was prevalent in a weighted average of 41.7% of patients.

While poor nutritional status leading to loss of muscle can have an adverse impact on length of hospitalization, complications, and survival, current malnutrition assessment tools have not been evaluated in the urological literature. Dr. Nepple and team highlighted that proper nutrition screening and monitoring are critical for bladder cancer patients undergoing cystectomy since this patient population is subject to multiple treatments that could affect nutrition status during a long period of therapy. They concluded that better tools are necessary to support the identification and management of malnutrition in these patients to improve surgical outcomes and reduce complications.

Relatedly, surgery preparedness is becoming a greater focal point in care, particularly with older patients. Duke University Medical Center, University of California San Francisco Medical Center, and Michigan Medicine have recently partnered to implement an innovative initiative to encourage senior patients to get in better shape—including improved nutritional intake—prior to surgery. Doctors at these hospitals have begun prescribing older patients exercise, recommending healthy foods to incorporate into their diets, and working to minimize any anxiety and stress in the weeks leading up to surgery. This new model provides older patients with a greater understanding of what to expect before, during, and after their surgery. Dr. Michael Englesbe, professor of surgery at Michigan Medicine and previous MQii Dialogue attendee, notes that having this knowledge prior to surgery empowers older patients to ask questions, voice hesitations, and take proper prepatory steps before a procedure. MQii Learning Collaborative participants can look to partner with surgical leaders and/or incorporate models such as these into their malnutrition quality improvement efforts to ensure optimal care and potentially better outcomes for their surgical patients who are malnourished or at-risk for malnutrition.

MQii Learning Collaborative News

Key Takeaways from the Learning Collaborative Participant Dissemination Workshop 

This week, Avalere and the Academy of Nutrition and Dietetics led a Dissemination workshop for Learning Collaborative participants. The workshop explained how participants can advance their quality improvement research through poster and panel presentations or publications to benefit patients, bring visibility to their team and facility, and support improved malnutrition care quality at hospitals across the nation.

The workshop opened with an overview from Kelsey Jones, MPA, Avalere, on how dissemination efforts help increase the value of clinical care and provide internal and external benefits to the project and care teams as well as the facility. 

 

Dr. Alison Steiber, Chief Science Officer of the Academy of Nutrition and Dietetics, then discussed how registered dietitians and nutritionists are uniquely qualified to published research studies.

 

Dr. Steiber highlighted:

1. Some of the most commonly cited barriers to dietitian-led research, including lack of training and support and lack of assistance publishing or presenting research findings;
2. Opportunities to use the MQii Learning Collaborative to collect and assess your facility’s data, receive training and assistance for dissemination activities, and use the network of other Learning Collaborative sites to discuss publication or presentation opportunities and troubleshoot research questions; and
3. Key components of meaningful data, including how to use data from process and outcomes measure to inform better malnutrition care.

Attendees also heard from Dr. Elizabeth Jimenez, PhD, RDN, LD, Director, Dietetics Practice-Based Research Network, Academy of Nutrition and Dietetics, on best practices in publishing research.

Dr. Jimenez’s 7 steps for effectively communicating research findings include:

1. Publish your research in a timely way to advance science;
2. Agree on authorship criteria and order up front;
3. Choose the appropriate journal;
4. Find and review author guidelines;
5. Review the relevant literature;
6. Submit a well-written manuscript for review; and
7. Respond to editor and reviewer suggestions.

Angel Valladares, MPH, Avalere, concluded the workshop with an overview of available tools for participants to leverage to support Learning Collaborative dissemination efforts.

You can access a recording of the full webinar and slide presentation. If you have any questions or need additional information, please contact us at [email protected].

Reminder: Planning to submit an abstract on your quality improvement research? Please remember to share the abstract (and any subsequent posters, slides, or manuscripts) with Avalere at least 30 days before the submission deadline. We will briefly review the abstract and provide you with the MQii logo for inclusion in the resource, as appropriate.

What’s Around the Corner?

Upcoming Events

Webinar: Recognizing Malnutrition—Strategic and Actionable Implementation in a Hospital Setting | March 7 at 12:30pm ET

Would you like to learn more about supporting malnutrition quality improvement in the hospital setting? Join Dr. Beverly Hernandez, a dietitian and researcher at Tampa General Hospital, and other speakers for a malnutrition-focused webinar put on by the Vizient HIIN. Beverly will share her experience establishing a malnutrition quality improvement program at Tampa General as part of her participation in the 2016 MQii Learning Collaborative. Her presentation will cover such topics as how Tampa General identified gaps in care, how they built and worked across interdisciplinary teams, and how they have grown since their initial quality improvement efforts. The webinar will be held on Wednesday, February 14 from 12:30pm-1:30pm ET and is open to both Vizient HIIN member hospitals and non-member hospitals. You can register for the event on the Community Knowledge Network website. 

Next Steps

• If you have received the 2018 participant or letter agreement, please be sure to sign and return the agreement as soon as possible

• If you have not yet received the 2018 participant or letter agreement, please reach out to your MQii Team Point of Contact for access to this resource