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The Dish provides a monthly update to participating sites enrolled in the MQii Learning Collaborative.
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SPOTLIGHT: NEW “COVID-19 CORNER”
First and foremost, 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.
As the pandemic continues to spread and sites of care experience increased demands, the MQii Leadership Team will be providing resources for responding to COVID-19 to Learning Collaborative members. These will include:
- An ongoing “COVID-19 Corner” in the Dish, reflecting updated resources related to patient care and malnutrition
- A dedicated section of our website with COVID-19-specific care resources and links to upcoming events offered by the MQii as well as the Academy of Nutrition and Dietetics, Abbott Nutrition Health Institute, American Society for Parenteral and Enteral Nutrition, and Defeat Malnutrition Today, among others. Resources reflect best practices for supporting the nutrition needs of hospitalized COVID-19 patients, tools and care delivery changes hospital clinicians are making, and the impact of COVID-19 on food access and associated increased risk for malnutrition
- A Q&A session with three expert clinicians on April 28 at 1:00 PM ET. This open-ended session will provide a forum to learn from leaders from across the country who are managing care and informing guidelines related to nutrition for COVID-19 patients (additional details below). Please feel free to email us questions in advance
- An “NFPE Tip of the Month” focused on diagnosing malnutrition during this pandemic (end of this newsletter)
Pulse Check: Request for Readers
If you are able, please fill out this brief COVID-19 “pulse check” so we can better understand your needs/challenges at this time. This can take less than 10 minutes of your time and we will use your responses (anonymously) to provide information, insights, and innovative practices to all MQii sites accordingly. Separately, you may also wish to provide more extensive feedback on the Academy’s survey (additional details below).
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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.
MQii Q&A Session: Tuesday, April 28, 2020 at 1 PM ET
Join us on Tuesday, April 28, at 1:00 PM ET for our first expert-led Q&A session focused on care for patients with COVID-19 who are malnourished or at risk for malnutrition. You will be able to ask questions of our 3 expert panelists, including:
- Beth Mordarski, RDN, LD, NFPE Program Manager, Academy of Nutrition and Dietetics;
- Beth Taylor, DCN, RD-AP, CNSC, FAND, FASPEN, FCCM, Research Scientist, Barnes-Jewish Hospital; and
- Sadeq Quraishi, MD, MHA, MMSc, Tufts Medical Center, Director of Tufts Anesthesia Research Center and Co-Lead of COVID-19 Innovations Team (PPE; Ventilator Solutions).
Please register for the session in advance here.
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Expert Webinar: “Interactions Between Malnutrition and Gastrointestinal Disease” | Wednesday, June 10 at 11:00 AM ET
Join us on Wednesday, June 10, at 11:00 AM ET for the MQii Expert Webinar, “Interactions Between Malnutrition and Gastrointestinal Disease.” During this live webinar, participants will learn about:
- The connections between gastrointestinal diseases, diet, and nutritional status
- How GI diseases affect physiology and present in nutritional assessments
- Suggestions for providing optimal interdisciplinary care to meet nutritional needs for patients with GI diseases
The webinar will feature Gerry Mullin, MD, MS, Johns Hopkins Medicine, and Laura Matarese, PhD, RDN, LDN, CNSC, FADA, FASPEN, FAND, East Carolina University. Attendees will be eligible to receive a one-hour CPEU credit for their participation.
Please register for the webinar in advance here.
Coffee Break: 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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Opportunities to Learn More about Learning Collaborative Data Findings
The in-person 2020 AcademyHealth Annual Research Meeting (originally scheduled for June 13–16, 2020) has shifted to virtual format to be held later this summer. Avalere plans to present two posters—“Piloting a Malnutrition Transitions of Care Program Coordinating Nutrition Care” and “Evaluation of the Variance Among Malnourished Patient Risk and Outcomes Related to Age, Race, and Gender from Hospital to Home”—based on findings from the MQii Learning Collaborative. The precise times and venues for sharing these presentations has yet to be determined.
Consider opportunities to share your MQii project and findings!
The following table outlines 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 the various audiences. While many 2020 conferences have either been cancelled, rescheduled, or moved to a virtual setting, we encourage you to still participate in these when possible. As noted below, the Academy is now accepting late-breaking abstracts for FNCE 2020. If you have new MQii projects, interesting recent data, or new innovations (e.g., responses to the COVID-19 pandemic), consider developing and submitting an abstract for this late-breaking category. Please reach out with any questions or for assistance in pulling submission materials together.
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MALNUTRITION IN THE NEWS
Tampa General Shows Outcomes Improvements with MQii Tools
BMJ Open Quality recently published a paper from MQii leadership and former Learning Collaborative member Beverly Hernandez from Tampa General Hospital (TGH) titled, “Impact of an interdisciplinary malnutrition quality improvement project at a large metropolitan hospital.” The project team at TGH used the MQii Toolkit to implement a multipronged approach to malnutrition quality improvement, enabling them to evaluate the impact of these interventions on patients’ length of stay (LOS), infection rates, and readmissions. TGH experienced a 25% reduction in LOS and a 35.7% reduction in infection rates among the target population. The article highlights opportunities for hospitals to identify malnutrition care gaps, reflects on the importance of interdisciplinary nutrition care, and offers a model for inpatient malnutrition quality improvement.
