A Comprehensive Nutrition‐Focused Quality Improvement Program Reduces 30‐Day Readmissions and Length of Stay in Hospitalized Patients

Sriram, Krishnan; Sulo, Suela; VanDerBosch, Gretchen; Partridge, Jamie; Feldstein, Josh; Hegazi, Refaat; Summerfelt, Wm. Thomas

doi:10.1177/0148607116681468

Cited by 93 publications

(109 citation statements)

References 32 publications

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“…According to the reviewed studies, although the tolerance of the patient to the resumption of the diet is not universal, it is generally high [85][86][87] The use of nutritional strategies, including the prescription of oral supplements in the postoperative period and after discharge from patients undergoing major operations, can prevent complications and reduce the chances of readmission 130,131 . This is especially important in elderly patients 132 .…”

Section: Howmentioning

confidence: 99%

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

De-Aguilar-Nascimento

Salomão

Waitzberg

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to present recommendations based on the ACERTO Project (Acceleration of Total Post-Operative Recovery) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures. Methods: review of relevant literature from 2006 to 2016, based on a search conducted in the main databases, with the purpose of answering guiding questions previously formulated by specialists, within each theme of this guideline. We preferably used randomized controlled trials, systematic reviews and meta-analyzes but also selected some cohort studies. We contextualized each recommendation-guiding question to determine the quality of the evidence and the strength of this recommendation (GRADE). This material was sent to authors using an open online questionnaire. After receiving the answers, we formalized the consensus for each recommendation of this guideline. Results: the level of evidence and the degree of recommendation for each item is presented in text form, followed by a summary of the evidence found. Conclusion: this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons, the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery. The prescription of these recommendations can accelerate the postoperative recovery of patients submitted to elective general surgery, with decrease in morbidity, length of stay and rehospitalization, and consequently, of costs.

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Section: Howmentioning

confidence: 99%

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

De-Aguilar-Nascimento

Salomão

Waitzberg

et al. 2017

Rev. Col. Bras. Cir.

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“…This necessitates the need for multi‐dimensional, innovative intervention strategies, flexibly delivered across the continuum of care, by multiple people, at multiple time points . Consequently, a revised inpatient model of care that includes systematised, interdisciplinary, and delegated care processes may be better placed to deliver effective and efficient malnutrition care in acute settings …”

Section: Introductionmentioning

confidence: 99%

Rationale and developmental methodology for the SIMPLE approach: A Systematised, Interdisciplinary Malnutrition Pathway for impLementation and Evaluation in hospitals

Bell

Young

Hill

et al. 2018

Nutrition & Dietetics

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“…Nutrition-focused interventions, such as dietary counselling and oral nutrition supplementation (ONS), have demonstrated success in improving outcomes after discharge (15)(16)(17) . Systematic reviews/meta-analyses have found that dietary counselling and ONS improve energy intake and weight gain, although they have a limited impact on mortality (18)(19)(20)(21)(22)(23)(24) .…”

Section: Introductionmentioning

confidence: 99%

Malnourished adults’ receipt of hospital discharge nutrition care instructions: a pilot study

Brooks

Vest

Shapero

et al. 2019

J Human Nutrition Diet

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Background Malnutrition remains an important yet under‐recognised problem among hospitalised adults. Although interventions exist aiming to improve nutritional status beyond hospitalisation, few studies examine how often and what type of nutrition care instructions are given at discharge. The present study sought to review nutrition‐focused discharge care provided to malnourished adults. Methods We reviewed the electronic medical record for discharge nutrition care instructions provided to adult patients identified by dietitians as malnourished over a 4‐month period. Results Seventy‐six eligible patients were identified during the study period. More than half of malnutrition cases (64.5%) were attributed to chronic illness. According to electronic medical record documentation, 6.6% received discharge instructions to consume oral nutrition supplements and 30.3% received new or changed prescriptions for vitamins/noncaloric supplements. Almost half of patients (47.4%) received general diet instructions that did not address malnutrition and 44.8% received inappropriate instructions to limit caloric intake. Conclusions A majority of malnourished adult patients receive inappropriate or inadequate nutrition care instructions at the time of discharge. Clinician education and redesign of nutrition care options in the electronic medical record may improve the provision of post‐discharge nutrition care instructions.

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A Comprehensive Nutrition‐Focused Quality Improvement Program Reduces 30‐Day Readmissions and Length of Stay in Hospitalized Patients

Abstract: 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.

Cited by 93 publications

References 32 publications

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

Rationale and developmental methodology for the SIMPLE approach: A Systematised, Interdisciplinary Malnutrition Pathway for impLementation and Evaluation in hospitals

Malnourished adults’ receipt of hospital discharge nutrition care instructions: a pilot study

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