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The Dish provides a quarterly update about the MQii and our Learning Collaborative.
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AT A GLANCE
- Begin using newly available Global Malnutrition Composite Score (GMCS) resources
- Get involved with the 50th annual National Nutrition Month® campaign led by the Academy of Nutrition and Dietetics
- Review the MQii Learning Collaborative structure and operations update and consider attending our March Coffee Break for more details
- Email us to share your progress or ask any questions
- Please inform us about any transitions in leadership, requested topics for future events, or additional events of interest to share with other members
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SPOTLIGHT: NEW GLOBAL MALNUTRITION COMPOSITE SCORE RESOURCES
The MQii team is frequently assessing what resources are needed to support Learning Collaborative members in their malnutrition quality improvement (QI) journeys. With the recent approval of the Global Malnutrition Composite Score (GMCS) reporting opportunity in the Hospital Inpatient Quality Reporting Program, the MQii leadership team recognizes the need for educational and supportive resources for members interested in promoting adoption of this quality measure at their hospitals. The GMCS FAQs document is a new core, comprehensive resource that will be continually updated. This document was developed in response to questions received during Coffee Breaks, webinars, and via email since the measure’s approval. We will update it periodically. You can also find on the MQii website a new infographic summarizing the value to reporting on the GMCS. This can be used to engage hospital decisionmakers and inform them of hospital-specific benefits. Additionally, the American Society for Parenteral and Enteral Nutrition (ASPEN) developed a practice tool for implementing malnutrition QI and reporting on the GMCS, and hosted a corresponding webinar. As always, the GMCS page managed by the Academy (i.e., measure steward) and the GMCS for IQR page on the MQii website are central points for updated information about the GMCS.
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The MQii team wants to hear from you: Have you received guidance or resources from your hospital’s electronic health record (EHR) vendor regarding GMCS implementation and testing at your hospital? If so, please let us know so that we can ensure our own efforts are not duplicative, but rather complementary. Also, please share any updates about future plans to progress towards GMCS adoption and reporting in your hospital. We would love to hear about your successes (or barriers) and potentially feature you in an upcoming training or other event.
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WHAT'S AROUND THE CORNER?
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DMT Webinar: “Strengthening the Hospital-Community Connection: Working Together to Address Malnutrition” | Tuesday, March 14, 2023, at 1 PM ET
Defeat Malnutrition Today will host a webinar on how implementing the GMCS can help to advance health equity and how connecting healthcare providers to their local communities can help ensure their success in improving quality of care. The panel will include Learning Collaborative member Southern Maine Health Care. You may register in advance to attend.
Coffee Break: “Upcoming Changes to the MQii Learning Collaborative” | Thursday, March 16, 2023, at 3 PM ET
This conversation will review 2023 changes to the MQii Learning Collaborative. We will address any member questions and seek feedback on maximizing the usefulness of the MQii initiative and resources.
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Learn and Network at Upcoming Conferences
The list of conferences below may be of interest to you or your team to attend. Feel free to contact us to see if other members of Learning Collaborative or the MQii leadership team will also attend.
- Society of Hospital Medicine Converge 2023, from March 26–29 in Austin, TX
- American Society on Aging 2023, from March 27–30 in Atlanta, GA
- ASPEN 2023 Nutrition Science & Practice Conference, from April 20–23 in Las Vegas, NV
- Clinical Nutrition Management Dietitian Practice Group 2023 Symposium, from April 27–29 in Raleigh, NC
- 2023 AcademyHealth Annual Research Meeting, from June 24–27 in Seattle, WA
- Nutrition 2023, from July 22–25 in Boston, MA
- 45th ESPEN Congress on Clinical Nutrition & Metabolism, from September 11–14 in Lyon, France (registration opens in early April)
View additional upcoming external events (such as conferences and webinars) on our MQii Learning Collaborative calendar.
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Consider Opportunities to Share Your MQii Project and Findings
The following list of conferences may be of interest to you or your team. We encourage you to look at the event websites, review submission criteria, and consider sharing your research with various audiences. Please reach out with any questions or for assistance in compiling submission materials.
