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The Dish provides a monthly update to participating sites enrolled in the MQii Learning Collaborative.
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SPOTLIGHT: SPOTLIGHT: NEW META-ANALYSIS ABOUT NUTRITION SUPPORT AND MALNUTRITION
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New Evidence Highlights Opportunities for Malnutrition Quality Improvement
In November, Gomes et al. published a meta-analysis and systematic review titled “Association of Nutritional Support with Clinical Outcomes Among Medical Inpatients Who Are Malnourished or at Nutritional Risk: An Updated Systematic Review and Meta-analysis” in JAMA Network Open. Upon reviewing 27 trials conducted between 1982 and 2019, the authors found that although methodological quality varied among the trials, nutritional support (including dietary advice, changes in organization of nutritional care, food fortification, extra snacks, oral nutrition supplements, and enteral nutrition) was associated with reduced mortality (8.3% vs. 11% in the control group) and non-elective hospital readmission rates (14.7% vs. 18% in the control group) among malnourished patients, concluding it is an important treatment to consider for this population. Benefits were greater for patients identified as malnourished than for those considered at-risk, indicating the high importance of ensuring accurate and consistent malnutrition screening, assessment, and diagnosis. This publication further adds to the growing body of evidence—to which many of you are contributing—that addressing malnutrition can lead to better quality outcomes.
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EXTEND YOUR PARTICIPATION IN THE MQII LEARNING COLLABORATIVE IN 2020—SIGN YOUR LETTER OF INTENT
Do you love being a part of the MQii Learning Collaborative? It’s time to renew your pledge and letter of intent to participate through 2020. Here are some of our accomplishments from the past year:
- Supported a total of 270 sites, with 90 submitting data, across 36 states (see Figure 1)
- Managed a data repository containing more than 300,000 patient records
- Hosted 8 expert webinars and 24 Coffee Breaks for Learning Collaborative members
- Developed and shared 2 videos and 1 presentation featuring member sites at FNCE
- Published a special Supplement to JAND, featuring 8 articles and 24 abstracts that highlight the impact of malnutrition quality improvement and reflect 88 total authors
- Authored more than 20 journal articles, white papers, presentations, and opinion pieces
- Advanced healthcare quality measurement through the development and testing of malnutrition electronic clinical quality measures (eCQMs)
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Figure 1. Geographic Representation of 2019 MQii Learning Collaborative Sites
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We continue to plan our content based on your feedback, such as focusing our December webinar on implementation and evaluation of screening tools and our upcoming Coffee Break focused on educating other clinicians about malnutrition. We are looking forward to expanding our education and training sessions next year to better support your quality improvement projects and dissemination of the results of your great work. In 2020, look for opportunities to participate in targeted pilot studies and learn more about transitions of care in the community setting.
Re-enrolling in 2020 includes the following steps:
- Tier 1 (i.e., data-sharing) sites need to sign an addendum to a previous participant agreement or a new 2020 participant agreement
- Tier 2 (i.e., non-data-sharing) sites need to sign a new 2020 participant agreement
You will receive this agreement in your inbox shortly; however, please reach out to [email protected] if you don't receive it by the end of December. As always, please let us know if you have any questions or concerns about engagement with the MQii.
Thank you for your continued partnership to improve malnutrition quality care!
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LEARNING COLLABORATIVE MEMBERS FEATURED FOR QI WORK
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Pioneers in Quality
In October 2019, the Joint Commission published a report titled “Pioneers in Quality™: Proven Practices Collection 2019,” featuring hospitals who have successfully leveraged electronic clinical quality measures (eCQMs) and health information technology (HIT) to advance quality improvement at their institutions. Two out of five hospitals recognized in the report are members of the MQii Learning Collaborative, Memorial Hermann and University of Pittsburgh Medical Center. Most notably, the report recognizes these organizations for their work in eCQM development and optimization of clinical/operational workflows to improve eCQM advancement. The work featured in this report is not specific to malnutrition but is reflective of the broader emphasis on data collection and evaluation that has enabled them to be such committed members of our Learning Collaborative. You can read more about the 4 malnutrition eCQMs that the Academy developed and view previous webinars that featured these systems in our Member Portal.
On behalf of the MQii Leadership Team, congratulations to the staff of both Memorial Hermann and University of Pittsburgh Medical Center on this accomplishment!
