News: Understanding malnutrition for positive patient outcomes

Malnutrition has historically been an issue in facilities, mainly because before 2012, no standard criteria existed for adult or pediatric malnutrition. With a widespread lack of awareness of national best practice guidelines for malnutrition, identifying and diagnosing malnutrition is often still difficult for providers and CDI specialists.

 

Joannie Crotts, RN, BSN, CPC, and clinical documentation and revenue integrity manager at Sarasota Memorial Health Care System in Sarasota, Florida, explained in the ACDIS webcast “Improving Identification, Documentation, and Treatment of Malnutrition in the Acute Care Setting,” that the collaboration between their CDI department and the clinical nutrition department didn’t begin until 2012.

 

The initiative came to the forefront when CDI specialists on Crotts’ team noted variations in criteria and clinical indicators used to diagnose malnutrition by providers while reviewing the hospital’s medical records, said Crotts.

 

“Without defined industrywide criteria in place, it was difficult for clinicians to consistently document malnutrition and differentiate between the different severity levels,” said Crotts.

 

The CDI specialists turned to their team of registered dietitians, and discovered there were new evidence-based national guidelines that had been recently developed.

 

“CDI really wanted to get more involved and learn more about the new criteria and how we could incorporate it in to our daily practice,” said Crotts. “So, [our] CDI and clinical nutrition departments started talking about how we would standardize and implement these guidelines house-wide so we could all be on the same page.”

 

This was the beginning of the Sarasota Memorial Health Care System Malnutrition Initiative. The objectives of the initiative, Crotts said, are to create consistent documentation across the hospital, create ways for early identification and intervention for those identified with malnutrition, and establish prevalence and impact of malnutrition on patient outcomes, length of stay (LOS), readmissions, and quality reporting.