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NUTRITION POLICY UPDATE
Nutrition Benefits in Medicaid 1115 Waivers
Individual states can submit Section 1115 demonstration waivers to test flexibilities in their Medicaid programs. These flexibilities can apply to eligibility, benefits offered, beneficiary costs, etc. States are increasingly testing the implementation of evidence-based food- and nutrition-related benefits, such as medically tailored meals and nutritional counseling, through 1115 waivers. Malnutrition and food insecurity are interrelated conditions that negatively impact patient health and outcomes. Multiple states received approval in late 2022 to implement benefit flexibilities that address health-related social needs, including food insecurity. Waivers from Massachusetts and Oregon were approved in September 2022 and Arkansas’ waiver was approved in November 2022. RDNs in these states should be aware of the potential expansion of their role for serving the Medicaid population, and RDNs in other states can advocate their state governments apply for similar waivers to better address nutrition needs in the Medicaid population. To learn more about this exciting trend, refer to this news release.
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NUTRITION RESEARCH
We are sharing several recent publications, reports, and blogs relevant to nutrition care processes, malnutrition, and quality improvement:
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NUTRITION IN THE NEWS
Private Sector Expanding Role as SNAP Benefit Increases Subside
COVID-19 pandemic-related expanded Supplemental Nutrition Assistance Program (SNAP) benefits have ended in many states as of March 1. SNAP benefits had increased during the pandemic for 41 million Americans, providing up to $258 more per month to beneficiaries with the greatest need. Amid both the growing food is medicine movement as well as this decrease in SNAP benefits, the private sector’s contributions are increasing. Companies such as Instacart are implementing initiatives to expand access to quality, nutritious foods for recipients as they face a drop in benefits. This major change in nutrition assistance is likely impacting many of the patients you are serving, including those with malnutrition and food insecurity, and they will greatly benefit from the programs and services your nutrition departments are providing to help optimize their health outcomes.
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LEARNING COLLABORATIVE RESOURCES AND RECOGNITION
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Updates to Learning Collaborative Structure
The MQii team is updating the structure and management of our Learning Collaborative in order to expand access to MQii resources and advance QI implementation as well as GMCS education and adoption. As described above, the March Coffee Break will provide a forum to discuss these changes. One primary change you may notice is that the MQii team has removed the password protection for the Member’s Area on the MQii website. This expands access to our event calendar and resource archives as well as reduces burden on Learning Collaborative members to keep track of the login information. The list of participants and map of members with also become outdated and will therefore be removed. We will continue to send the Dish and host Coffee Breaks as well as offer GMCS-related resources and events throughout the year.
FNCE Video Recordings Available
Three videos about the MQii were featured at the 2022 Food & Nutrition Conference & Expo. We are pleased to share that these video recordings have recently been posted on the Abbott Nutrition Health Institute website:
Congratulations to Members
Congratulations to Learning Collaborative member Young Hee Kim from Baystate Health on her recent election as a House of Delegates Director for the Academy of Nutrition and Dietetics! She will serve a three-year term on the Academy Board of Directors and House Leadership Team, working with other directors to triage professional and member issues, facilitating and/or appointing task forces, and more.
NFPE: Putting It All Together
Let’s review some recommendations for positions of patients' limbs and tissues when performing NFPEs. Note that when the ideal position isn’t achievable, it is important to document any limitations.
- Pectoralis muscle: The ideal patient position for assessing the pectoralis muscle is for the patient to sit up as close to a 90-degree angle as possible with shoulders in a neutral position. Ensure the elbows are not on armrests and the patient is not hunched over.
- Subcutaneous fat: When assessing the triceps region for subcutaneous fat status, have patients bend an arm into a 90-degree angle. You can assist by holding the wrist, if needed.
- Scapula: When assessing the muscles around the scapula region, if patients are in a bed or chair, have them lean forward, put the arm out in front of their body, and push the palm of their hand against your palm. Or, if patients are ambulatory, they can put their arm out and press against the wall.
- Quadriceps: When assessing the quadriceps, the thigh should be off of the bed or chair. Patients can bend their leg and set their heel on the bed, or you can prop their leg off the chair with a footrest.
To learn more about the NFPE techniques and positions, the Academy’s NFPE Hands-on Training Workshops are available in the live virtual or in-person formats. Visit www.eatrightpro.org/nfpe to see upcoming dates and locations in March and April.
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