Learning Collaborative
 
January 27, 2020
The Dish
The Dish provides a monthly update to participating sites enrolled in the MQii Learning Collaborative.
 
 
 
SPOTLIGHT: OPPORTUNITY TO SUPPORT MALNUTRITION REVIEW WITH THE ACADEMY’S EVIDENCE ANALYSIS CENTER 
The Academy of Nutrition and Dietetics’ Evidence Analysis Center (EAC) is seeking a multidisciplinary team of nutrition experts to develop a systematic review and evidence-based guideline on malnutrition in older adults. The review will focus on assessment methods and interventions for preventing or treating malnutrition in older adults living in the community or long-term care. This is an excellent opportunity to leverage your experience in the MQii to improve care for these patients. You can read more about this opportunity and application process in the Workgroup Member section of the EAC website. The deadline to apply is February 5, 2020. The Academy is also seeking a patient advocate to apply to help direct this review and guideline development. If you are aware of appropriate candidates, please direct them to the online application form on the EAC website. 
 
 
 
LEARNING COLLABORATIVE PARTICIPANT UPDATES 

Call to Action: Support the Inclusion of Quality Measures in the Merit-Based Incentive Payment System (MIPS)

Malnutrition Quality Measures Included for 2019-2020 MIPS Reporting
As was recently announced by the Academy of Nutrition and Dietetics, we partnered with the Premier Clinician Performance Registry and the U.S. Wound Registry in 2019 to include malnutrition-focused quality measures in their respective Qualified Clinical Data Registries (QCDR). This is an incredibly important development for the field of nutrition care, as these would be the first quality measures directly relevant to the care of patients at-risk of malnutrition or with malnutrition. These measures are being made available for clinicians eligible to participate in the Merit-Based Incentive Payment System (MIPS). The focus of the included quality measures vary only slightly from those included in the MQii, but equally promote health care team collaboration among physicians and RDNs.

The measure includes physicians reporting with the referral to an RDN of preoperative patients who are identified to be at risk for malnutrition and appropriate diagnoses of malnutrition; RDNs directly report completed nutrition assessments with recommendations/interventions for patients identified to be at risk for malnutrition.

Requesting Your Help to Ensure Malnutrition Quality Measures Remain in MIPS
As part of the measure inclusion process, the Centers for Medicare and Medicaid Services (CMS) requires that measures meet minimum reporting thresholds in order to continue to approve those measures for reporting by MIPS participating clinicians. Therefore, we are seeking participants from the Learning Collaborative who can partner with us to fulfill the minimum reporting requirements.
What You Can Do to Help
If you are already a Tier 1 participant, you would simply need to add a few new data elements to your existing data reports. For all the available measures, the most notable data element is the National Provider Identification (NPI) number for each encounter's associated provider. The NPI number is necessary for the MIPS because the program is intended for individual provider (or group practice) performance.*

If you are interested in supporting the inclusion of the measures so that nutrition care providers have more measures available for them to report in upcoming years of the MIPS, Avalere can provide technical assistance to your team to be able to fulfill the reporting requirements. Of note, any data that you share for this effort will not be used to assess your organization's performance in the MIPS. Your organization will still be able to make the decision on how it would like to participate in the MIPS.

Please reach out to Angel Valladares if you are interested in supporting this effort to make sure identification and treatment of malnutrition risk and malnutrition are included as part of the MIPS moving forward.

*Of note: NPI data are not considered protected health information. Only names of the individuals associated with the corresponding health information (i.e., the subjects of the records) and of their relatives, employers, and household members must be suppressed. There is no explicit requirement to remove the identification numbers of providers to ensure a de-identified data set.
Reminder to Sign Your Participant Agreement

This is a reminder to please sign your letter to participate in the 2020 MQii Learning Collaborative as soon as possible.
  • Non-data-sharing sites: please sign your letter of intent
  • Data-sharing sites: please sign an addendum to your previous agreement
You should have previously received these materials in your inbox but please reach out to [email protected] if you have not. Please let us know if you have any questions or concerns about engagement with the MQii as well as any changes in leadership in your nutrition care team. We look forward to working with you in the upcoming year!
WHAT'S AROUND THE CORNER?
Please check the MQii Learning Collaborative Calendar to see an upcoming schedule of exciting events with corresponding registration links, including 2020 MQii Learning Collaborative Expert Webinars through the end of 2020. We hope you will join us.
Expert Webinar: "Improving Patient Outcomes & Decreasing Hospital Costs Through Nutrition: The Project Experience” | Wednesday, January 29, 2020 at 3:00 PM ET

