A Leadership Taxonomy for Clinical Dietetics Practice

Clinical Leadership and Innovation Help Achieve Malnutrition Quality Improvement Initiative Success

“…Patten and Sauer identified the seven change behaviors of leaders as the ability to analyze the work environment, envision change, advocate change, improve work methods, build relationships with supporters, seek professional opportunities, and represent and promote the team. 8 The MQii Toolkit was designed specifically "to support changes in the care team's clinical knowledge of and use of best practices for malnutrition care." 9 The importance of change behavior was consistently recognized during each interview with the four clinical nutrition leaders and was described as being an instrumental leadership skill during the planning and implementing of the MQii at each of their health care institutions.…”

“…Patient-focus behaviors in the clinical dietetics leadership taxonomy include those related to improving patient satisfaction, outcomes, and safety. 8 Patient focus is instrumental to the MQii as well, because it was established "to advance evidence-based, high quality, patient-centered care for hospitalized older adults (age 65 and older) who are malnourished or at risk for malnutrition" and the MQii "places the patient at the center of the quality improvement process." 9 Indeed, improved patient outcomes are central to clinical care, as Kight described, "Our hospital is dedicated to quality improvement and improving patient care.…”

“…Technical behaviors for a leader in clinical dietetics are described in three parts: developing mastery of clinical knowledge and skills, applying current research to primary care, and promoting the role of the RDN as a credible source of nutrition information. 8 These behaviors are interwoven throughout the MQii process. 9 Angie Pahl, RDN, medical nutrition therapy supervisor at Spectrum Health, discussed how the MQii has helped further clinical skills and showcase the RDN.…”

“…The clinical dietetics leadership taxonomy includes five components of leadership, addressing: change, patient focus, self-direct, technical, and relationship behaviors ( Figure 1). 8 The MQii Toolkit supports similar informal leadership behaviors for a successful quality initiative, including guidance for project champions to encourage their teams to focus on delivery systems, patients, teambased processes, and the use of data. 9 Patten and Sauer reported that the taxonomy supports one of the Academy's new principles, which is to "amplify the contribution of nutrition practitioners and expand workforce capacity and capability" 10 and that the taxonomy provides "clear and specific direction for clinical RDNs [registered dietitian nutritionists] as they develop their own leadership."…”

“…9 Patten and Sauer reported that the taxonomy supports one of the Academy's new principles, which is to "amplify the contribution of nutrition practitioners and expand workforce capacity and capability" 10 and that the taxonomy provides "clear and specific direction for clinical RDNs [registered dietitian nutritionists] as they develop their own leadership." 8 The taxonomy can also help define opportunities for clinical leadership in quality improvement. The current article applies the clinical dietetics leadership taxonomy to describe how RDNs at three health care systems or institutions are leading innovations and achieving success in quality improvement through implementation of the MQii.…”