Learning Collaborative
 
March 25, 2021

The Dish

The Dish provides a quarterly update to participating sites enrolled in the MQii Learning Collaborative.
 
AT A GLANCE
  • Sign and return your self-enrollment form/addendum to participate in the Learning Collaborative in 2021 (if you have not already done so) as soon as possible
  • Visit the updated MQii website and Toolkit to view the changes and access helpful materials
  • Attend the upcoming March 29 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  
 
 
SPOTLIGHT: REDESIGNED MQii TOOLKIT AND WEBSITE 

Happy new year and happy National Nutrition Month! We are thrilled to share with you the recently completed redesign of the MQii Toolkit and website. We incorporated the helpful feedback our Learning Collaborative members have provided over the years to make the site more user-friendly and better aligned with the Nutrition Care Process. We hope that the redesign will allow members to more easily find useful resources, such as guidance to support establishing their quality improvement projects, data collection tools, malnutrition evidence and publications, and other helpful materials. Additionally, a new calendar page will highlight upcoming events and opportunities of interest. We invite you to join our March 29 Coffee Break so that we can introduce you to the new website and answer any questions you may have.

As a reminder, we are now sending the Dish on a quarterly basis. We will continue to send periodic reminders about Coffee Breaks and any other special requests or research opportunities via email. As noted above, we will also post upcoming conferences and other external events of interest on the MQii website calendar. Please also let us know if you have suggestions about events to highlight.
 
COVID-19 CORNER
 
 
As the pandemic continues, the MQii Leadership Team is compiling resources about responding to COVID-19 for Learning Collaborative members. Here are a few resources and updates that may be of use to you during this time:
WHAT'S AROUND THE CORNER?
Please check the MQii Learning Collaborative Calendar to see a schedule of upcoming events with corresponding registration links.

Coffee Break: “Introduction to the Redesigned MQii Toolkit and Website” | Monday, March 29, 2021, at 12:00 PM ET

We will use this time to introduce the redesigned Toolkit and website, including walking you through the new format and answering any questions you may have about available resources or how to access them. We encourage you to send questions in advance to [email protected].

Please register for the Coffee Break in advance here.  
Coffee Break: “Using Nutrition Care to Address Preventable Injuries” | Thursday, April 22, 2021, at 12:00 PM ET

Given the importance of appropriate nutrition care to better manage preventable injuries and promote wound healing, experts Caroline Fife, MD, and Nancy Munoz, DCN, MHA, RDN, FAND, will join this conversation to talk with us about their interdisciplinary work and answer your questions.

Please register for the Coffee Break in advance here.  
As a reminder, you can access member-only content, including webinar recordings and slides, a calendar of upcoming events, and archived Dish newsletters, on the MQii Member Portal. As a reminder, the login information is: Username: MQii Password: MQiiLC2018!
Consider opportunities to share your MQii project and findings!

The following list 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. You may also view additional upcoming external events (such as conferences and webinars) on our new MQii Learning Collaborative Calendar.

Conferences with upcoming submission deadlines:
 
 
 
CONGRATULATIONS TO OUR LEARNING COLLABORATIVE MEMBERS

Congratulations to YoungHee Kim from Baystate Medical Center for her election as an incoming 2021–2022 Commission on Dietetic Registration Commission Officer. Note that she will be speaking in an upcoming free webinar, “Essential Practice Competencies for RDs and DTRs and Credential Protection.” Please let us know of any exciting news you may have about your elections to committees or practice groups, new roles in your organization, or other promotions so we can share them with the entire Learning Collaborative. We look forward to celebrating your accomplishments! 
LEARNING COLLABORATIVE PARTICIPANT RESOURCES

NFPE: Putting It All Together  

“Although when recognized, malnutrition is usually reversible and preventable, it often goes unrecognized.” ~Butterworth, 1974

The 2016 Healthcare Cost and Utilization Project report indicated that only 8% of hospitalized patients received a diagnosis of malnutrition at discharge. Comparing this statistic to national data showing 20–50% prevalence suggests that malnutrition continues to be underdiagnosed by physicians. The 1974 article, “The Skeleton in the Hospital Closet,” included an overarching message about the need to involve dietitians, which still holds true today. RDNs are integral team members to assess, identify, and document malnutrition signs and symptoms; they also intervene and monitor to assess the impact on patient outcomes. RDNs should continue to ensure they have the tools (e.g., NFPE skills, malnutrition characteristics) to provide information to the medical team to support the malnutrition diagnosis and improve outcomes.