Join us on Wednesday, January 29 at 3:00 PM ET for the MQii Expert Webinar, “Improving Patient Outcomes & Decreasing Hospital Costs Through Nutrition: The Project Experience.” During this live webinar, participants will learn how to:
  • Describe the importance of a comprehensive malnutrition program and its impact on clinical quality outcomes, including morbidity, mortality, and readmissions; and
  • Explain how to lead an interdisciplinary team to promote best practices and implement strategies to improve data collection and reduce healthcare costs.
The webinar will feature Amanda Goldman, MS, RD, LD, FAND, Healthcare Industry Sales Strategist at Gordon Food Service (and former System Director of Quality and Wellness for the Catholic Health Initiatives Food & Nutrition Services) and Sharon Siegel, RD, LD, System Clinical Nutrition Manager at Sodexo.

Attendees will be eligible to receive one-hour CPEU credit for their participation.

Please register for the webinar in advance here.
Coffee Break: Meeting the Needs of Inner City and Rural Patients with Malnutrition | Tuesday, February 11 at 1:00 PM ET 
(Note: we are finalizing the date and time and will send an update if these details change)

Our member sites serve patients in a variety of geographical settings and we hope this conversation will provide an opportunity to connect and share best practices with other sites serving similar patient populations.

Please register for the Coffee Break in advance here.
Expert Webinar: “How Malnutrition Presents in Patients with Mental Health Conditions” | Wednesday, February 19, 2020 at 11:00 AM ET

Join us on Wednesday, February 19 at 11:00 AM ET for the MQii Expert Webinar, “How Malnutrition Presents in Mental Health Conditions.” During this live webinar, participants will learn about:
  • The etiology and presentation of malnutrition in patients with mental health disorders;
  • Ways to identify and treat malnutrition among these patients in various settings; and
  • Additional resources and opportunities for dietitians to improve patient care.
The webinar will feature Sharon Lemons, MS, RD, CSR, FAND, LD, Lead Dietitian at My Health, My Resources of Tarrant County, and April N. Hackert, MS, RDN, CEDRD, Psychiatric Clinical Research Dietitian/Chef/Visionary Educator at Choose to Change Nutrition Services and University of Illinois at Urbana-Champaign.

Attendees will be eligible to receive one-hour CPEU credit for their participation.

Please register for the webinar in advance here.
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].
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!
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.
 
 
 
NUTRITION POLICY UPDATE
In November 2019, the US Government Accountability Office (GAO) released a report about older adult meal programs, which found that due to programs’ variability in adhering to nutrition requirements and reporting on operations, improved monitoring is needed to ensure meal programs meet varying needs of older adults in the US. The report includes recommendations for the US Department of Agriculture (USDA) and Department of Health and Human Services (HHS) to improve federal nutrition programs that serve our older adults. One of these recommendations is for HHS to include a plan to address this problem in future Dietary Guidelines for Americans.

Additionally, Defeat Malnutrition Today (DMT) is holding a webinar titled, “GAO Report Discussion: What’s Next for Federal Senior Nutrition Programs?” to discuss the report, its recommendations, and policy going forward on Tuesday, January 28 at 2:00 PM ET. You may register for the DMT webinar here
LEARNING COLLABORATIVE PARTICIPANT RESOURCES
NFPE “Tip of the Month” 
Nutrition screening is an important first step to recognize if a patient is at risk for malnutrition and can be performed by trained personnel. There are several nutrition screening tools available and it can be challenging to decide which one to use.

The Academy of Nutrition and Dietetics’ Nutrition Screening for Adults Workgroup recently conducted a systematic review of the evidence on nutrition screening tools and determined it is the position of the Academy that “the Malnutrition Screening Tool (MST) should be used to screen adults for malnutrition (undernutrition) regardless of their age, medical history, or setting.”

Once a patient is screened, the registered dietitian nutritionist can conduct a nutrition assessment, including the nutrition focused physical exam (NFPE), to aid in identifying if the patient is malnourished and provide supportive data for the malnutrition diagnosis.
NEXT STEPS
  • Attend the upcoming February Coffee Break if you have questions regarding your malnutrition quality improvement efforts or want to discuss malnutrition in different geographical settings
  • Note: we will send an updated link shortly if the time and date change
  • Share your progress or reach out with any questions to your MQii Point of Contact. Please also let us know about any transitions in leadership, requested topics for future events, or additional events of interest to share with other members 
  • Please sign and return your letter of intent/addendum to participate in the Learning Collaborative as soon as possible