Learning Collaborative

August 29, 2018

The Dish

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

Spotlight: Advancing Patient-Centered Malnutrition Care Transitions

Explore opportunities to engage in malnutrition-focused transitions of care!

In July, the Academy of Nutrition and Dietetics, Defeat Malnutrition Today Coalition, and Avalere Health released the “Advancing Patient-Centered Malnutrition Care Transitions” Dialogue Proceedings. The proceedings (and associated infographic) are the output of a one-day, multi-stakeholder convening to discuss challenges to effective malnutrition care as patients transition across settings, and identify real-world solutions to better integrate nutrition risk identification and care into existing care transition pathways and accountable care models. The Dialogue event was the result of recognition that patients frequently are at risk for and/or develop negative health outcomes related to malnutrition, including increased risk of chronic disease, frailty, falls, and loss of independence, due to insufficient malnutrition recognition and care across settings. 

The Dialogue took place on March 14, 2018 in Washington, DC. Participants included representatives of hospitals and health systems, professional societies, community-based providers, community support organizations, patient advocacy groups, payers, and others. The results of their discussion are the basis for these proceedings, which outline key considerations and recommendations for clinicians/community and social service providers, patients/caregivers, payers, and policymakers to advance patient-centered malnutrition care transitions.

Many MQii Learning Collaborative sites are already doing work to improve malnutrition-focused discharge planning and support the needs of patients who are malnourished or at-risk of malnutrition as they transition across care settings. You may find the proceedings useful as you evaluate opportunities to improve malnutrition care transitions to/from your facility (Appendix 6, “Action Steps for Operationalizing Key Recommendations,” should be particularly helpful as you consider specific steps to advance these activities).

If you are not already engaged in discharge planning and care transition activities through the MQii Learning Collaborative, but would like to get involved, please reach out to your MQii Point of Contact to express your interest and share any information on the activities you are currently undertaking to support transitions of care.

MQii Learning Collaborative News

MQii in the United Kingdom (UK)

The National Health Service (NHS) in the UK recently launched an effort to support improved malnutrition-focused care in various NHS trusts and has chosen to use MQii tools and resources to do so. In September, the NHS will share a select set of MQii tools, modified to fit the British healthcare system, to a number of NHS hospitals for use and evaluation. We are excited to see how these tools will be adopted in the UK. Stay tuned for updates on their progress!

Academy of Nutrition and Dietetics Focuses on Malnutrition in September

Throughout the month of September, the Academy of Nutrition and Dietetics is highlighting malnutrition through articles, research updates, and webinars. The “September Spotlight on Malnutrition” aims to raise awareness and share best practices about how to manage malnutrition. For example, this month’s issue of the Journal of the Academy of Nutrition and Dietetics features a number of articles on malnutrition and highlights the work of the MQii:

• President’s Page: We’re Part of the Solution: Malnutrition Prevention, Treatment
• Question of the Month: What Is a Registered Dietitian Nutritionist’s Role in Addressing Malnutrition?
• Public Policy News: Elevating Malnutrition Care Coordination for Successful Patient Transitions

In addition, the Academy will be hosting a series of malnutrition-focused continuing educational webinars every Wednesday through the Academy’s Lifelong Learning Center. The Spotlight will culminate in Malnutrition Awareness Week (MAW), an effort supported by the Academy and led by the American Society for Parenteral and Enteral Nutrition from September 24-28 to showcase the issue of malnutrition.

MQii Learning Collaborative members are encouraged to review the articles highlighted above as well as participate in educational webinars and social media opportunities throughout the month of September to learn more about evidence-based malnutrition care and contribute your experience from your MQii participation.

Tier 1 Sites Seeking Support for Performance Data Extraction & Reporting

At this point in the year, we have supported numerous sites with EHR data extraction and reporting for performance feedback. MQii participation has helped participants both quantify the magnitude of their existing gaps in care as well as monitor and evaluate the success of their quality improvement efforts to close those gaps.

If you have enrolled as a Tier 1 site but have not begun the process of data extraction and reporting, the MQii Team is available to support you! Here are the steps we recommend to get you started:

1. Gain IRB Approval / Exemption: If you are not allowed to move forward without IRB approval or exemption, we encourage you to begin the process of submitting for IRB review.
1. You can use our MQii Study Protocol to complete the application; it is recommended that you apply for exemption or expedited review since no PHI will be requested.
2. Identify IT Team Liaison: If you do not already have an established relationship, work with your leadership to identify the right contact on your IT team to support you with generating the data extract.
3. Share the Transmission Template: Share the MQii eCQM Data Transmission Template  with your established IT contact, this resource will provide them with everything they need to build the extract report.
4. Setup a Review Call with Your IT Contact & The MQii Team: We encourage you to invite our team to an initial review meeting with your IT contact, this has significantly expedited the extraction process for participants.

Remember, we are available to provide your team with technical support and answer any questions. We have completed this process with several dozen hospitals and have experience with a number of EHR platforms. The MQii Team is ready to support your data extraction and analysis efforts!

What’s Around the Corner?

Upcoming Events

Expert Webinar: Nutrition-Focused Physical Exam Mini-Session | September 17 at 12 PM ET

Join us on Monday, September 17^th at 12 PM ET for the MQii Expert Webinar, “Nutrition-Focused Physical Exam Mini-Session.” Participants will have the opportunity to hear from a certified Nutrition-Focused Physical Exam (NFPE) trainer regarding best practices for performing an accurate and effective assessment. Attendees will also have the opportunity to ask questions and troubleshoot any NFPE challenges they may be encountering. The session will:

1. Highlight the NFPE as a tool for assessing patients for malnutrition;
2. Provide training to familiarize attendees with process and approach for the NFPE; and
3. Address questions regarding the NFPE by a certified trainer.

