Thirty-day readmissions and LOS were significantly lowered for malnourished inpatients by use of an EMR-cued MST, prompt provision of ONS, patient/caregiver education, and sustained nutrition support.

Background: Identification and treatment of malnutrition across the care continuum can help prevent illness onset or relapse and maximize the effectiveness of other medical treatments. This study aimed to evaluate the effect of a nutrition-focused quality improvement program (QIP) conducted in a home health agency (HHA) on hospitalization rates and healthcare costs incurred over 90 days. Methods: This was a multisite, pre-post QIP implemented at 2 branches of an Illinois-based HHA. The QIP included 1546 patients who were (1) at-risk or malnourished hospitalized patients discharged to the HHA, (2) referred by a physician during an outpatient visit, or (3) enrolled in the HHA through a skilled nursing facility. A historic (n = 7413 patients) and concurrent group (n = 5235) of patients were used for comparisons. Propensity score matching was used to account for imbalances in patient characteristics. Results: The QIP led to reduced relative risk of hospitalization post-enrollment to the QIP by 24.3%, 22.8%, and 18.3% at 30, 60, and 90 days, respectively, when compared with the historic group, and by 18.2%, 16.2%, and 12.1% when compared with the concurrent group. Total cost savings from reduced 90-day healthcare resource utilization was $2,318,894, or $1500 per patient treated. Conclusions: Rates of hospitalization and healthcare resources can be significantly reduced through the implementation of a nutrition-focused QIP delivering oral nutritional supplements in home health settings for adults atrisk/malnourished. These results highlight the importance of nutrition as a strategy for HHAs and other post-acute care institutions to improve patients' health outcomes and generate cost savings. (JPEN J Parenter Enteral Nutr. 2020;44:58-68)

Background: Addressing nutrition needs of inpatients results in improved health outcomes. We conducted a post hoc analysis of previously published data. The aim of this analysis was to evaluate the clinical benefits of a nutrition quality improvement program (QIP) in surgical patients when compared with medical patients. Methods: Data were collected from 1269 QIP patients and 1319 historical controls. These combined 2588 patients were categorized into surgical (390, 15%) and medical (2198, 85%) patient subgroups. Results: Readmission rate relative risk reductions were significantly higher among surgical patients when compared with the medical patients (46.9% vs 20.6%, P < .001). Average length of stay decreased significantly for both groups (29.0% and 29.6%, P = .8). Conclusion: Malnourished hospitalized surgical and medical patients experienced improved readmission rates and length of stay. However, surgical patients saw a significantly greater reduction in the readmission rate when compared with the medical patients, thus highlighting the importance of nutrition on surgical outcomes. The ClinicalTrials.gov Identifier for this study is NCT02262429. (JPEN J Parenter Enteral Nutr. 2018;00:1-6)

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