To learn more about how to obtain NFPE skills and register for the Academy’s live, virtual, and hands-on NFPE training workshops, visit www.eatrightpro.org/nfpe or email [email protected].

Upcoming Webinar

Kristi Mitchell and Sharon McCauley from the MQii Leadership Team will present in an upcoming webinar titled, “Nutrition-Related Quality Measures: How Might They Improve Care for People with Chronic Conditions,” hosted by the National Health Council, on April 9. This webinar presents an excellent opportunity to share the significance of the MQii and successes of our Learning Collaborative members with a wide audience. We encourage you to participate if you are able.  

Recent Podcasts of Interest

The MQii team at Avalere recently recorded two podcasts that may be of interest to you. The first podcast was titled, “Patient Health, Food Insecurity, and the Impact of Medically Tailored Meals,” and shared findings from two leading medically tailored meal organizations, including their strategies for generating evidence and influencing policy. The second podcast featured two of our Learning Collaborative members, Jodie Orwig and Lori Hartz, discussing their experiences with “Telehealth Barriers and Opportunities for Nutrition Care Arising from the COVID-19 Pandemic.” Thank you very much to Jodie and Lori for sharing these insights with us!  
RESOURCES FROM THE ACADEMY

The Academy is celebrating National Nutrition Month and sharing many resources on its website. Messaging in week 4 focuses on the need to “consult a registered dietitian nutritionist.” On the website, you can find ideas for engaging your professional and patient audiences, a campaign toolkit with materials to present to your colleagues and patients, and a social media toolkit with materials to share with your broader virtual audiences—all of which highlight and celebrate the important role of nutrition in providing quality healthcare and promoting the health of all Americans. The Centers for Medicare & Medicaid Services (CMS) also promoted the importance of medical nutrition therapy and related services in recognition of the month.  

Many of you have also asked us about providing more opportunities for NFPE trainings and we are pleased to share that the Academy is offering several upcoming virtual trainings. While the ability to conduct in-person assessments has been limited for many of you during the pandemic, these trainings present a great opportunity to learn or practice your skills in a safe setting so that you can put them into practice as soon as you can safely interact with patients again.

Finally, the Academy recently announced the release of its Primary Care Toolkit, which is available free for members and for purchase by non-members. It includes background information about how value-based payments can expand patient access to dietitians and payment for nutrition services as well as tips and tools for advancing your own practice in new team-based models of care. 
MALNUTRITION RESEARCH

The recent Special Issue: Enteral Nutrition Tolerance in Critical Illness of Nutrition in Clinical Practice included an article titled, "The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper.” The authors explain the evidence for the important point (and common misunderstanding) that the well-known visceral proteins, serum albumin and prealbumin, characterize inflammation rather than describe nutrition status, and are thus inappropriate indicators of proxy measures of total body protein, total muscle mass, or malnutrition. This paper could be a helpful resource for those of you working to educate your fellow clinicians about appropriate indicators and methods of screening, assessment, and diagnosis for malnutrition. 
NUTRITION POLICY UPDATES

In February, the Academy submitted comments to CMS to advocate for the addition of several quality measures to the Nutrition/Dietician Specialty Set in program year 2022 of the Medicare Quality Payment Program. The Academy commented that screening measures, such as for depression and diabetic peripheral neuropathy, should be added to measures reportable by dietitians because they fall under RDNs’ Standards of Practice and Standards of Professional Performance; further, these additions would emphasize that dietitians are integral parts of interprofessional teams for comprehensive, patient-centered care.

Meanwhile, the MQii Leadership Team is working to support adoption of the Global Malnutrition Composite Score, which is a composite measure based on the 4 malnutrition eCQMs, into the Hospital Inpatient Quality Reporting (IQR) program. We are pleased to share that the Measure Applications Partnership (which is convened by the National Quality Forum, or NQF) recommended this composite measure for inclusion in the Hospital IQR Program pending NQF endorsement; NQF will make its final endorsement decision this summer. This presents an important step toward advancing quality malnutrition care in hospitals around the country.