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May 03 2013
Addressing Patient Malnutrition Requires Interdisciplinary Collaboration
By: Ainsley Malone, M.S., R.D., C.N.S.C., L.D.

Like many health conditions, malnutrition requires an integrated treatment approach. Yet, many hospitals across the country lack a comprehensive, collaborative and interdisciplinary treatment plan involving, dietitians, nurses, hospitalists and other physicians. Given the startling fact that as many as 1 in 3 patients enters the hospital malnourished1-3—which can have a devastating effect on patient recovery, medical complications and health outcomes—a sustained and committed effort to instituting nutrition treatment plans that foster interdisciplinary collaboration is essential.

The time is ripe for action. The changing dynamics within the healthcare environment strongly encourage interdisciplinary clinician efforts to drive the quality of patient treatment, which, in effect, improves patient outcomes and reduces cost of care. For more than 35 years, A.S.P.E.N. has strongly encouraged clinicians, from a variety of disciplines, to implement nutrition treatment models within hospitals that comprehensively treat malnutrition from admission to discharge. The effect of having this type of model in place—whether through a formal nutrition team or a mechanism that encourages cross-disciplinary collaboration—prompts hospitals and clinicians to consider broader treatment approaches.

In my current role as a nutrition support dietitian for the Mount Carmel West Hospital in Columbus, Ohio, I am deeply involved in the management of patients requiring enteral and parenteral nutrition support therapies. In order to be successful in properly identifying and treating patient malnutrition, I collaborate with an array of clinicians to address their patient’s nutritional needs in a comprehensive manner. This type of interdisciplinary approach is critical for a patient’s overall recovery.

The configurations of nutrition treatment plans in hospitals vary considerably. While most models contain basic components related to screening measures and nutritional interventions, far too many lack the requisite input and insights from different clinician perspectives. Nurses, physicians, and other healthcare providers must work in concert with one another to ensure that patient nutrition is addressed throughout the entire hospitalization process through discharge. While progress has been made on this front, more needs to be done to elevate the role of nutrition.

With the establishment of the Alliance to Advance Patient Nutrition, we can demonstrate how clinicians and hospital administrators can leverage these collective insights to dramatically reduce the negative effects of hospital malnutrition. This is an exciting effort and I look forward to spreading the word and making a substantive difference in improving the collective health outcomes of America’s patients.

1Coats KG et al.. J Am Diet Assoc 1993; 93: 27-33.
2Giner M et al. Nutrition 1996; 12: 23-29.
3Thomas DR et al.Am J Clin Nutr 2002; 75: 308-313.