Fighting to end malnutrition in the hospital

Often the dietitians at the hospital will know where the patient needs are, but what they need most are partners and a voice to the rest of the hospital. For example, at the University of Kansas Hospital, one of the important steps we took as a team was to get ordering privileges for our registered dietitians. This way they could order calorie counts, supplements, and multivitamins and move along the plan of care instead of leaving notes and waiting for orders to be implemented.

Question: What can be done to better treat patient malnutrition in the hospital?

Dr. Parkhurst: The Alliance to Advance Patient Nutrition is at its core a call to action. We’re trying to get the attention of physicians, dietitians, nurses, pharmacists, and hospital administrators. What we’re advocating for are more systemized nutrition care practices and more interdisciplinary collaboration.

There are three basic things that need to happen in order to drive real change in a hospital setting:

First, we need to make sure that all of our patients are getting screened for risk when they are admitted using a simple, validated screening tool.

Second, there needs to be a system in place so that when there’s a positive screen it prompts a timely, full nutrition assessment by a dietitian. And then that information and recommendations need to be effectively communicated back to the patient’s health care team so that there can be immediate interventions as indicated. Ongoing monitoring also needs to be part of that systemized approach.

Third, we need to integrate the nutrition care plan into the discharge plan. We need to ensure that the goals and improvements we make in the hospital don’t get lost in the transition of care.

Take us to your leader. Nominate a hospitalist whose work inspires you. E-mail suggestions to mschneider@frontlinemedcom.com.