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2019 FNCE Videos
We are pleased to share links to the videos featuring MQii members that were played during the opening and closing sessions of FNCE this year. Video 1 features Raj Kumari, DSc, RDN, Clinical Nutrition Manager at Overlook Medical Center, and Angela Lago, MS, RDN, LDN, CNSC, Clinical Nutrition Manager from New Hanover Medical Center. Video 2 also features Angela Lago as well as feature Rya Clark, RDN, LD, CNSC, Clinical Nutrition Manager at Memorial Hermann. We enjoyed working with their entire care teams to develop the videos and we hope the audience found them inspiring. If you have any trouble viewing these videos, please contact [email protected].
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WHAT'S AROUND THE CORNER?
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Expert Coffee Break #1: Educating Other Clinicians about Malnutrition | Wednesday, January 15 at 11:00 AM ET
We have recognized this topic as a recurring concern, so we would like to offer this facilitated discussion so that members can share best practices and recommended resources for teaching a variety of clinicians about various populations at risk for malnutrition and how to best screen, diagnose, and document it in electronic health records.
Please register for the Coffee Break in advance here.
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For all of our expert webinars and Coffee Breaks, we encourage you to send any questions you have for the speakers in advance of the webinar to [email protected].
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We are working to finalize our 2020 MQii Learning Collaborative Expert Webinar schedule. Once our webinars are confirmed, we will share upcoming registration information and update our Learning Collaborative calendar. Stay tuned!
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 the calendar of upcoming events, pre-recorded educational webinars, and archived Dish newsletters, on this site. As a reminder, the login information is: Username: MQii Password: MQiiLC2018!
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Consider opportunities to share your MQii project and findings!
The following table outlines several meetings and conferences that may be of interest to Learning Collaborative members in the coming months. We encourage you to look at the event websites, review submission criteria, and consider sharing your research with these various audiences. Please reach out with any questions or for assistance in pulling these together.
As a reminder, your signed participation agreement asks you to "share any MQii Learning Collaborative-related materials (e.g., press releases, blog posts, publications, poster presentations) you plan to make public with Avalere for review 30 days prior to submission or public release to ensure proper acknowledgement is reflected. Please note that the MQii is a trademarked entity and should be referred to as such (including use of the full name or the abbreviation, “MQii”) in any publications. This includes, but is not limited to, white papers, manuscripts, posters, press releases, blog posts, and/or other public visibility efforts."
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LEARNING COLLABORATIVE PARTICIPANT RESOURCES
NFPE “Tip of the Month”
If a patient is readmitted within a week of being discharged, does an NFPE (nutrition focused physical exam) need to be repeated?
Yes, an NFPE should be completed upon a new admission and a physician should not rely on the assessment from the previous admission. Given the fact that changes can occur between admissions, it is important for the RDN to complete a new nutrition assessment, including the NFPE, to evaluate if malnutrition is present and if so to what degree. This, in part, helps to ensure that the appropriate nutrition diagnosis is documented.
A recent study in JAND provides data that support the benefit of RDNs performing NFPEs to aid in providing the appropriate nutrition diagnosis related to the degree of malnutrition. The Academy suggests performing an NFPE on patients weekly upon follow-up to assess for changes or stabilization. Although significant improvement may not be expected in this short period of time, the RDN can assess decline in nutrition status, which may lead to further nutrition interventions or adjustments in the current intervention. An NFPE may also reveal stabilization of nutrition status, which can support continuation of the current nutrition intervention. By performing the NFPE weekly, RDNs can better adjust the patient's nutrition intervention to aid in positive outcomes.
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NEXT STEPS
- Attend the upcoming January Coffee Break if you have questions regarding your malnutrition quality improvement efforts
- Share your progress or reach out with any questions to your MQii Point of Contact. We want to hear about any developments you have experienced as well as any challenges you are encountering
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CATCHING UP ON 2019?
Did you miss an educational webinar this year? Would you like to review an expert webinar recording for CPEU credit? Are you trying to get caught up on MQii Dish newsletters? All archived MQii materials are available on the MQii Learning Collaborative Member Portal using the following login information: Username: MQii Password: MQiiLC2018!
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On behalf of the entire MQii Team, we would like to wish you a happy and healthy holiday season! We look forward to working with you in 2020.
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