After this 60-minute webinar, participants will be familiar with the NFPE and will be able to begin assessing their NFPE skills to identify malnutrition among patients. Attendees will be eligible to receive one hour CPEU credit for their participation.

The webinar will feature Beth Mordarski, RDN, LD, NFPE Program Manager at the Academy of Nutrition and Dietetics and certified NFPE Workshop Trainer. Beth has over 17 years of clinical experience, which assisted Beth in the development of the Academy’s Nutrition Focused Physical Exam Hands-on Training Workshop and NFPE Pocket Guide. She finds it rewarding to be able to pass on the NFPE skills to fellow dietitians across the United States and the world. Beth enjoys being a dietetic intern preceptor for graduate students and actively participates in research related to NFPE and malnutrition. 

Lori Granich, Director, Lifelong Learning and Engagement at the Academy of Nutrition and Dietetics, will provide a brief introduction to the session.

Please register for the webinar in advance here. We encourage you to send any questions you have for the speakers in advance of the webinar to [email protected].We hope you can join us!

Note: In addition to the NFPE Mini-Session, if you would like more in-person education on the NFPE, the Academy offers an interactive, hands-on training workshop to provide registered dietitian nutritionists with skills and knowledge to perform nutrition-focused physical exam skills in the workplace and aid in the nutrition diagnosis of malnutrition. An adult NFPE Workshop will be held on October 8, 2018 in Zachary, LA and a Pre-FNCE Workshop will be held on October 20, 2018 in Alexandria, VA. You can find additional information on these trainings in the attached flyer, or at www.eatrightpro.org/nfpe.

In case you missed it: If you missed previous MQii Learning Collaborative expert webinars, you can access webinar recordings and slides on the MQii Member Portal. You will also find other member-only content, including educational webinars and archived “Dish” newsletters, on this site. As a reminder, the login information is as follows: Username: MQii  Password: MQiiLC2018!

Every year, the Academy of Nutrition and Dietetics organizes the Food and Nutrition Conference and Expo (FNCE) for registered dietitian nutritionists and other food and nutrition experts. FNCE 2018 will be held in Washington, D.C. from October 20-23. We are excited to share that we will be holding a MQii Learning Collaborative participant reception on the evening of Sunday, October 21 (additional details will be forthcoming).

In addition to the MQii Reception, you may wish to attend the MQii session, “Dietitians Leading Innovation: Using Date for Quality Improvement and Patient-Focused Transitions of Care” on October 22 from 1:30-3:00 PM ET. The session will feature a number of your MQii Learning Collaborative colleagues, who will share how registered dietitian nutritionists (RDNs) are using data to show the value of nutrition care, provide attendees with actionable steps to partner with information technology colleagues to collect malnutrition quality improvement data, and offer RDNs examples of opportunities to incorporate nutrition strategies throughout transitions of care for patients. Other sessions in the Malnutrition track that you may be interested in include:

• The Future of Pediatric Malnutrition: Establishing Prevalence, Ensuring Prevention
• The Socioeconomics of Malnutrition: Food Insecurity Screening and Intervention

Additional sessions focusing on malnutrition will also be featured.

As a member of the MQii Learning Collaborative, you are entitled to a participant-only discounted rate to attend FNCE 2018. You should have received an email reflecting this promotional rate and the registration code earlier this month; if you did not receive it, please check your “Spam” and “Clutter” folders in your mailbox. If you still are unable to locate it, reach out to your MQii Point of Contact at [email protected]. To register and for additional information on FNCE, please visit www.eatrightFNCE.org.

Please let us know if you are planning to attend FNCE 2018 so we can connect in-person and provide you with additional details on MQii-focused events. Please also let us know if you will be presenting any malnutrition-focused work at FNCE (poster, panel session, or otherwise) so we can share it with your MQii Learning Collaborative colleagues!

The IHI is now accepting storyboards to be considered for presentation at their 2018 Annual Forum in Orlando, FL on December 9-12. The storyboards provide an opportunity to highlight your malnutrition quality improvement project, reflect on any key insights or learnings from your efforts, and share any findings of your journey to date. MQii Learning Collaborative participants are encouraged to develop and submit a storyboard if they are interested in potentially presenting at the IHI Annual Forum. If you plan to submit, please let us know by sending a brief description of your poster to your MQii Point of Contact. Submissions are due to IHI by September 28, 2018 at 11:59 PM ET.

ASPEN is currently accepting abstracts for the ASPEN 2019 Nutrition Science & Practice Conference in Phoenix, AZ on March 23-26, 2019. If you were unable to submit a poster for the 2019 Food and Nutrition Conference and Expo (FNCE), consider submitting an abstract highlighting your malnutrition quality improvement work for ASPEN 2019. In your abstract, you are encouraged to share your innovative malnutrition quality improvement work, results, and practice implications. If you plan to submit, please let us know by sending a brief description of your poster to your MQii Point of Contact. Submissions are due to ASPEN by October 2, 2018 at 11:59 PM ET (submit by September 18, 2018 to receive the “early bird” submission fee of $50).

Next Steps

1. Check out the MQii Member Portal Page
• Log in information— Username: MQii  Password: MQiiLC2018!
2. Attend an upcoming Welcome Webinar (if you have not attended one already) and/or Coffee Break
3. Share your progress with your MQii Point of Contact – we want to hear about any developments you’ve experienced, as well as any challenges you might be encountering!
4. Begin to fill out your Project Charter as you start to identify plans for your malnutrition quality improvement project(s)
5. Watch the educational videos and explore the resources in the MQii Toolkit