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The Dish provides a monthly update to participating sites enrolled in the MQii Learning Collaborative.
We would like to acknowledge all of the clinicians and other healthcare workers reading our newsletter in the midst of the current COVID-19 pandemic. You are all doing wonderful work to care for your patients and we thank you for your dedication and service to our country.
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SPOTLIGHT: OPPORTUNITIES TO SUPPORT EMERGENCY FOOD ACCESS IN RESPONSE TO COVID-19 PANDEMIC
In light of the recent Coronavirus disease outbreak, please reference this update from the Academy for resources and more information specific to dietitians. Patients who are malnourished are at greatly increased risk of contracting and suffering from COVID-19, so we know that it is critical to ensure these patients have adequate access to food during this time. This is further exacerbated by the fact that they might be restricted to their homes and unable to access food. The Academy has called for the U.S. Department of Agriculture and Department of Health and Human Services to expand flexibility and funding for federal nutrition programs so that state and local programs can address imminent community needs. We encourage you to respond to the Academy’s action alert.
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WHAT'S AROUND THE CORNER?
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Please check the MQii Learning Collaborative Calendar to see a schedule of upcoming events with corresponding registration links, including 2020 MQii Learning Collaborative Expert Webinars.
Opportunities to Learn More about Learning Collaborative Data Findings
Pending the state of COVID-19 in the upcoming months, Kirk Kerr from Abbott will deliver a presentation titled, “Differences in Nutrition Interventions Among Malnourished Hospitalized Patients” (time TBD) at ASN Nutrition 2020, currently scheduled for May 30−June 2, 2020. This presentation is based on findings from Learning Collaborative data. We encourage you to let us know if you also plan to attend so we can connect with you.
While the in-person meeting for ISPOR 2020: HEOR: Advancing Evidence to Action has been cancelled, the findings that Emily Belowich from Avalere Health planned to present during a poster session on May 18 will instead be published in a forthcoming issue of Value in Health.
Expert Webinar: “A Closer Look into the Role of Nutrition in ERAS Protocols” | Wednesday, April 22nd at 11:00 AM ET
Join us on Wednesday, April 22nd at 11:00 AM ET for the MQii Expert Webinar, “A Closer Look into the Role of Nutrition in ERAS Protocols.” During this live webinar, participants will learn about:
- Best practices to support nutrition care for surgical patients from pre-admission through discharge
- An example of successful incorporation of nutrition care into an ERAS program, including strategies to change culture, tools to overcome barriers, and measures of success
The webinar will feature Paul Wischmeyer, MD, EDIC, FASPEN, FCCM, Duke University School of Medicine, and Gina Ward, MS, CD, RD, Steward Health Care. Attendees will be eligible to receive a one-hour CPEU credit for their participation.
Please register for the webinar in advance here.
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Coffee Break #1: Partnering with Community Food Resources to Address Malnutrition/Food Insecurity | Thursday, April 23rd at 2:00 PM ET
Recognizing that food insecurity increases risk of malnutrition and associated outcomes, working with established community food resources to address your patients’ needs can help optimize their nutrition status. This conversation will serve as an opportunity to learn what steps other members have taken to better address food insecurity among their patients and/or local community and identify opportunities to apply these approaches to your patient populations.
Please register for the Coffee Break in advance here.
Coffee Break #2: Integrating Nutrition into ERAS Programs | Monday, May 11th at 2:00 PM ET
Many of our members are working on better integrating nutrition care into Enhanced Recovery After Surgery (ERAS) programs in their hospitals. Following our April MQii Expert Webinar, this conversation will provide an opportunity for small group discussion to share examples of successes and best practices for gaining support from other disciplines.
Please register for the Coffee Break in advance here.
For all of our expert webinars and Coffee Breaks, we encourage you to send any questions for the speakers in advance to [email protected].
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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 together submission materials.
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MALNUTRITION IN THE NEWS
Recent Articles Showcase Impact of Malnutrition Diagnosis
Two recent articles call attention to the importance of making accurate malnutrition diagnoses. Last month, emergency medicine physician assistant James Haines and colleagues wrote an article in Clinical Advisor titled, “Malnutrition in the Elderly: Underrecognized and Increasing in Prevalence,” arguing that malnutrition is common but widely underdiagnosed in the elderly. The piece highlighted that multidisciplinary teams are necessary to provide a proper diagnosis and effective intervention to treat these patients.
Relatedly, Politico published an article earlier this month titled, “AI was supposed to save health care. What if it makes it more expensive?” supporting artificial intelligence (AI) as a helpful way to document and treat conditions for high-risk patients—including those at risk for malnutrition. But it also outlines the unintended overdiagnosis and overtreatment, potentially leading to higher healthcare costs. The author argues that industry uncertainty about how to best utilize the technology in practice and lack of buy-in from clinicians serve as barriers to triaging patients and treating them efficiently. As experts in diagnosing malnourished patients and prioritizing their needs, dietitians in our Learning Collaborative can seek more information through the Academy (such as material from last year’s House of Delegates meeting) and other avenues to learn about how AI can best be used to improve patient care and help to implement it in practice with their care teams.
Both of these articles call attention to the need to improve accurate documentation of malnutrition status and risk. As noted in the January Dish, the Academy recently convened a workgroup to conduct an updated review of malnutrition screening tools, resulting in publication of the systematic review and corresponding position paper in the April issue of JAND. The Academy continues to recommend using the MST to screen patients across backgrounds and practice settings for the highest validity and other parameters.
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LEARNING COLLABORATIVE PARTICIPANT RESOURCES
NFPE “Tip of the Month”
Food insecurity is a problem that affects people across the country and across many different populations. While the national prevalence is about 11%, it varies widely and is almost twice as high in certain minority groups and families with single mothers. A study in Public Health Nutrition showed one-fourth of veterans are food insecure, including 12% reporting very low food insecurity. As healthcare clinicians, we may see patients with food insecurity every day.
What can we do to address food insecurity?
- Identify patients with an easy to use two-question food insecurity screen by Hunger+Health (a partner of Feeding America).
- Refer patients to available food programs.
- Look to create a food distribution program connected with your facility. Some medical facilities—such as Cincinnati VA Medical Center in Cincinnati, OH, and Connectus Health in Nashville, TN—are opening a food pantry at their center to provide food to those in need.
How do we assess for malnutrition?
As registered dietitian nutritionists, we assess patients for malnutrition utilizing the Academy/ASPEN malnutrition characteristics and identify if the etiology is inflammation or starvation, environmental, or social circumstances as we proceed with the assessment. Asking food insecurity questions to our patients can aid in identifying the etiology of these circumstances and aid in appropriate interventions.
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NEXT STEPS
- Attend the upcoming April Coffee Break if you have questions regarding your malnutrition quality improvement efforts or want to discuss new or continuing malnutrition quality improvement programs
- 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
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