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Learning
Collaborative
January 30, 2019
The
Dish
The
Dish provides a monthly update to
participating sites enrolled in the MQii Learning
Collaborative.
Spotlight:
Journal of Nursing Care Quality
Highlights Malnutrition Quality Improvement
Intervention
Impact of a
Nutrition-Focused Quality Improvement
Intervention on Hospital Length of
Stay
In December, the
Journal of Nursing Care Quality published
an
article on the impact of a
nutrition-focused quality improvement intervention
on hospital length of stay. Recognizing the high
prevalence of malnutrition among hospitalized
patients, which often goes undiagnosed and untreated
and can contribute to worsened patient outcomes,
three hospitals sought to improve nutrition care by
implementing a quality improvement (QI) initiative.
The retrospective cohort study examined the medical
records of adult patients from three hospitals of
KentuckyOne Health, part of the CommonSpirit Health
(formerly Catholic Health Initiatives): Jewish
Hospital in Louisville, Kentucky, and Saint Joseph
Hospital and Saint Joseph East in Lexington,
Kentucky. The hospitals implemented a program
whereby all patients received a screening for
nutrition risk on hospital admission using the
Malnutrition Screening Tool (MST). Patients with
evidence of malnutrition risk (score ≥2 on the MST)
were subsequently ordered oral nutrition supplements
(ONS) without waiting for further assessment by a
dietitian.
The results found the
average time from hospital admission to oral
nutrition supplement initiation was reduced by 20
hours after the quality improvement initiative was
introduced and the length of stay decreased 0.88
days for patients at nutritional risk compared to
patients not at nutritional risk. As the outcomes
indicated, the authors suggest that interventions
focused on improving nutrition in hospitalized
patients represent a low-risk, cost-effective
strategy to improve malnutrition care. Furthermore,
experts recommend a number of measures to ensure
effective nutrition care in hospitals, including the
development of an institutional culture of good
nutrition care that extends to all stakeholders and
clarifying and defining roles for each
clinician.
The QI effort
introduced by these hospitals may provide an example
for Learning Collaborative hospitals seeking to
improve the identification and rapid treatment of
hospitalized patients at nutritional risk. As a 2019
member of the Learning Collaborative, CHI may also
be able to provide guidance and insights on how to
successfully introduce such a program to other
Learning Collaborative hospitals that may be
interested.
Morrison
Healthcare Announces Partnership with the MQii
Learning Collaborative
Morrison Healthcare,
a leading national food and nutrition services
company, recently announced a
partnership with the Academy of
Nutrition and Dietetics and Avalere Health to
increase participation in the MQii Learning
Collaborative. The goal of this effort is to support
Morrison’s Nutrition Care Model programs that work
to improve patient nutrition care across the
continuum. Morrison currently serves more than 776
hospitals and healthcare systems and uses the Power
of Food to create personalized dining experiences
for patients and in their cafes to advance the
healing and healthful missions of Morrison’s
clients.
Mary Russell's
President's Page
In the January
edition of the Journal of the Academy of
Nutrition and Dietetics (JAND),
Mary Russell, President of the
Academy, published an article highlighting
the importance of preventing, identifying, and
treating malnutrition. MQii was highlighted as
making significant progress in addressing this
issue. Ms. Russell interviewed two Academy members
who are recognized experts in malnutrition to glean
key strategies for successfully working in this
space: Patricia J. Becker, MS, RDN, CSP, CNSC,
pediatric nutrition specialist at Dayton (Ohio)
Children’s Hospital Medical Center and chair of the
Pediatric Nutrition Dietetic Practice Group and
Terese Scollard, MBA, RDN, LD, FAND, regional
clinical nutrition manager at Providence Health
& Services in Portland, Oregon. First, it is
important to know the definition of malnutrition and
what the validated malnutrition screening tools are.
Second, dietitians have to understand the causes and
consequences of malnutrition, and address gaps that
miss prevention opportunities or make malnutrition
worse. Through various educational opportunities
provided by the Academy, Registered Dietitian
Nutritionists (RDNs) can position themselves as key
participants on interdisciplinary teams to address
malnutrition across all care settings.
Identifying and
Documenting Malnutrition in Inpatient
Rehabilitation Facilities
Wendy Phillips, MS,
RD, CNSC, CLE, NWCC, FAND, Division Director of
Clinical Nutrition for Morrison Healthcare,
published an article in
the January edition of JAND shedding light on
identifying and documenting malnutrition in
inpatient rehabilitation facilities. The article
breaks down the standardized characteristics of
malnutrition identification, as defined by the
Academy of Nutrition and Dietetics and the American
Society of Parenteral and Enteral Nutrition and
reveals a gap in successful malnutrition
identification and treatment in inpatient
rehabilitation facilities (IRFs). Ms. Phillips
emphasizes that RDNs should use standardized
criteria to determine the degree of protein-calorie
malnutrition and collaborate with physicians to
document this as a medical diagnosis, while
implementing appropriate nutrition interventions.
