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Quality Improvement Matters

The growing focus on Quality Improvement in healthcare has evolved from being “important” to “essential”. Improving patient outcomes, processes, and efficiencies is key, and a formal QI program can help achieve those goals.

Patient and hospital icon

Malnutrition impacts both patients and hospitals

Malnutrition is a hidden cause of1,2:

  • Poor health outcomes
  • Rising healthcare costs
  • Increased utilization of resources
  • Increased length of hospital stays
  • Contributing to morbidity and mortality

 

Malnutrition is prevalent in the hospital environment

Infographic showing malnutrition statistics

Nationwide assessment of hospital patient nutrition status12

Nationwide assessment chart

*Data from 2012-2013 study collected from ASPEN, AMSN and SHM members, plus 1,777 unique email addresses.

An individualized, nutrition-focused Quality Improvement program can lead to achievable results8,13-16

For at-risk patients:

  • Improve patient outcomes
  • Highlight areas where improvement is possible
  • Create quality benchmarks

For hospitals:

  • Improve processes
  • Increase efficiency
  • Lower operating costs
Doctor holding a clipboard with an elderly patient

Real-world impact

How a QI nutrition program impacted St. Francis Healthcare15,16

Five year evolution of a malnutrition treatment program

The process:

  • Benchmarking study
  • Nutrition screening pilot
  • Malnutrition clinical pathway
  • Outcomes studies 1 & 2

Optimized nutrition screening and intervention resulted in significant
positive outcomes.15,16

Chart showing positive outcomes from optimized nutrition screening and intervention
Download Clinical Summary (34 KB)  

Components of Quality Improvement

To make improvements, an organization needs to understand its own system and key processes

Resources

  • People
  • Infrastructure
  • Materials
  • Information Technology
  • Patient care process/protocol

Activities

  • Screening
  • Intervention
  • Discharge and follow-up

Goals & Results

  • Optimized healthcare provided
  • Patients’ health status improved
  • Patient satisfaction increased
  • Readmission rates reduced

Adapted from HRSA : http://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement

eQIP aggregates participant data for benchmarking and identification of improvement opportunities

Malnutrition screening chart

The national report can be accessed at www.abbottnutrition.com/eqip
Data from the November 2015 eQIP National Report from 48,732 adult hospital patients (aged 18 years and older) collected from June through September 2015.

Need more information?

Quality Improvement resources

We have curated literature supporting quality improvement in healthcare that highlights the impacts specific to nutrition care. Download the PDFs below for summaries of some of the studies related to QI and nutrition.

 

The five-year evolution of a malnutrition treatment program in a community hospital.

Detailed information on the five-year St. Francis Hospital patient care quality improvement project in Wilmington, Delaware.

Download this article abstract which includes the study design. PDF(34 KB)
 

Nutritional screening of elderly patients: a health improvement approach to practice.

Information on a quality improvement nutrition intervention study using the Malnutrition Universal Screening Tool (MUST) in elderly patients.

Download this article abstract which includes the study design. PDF(28 KB)
 

Assessment of food intake in hospitalized patients: a 10-year comparative study of a prospective hospital survey.

Study design for a 10-year food quality control and improvement process including a protein-energy needs comparison among hospitalized patients.

Download this article abstract which includes the study design. PDF(28 KB)
 

Early recognition of malnutrition in the older adult: a quality improvement project using a standardized nutritional tool.

Study design for a quality improvement project identifying nutritional status of older adults in primary care, and interventions to improve clinical outcomes.

Download this article abstract which includes the study design. PDF(29 KB)
 

Download our QI presentation.

 

Download presentation. PDF(1,261 KB)

References :

  • Correia MITD, Waitzberg DL.Clin Nutr. 2003:22(3):235-239.
  • Norman K, et al. Clin Nutr. 2008;27:5-15.
  • Felder S, et al. Nutr. 2015;31:1385-1393.
  • Guenter P, et al. Jt Comm J Qual Patient Saf. 2015;41:469-473.
  • Rahman A, et al. Nutr Clin Pract. 2015;30:709-713.
  • Corkins MR, et al. JPEN J Parenter Enteral Nutr. 2014;38:186-195.
  • Tappenden KA, et al. JPEN J Parenter Enteral Nutr. 2013;37(4):482-497.
  • Somanchi M, et al. JPEN J Parenter Enteral Nutr. 2011;35(2):209-216.
  • Braunschweig C, et al. J Am Diet Assoc. 2000;100(11):1316-1322.
  • Krumholz HM. N Engl J Med. 2013;100-102.
  • Beattie AH, et al. Gut. 2000;46(6):813-818.
  • Agarwal E, et al. Clin Nutr. 2013;32:737-745.
  • Patel V, et al. Nutr Clin Pract. 2014;29(4):483-490.
  • Starke J, et al. Clin Nutr. 2011;30(2):194-201.
  • Rypkema G, et al. J Nutr Health Aging. 2004;8(2):122-127.
  • Brugler L, et al. J Qual Improv. 1999;25:191-206.
  • Brugler L, et al. Clin Resour Manag. 2000;1:183-186.