ACPM Newsletter Highlights Importance of Malnutrition Diagnosis and Care
The March newsletter from the American College of Preventive Medicine (ACPM) featured an article titled, “CMS Approves Including New Malnutrition Clinical Quality Measures into 2 QCDRs,” by Dr. Refaat Hegazi, Abbott’s medical director of Adult Nutrition. The article was published on behalf of ACPM’s Prevention Alliance, which is a diverse group of organizations (including members from physician networks, academic institutions, biopharmaceutical companies, and more) committed to advancing the power of prevention. As background about the measures, the article highlighted the importance of malnutrition diagnoses to implement efficient and effective malnutrition interventions, including nutrition education, congregate and home-delivered meals, and oral nutrition supplements in community settings. This article represents a significant opportunity to raise awareness of the importance of nutrition care and opportunities to meet quality reporting requirements using the MQii measures for physicians engaged in preventive medicine.
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LEARNING COLLABORATIVE PARTICIPANT RESOURCES
Opportunity to Submit Grant Application
Pfizer recently announced its COVID-19 Competitive Grant Program to fund efforts for quality improvement programs responding to COVID-19. Given the significant impact of COVID-19 on the nutritional status of individuals who contract the disease, care for other hospitalized individuals, and the availability of community nutrition supports, we encourage any interested Learning Collaborative members to consider applying for one of these grants (specifically Category B: Quality & Process Improvement Grants). These grants offer a unique and significant opportunity to elevate the importance of nutrition care during this time and expand your facility’s impact. Responses are due by 5/22, but since Pfizer will review and make funding decisions within 10 days of submission, you are encouraged to respond as soon as possible. Please contact us at [email protected] if you intend to submit an application or if you have any questions.
QCDR Microlearning Series for Academy Members
The Academy now offers a free series of four, 15-minute webinars about Qualified Clinical Data Registries (QCDRs). They include background information about QCDRs and the benefits of Merit-based Incentive Payment System (MIPS) reporting via QCDRs, as well as information on the Academy’s collaboration with the Premier Clinician Performance Registry and the US Wound Registry (as shared in last month’s announcement) to obtain credit for quality reporting under MIPS. This is an important step to increase adoption and impact of the malnutrition electronic clinical quality measures (eCQMs) for improving patient care. Dietitians are eligible for 1-CPEU hour for participating in this series.
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Contribute to the Academy’s Survey
The Academy of Nutrition and Dietetics’ Nutrition Research Network is conducting a research study (HRRC# 20-187) to describe changes in dietitians’ roles and practices during and after the COVID-19 pandemic. This study will inform current Academy COVID-19 efforts and future policy and advocacy initiatives, education, and research.
The study will involve completing a 20-minute survey related to your primary practice area. You may be asked to complete this survey more than once to assess changes in roles and practices over time. Participation is voluntary, does not include compensation, and responses will be used anonymously. If you are interested, please review the Academy’s research consent document to continue on with the survey.
If you have questions prior to participating, please contact the study team at [email protected].
NFPE “Tip of the Month”
What do RDNs need to consider when identifying malnutrition during the COVID-19 pandemic?
During this unprecedented time, adjustments may be necessary when providing a nutrition assessment for a patient and evaluating the six adult malnutrition characteristics to identify if malnutrition is present. Four of the six malnutrition characteristics are part of a nutrition focused physical exam (NFPE) and the ability to perform an NFPE may be limited at this time. If an RDN is unable to perform an NFPE, the RDN will need to utilize the remaining two characteristics, energy intake and weight loss, and should evaluate all data available for these two characteristics. Ideally, the RDN will be able to utilize, compare, and assess supportive data from previous admissions or outpatient healthcare appointments and put the data together with the whole clinical picture of the patient to identify if malnutrition is present. If additional supportive data are not available at this time, the RDN can indicate that “the patient is at risk for or at a low threshold for malnutrition due to [insert information here].” The RDN should continue to follow closely and will reassess criteria as additional data become available. It is important to ensure the RDN has data to support the nutrition diagnosis of malnutrition. RDNs can visit the Academy of Nutrition and Dietetics’ COVID-19 Professional Resource Hub for additional COVID-19 resources and view the Academy’s Front Line Series Webinars.
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NEXT STEPS
- Respond to our COVID-19 pulse check and visit the COVID-19 page on our website for more resources
- Attend the upcoming May Coffee Break if you have questions regarding your malnutrition quality improvement efforts or want to discuss new or continuing malnutrition initiatives
- 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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