These recommendations are consistent with the goals
listed in the 2017 resource, the
National Blueprint:
Achieving Quality Malnutrition Care for Older
Adults, published by the Defeat
Malnutrition Today coalition in partnership with
Avalere Health.
Survey to Review
MQii Learning Collaborative
In case you missed the
email that was sent in mid-December, we would like
to take a moment and get a “pulse” check to better
understand what types of assistance our team can
provide in 2019 to help you achieve your
malnutrition quality improvement goals. As such, we
have created a survey with a few simple questions to
seek your feedback. All input is welcome. We
would appreciate if you would take 2-3 minutes
and fill out the survey.
Do you have a great
story to tell about your organization’s malnutrition
quality improvement efforts to date? For
example:
- Did you overcome significant hurdles to pull
together an interdisciplinary team?
- Do you have an interesting story regarding how
you engaged with your IT department to collect
and review your performance data?
- Do you have results to share regarding how the
quality of your care changed following your
pilot project, or its effect on patient
outcomes?
- Have you made strides in considering ways to
support malnourished patients as they transition
across care settings (e.g., pre-admission or
post-discharge programs)?
- Have you found interesting or meaningful ways
to better engage patients in their malnutrition
care?
- Even if you are just getting started, do you
have insights on what
tools/resources/information were most useful to
initiate your quality improvement project?
If so, we want to help
you share your experience! We are exploring
opportunities to highlight and disseminate MQii
Learning Collaborative members’ efforts to date. If
you are interested in participating in this effort,
please consider developing a brief abstract to
reflect your story and key insights or findings from
your efforts. Please send it to your MQii Point of
Contact by Feburary 20, 2019. We will then work with
you to determine how best to disseminate your work.
FNCE
Now Accepting Abstracts
The Academy of
Nutrition and Dietetics’ will host its annual Food
and Nutrition Conference and Expo (FNCE) in
Philadelphia, PA on October 26-29, 2019. The 2019
Call for Abstracts for poster presentations is now
open through February 15th. Interested
individuals are encouraged to submit a brief,
written summary (no more than 250 words) of the
specific ideas or concepts to be presented, and a
statement of their relevance to practice or
research. We hope many of you will take advantage of
this opportunity to submit an abstract
to FNCE!
What's
Around the Corner?
Upcoming
Learning Collaborative Webinars
MQii Learning
Collaborative Participant Dissemination
Workshop
Join us on Wednesday,
February 13th at 12:00PM ET for the
MQii Learning Collaborative Participant
Dissemination Workshop. Participants
will have an opportunity to discuss their interest
in dissemination activities, and understand what
research questions they can address with their data
and experiences. Additionally, speakers in this
workshop will highlight what resources are available
to Learning Collaborative participants to
disseminate their efforts. Topics will
focus on:
- Development of a successful abstract for
posters and publications;
- Best practices when publishing; and
- Examples of MQii abstracts to guide
participants.
The webinar will
feature Sherri Jones, MS, MBA, RDN, LDN, SSGB, FAND,
Senior Improvement Specialist at University of
Pittsburgh Medical Center; Catherine D’Andrea, RD,
LD, Manager, Quality Initiatives at the Academy of
Nutrition and Dietetics; and Mujahed Khan, Senior
Manager, Quality Improvement at the Academy of
Nutrition and Dietetics.
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!
Do you know others
interested in supporting malnutrition quality
improvement?
If you have colleagues
at other hospitals that are interested in learning
more about how to support high quality malnutrition
care and collaborating with hospitals throughout the
United States to do so, encourage them to join the
MQii Learning Collaborative. Enrollment is still
ongoing. Individuals can complete an interest
form to let us know that they wish to
learn more.
Next
Steps
- Attend the
upcoming Welcome Webinar on Thursday,
February 14 at 3:00 PM
ET (if you have not
attended one already), expert webinars, and
relevant Coffee Break if you have questions
regarding your malnutrition quality improvement
efforts.
- Coffee
Breaks are open-format, interactive
sessions that allow participants to discuss
particularly challenging questions around
engaging their IT teams and preparing for eCQM
and outcomes data extraction in addition to QI
project support. Participants
are encouraged to attend and bring their
questions, suggest ideas to other participants
who are encountering obstacles, or just listen
in and be inspired by the discussion.
- 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!
- Fill out your
Project
Charter once you identify plans for
your malnutrition quality improvement
project(s)
- Watch the
educational videos and expert
webinar recordings available on the
MQii Member
Portal
(log in information — Username:
MQii Password:
MQiiLC2018!) and
explore the resources in the MQii
Toolkit
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