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Aug 27 2014
Alliance Charts Progress in Addressing Hospital Malnutrition

At a time when one in three Americans is malnourished upon admission to the hospital, a new report – Alleviating Hospital-Based Malnutrition: A Baseline Progress Report – finds growing recognition of this pervasive public health problem and a greater focus on instituting effective nutrition practices in hospitals.

Issued August 13, 2014 in recognition of the one-year anniversary of the Alliance to Advance Patient Nutrition, the report provides an assessment of the state of hospital-based malnutrition in the U.S., finding malnutrition affects patients of all ages and is prevalent among the medically underserved and older adults, especially those with chronic diseases such as cancer and cardiovascular disease. Moreover, because the number of Americans aged 65 and over is estimated to top 90 million by 2060, the report projects a significant increase in malnutrition in the coming years, underscoring the need to ensure nutrition therapy is a critical component of quality care in the nation’s hospitals.

Calling hospital malnutrition a “serious threat to the improved delivery of healthcare” the report cites a growing body of evidence that associates the effective treatment of malnutrition in the hospital with a 25 percent reduction in the incidence of pressure ulcers,i 14 percent fewer overall complications,ii an average reduced length of hospital stay of approximately 2 days,iii,iv and, perhaps most important given healthcare reform, a 28 percent drop in avoidable hospital readmissions.v

"There is a growing body of evidence supporting the positive impact nutrition has on improving patient outcomes," said Melissa Parkhurst, MD, FHM, and medical director of the Nutrition Support Service at the University of Kansas Hospital, and the Alliance representative for the Society of Hospital Medicine. "We are seeing that early intervention can make a significant difference. As physicians, we need to work with the entire clinician care team to ensure that nutrition is an integral part of our patients' treatment plans."

Because untreated malnutrition can delay recovery and increase medical complications, the Alliance to Advance Patient Nutrition was formed in May 2013. To drive awareness and systems change, the Alliance issued a pioneering consensus paper on June 4, 2013 and then published specific recommendations for hospital administrators and clinicians to institute effective nutrition practices along with the resources and tools to put these recommendations into practice.

A year later, qualitative results indicate the Alliance’s recommendations are being implemented by interprofessional care teams across the country. As documented in the progress report, a number of hospitals are working to incorporate Alliance protocols into their processes. Success stories highlighted include:

  • Mercy Health, a large health system of 21 hospitals based in Cincinnati, OH, which implemented an interprofessional approach to identify and treat malnourished patients and provide standardized written instructions for nutrition care at discharge.
  • TouchPoint Support Services at St. John Providence Health System in Metro Detroit, MI, which is now screening 100 percent of its patients on admission and providing ongoing assessment for every patient diagnosed as malnourished.
  • Pardee UNC Healthcare in Hendersonville, NC, which implemented a comprehensive nursing protocol to screen and treat malnourished patients, which has reduced the incidence of pressure ulcers, avoidable readmissions, infections, and falls.

Read Alleviating Hospital-Based Malnutrition: A Baseline Progress Report to learn more about the progress made by the Alliance to reduce malnutrition in the hospital.

i Stratton RJ, Ek AC, Engfer M, et al. Enteral nutritional support in prevention and treatment of pressure ulcers: a systematic review and metaanalysis. Ageing Res Rev. 2005;4:422-450.

ii Milne AC, Potter J, Vivanti A, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009(2):CD003288.

iii Brugler L, DiPrinzio MJ, Bernstein L: The five-year evolution of a malnutrition treatment program in a community hospital. J Qual Improve 1999;25(4):191-206.

iv Smith PE, Smith AE. High-quality nutritional interventions reduce costs. Healthc Financ Manage. 1997;51:66-69.

v Gariballa S, Forster S, Walters S, Powers H. A randomized, double-blind, placebo-controlled trial of nutritional supplementation during acute illness. Am J Med. 2006;119(8):693-699.