Hospitals are paying more attention to food for two reasons: cutting readmissions and increasing patient satisfaction.
With malnutrition increasing costs, length of stay, and poor patient outcomes, more than 100,000 U.S. dietitians, nurses, hospitalists and other physicians and clinicians launched an interdisciplinary partnership called the Alliance to Advance Patient Nutrition in May to improve patient outcomes through nutrition intervention in the hospital. The alliance urged early nutrition screening, assessment and intervention in hospitals. It also launched a website—www.malnutrition.com—to provide hospital-based clinicians guidance on how to combat the problem.
One out of three patients enters the hospital malnourished, and more become malnourished during their stay. Malnourished patients are two times more likely to develop a pressure ulcer and have three times the rate of infection. Malnutrition increases costs, length of stay, and unfavorable outcomes. Properly addressing hospital malnutrition improves quality of care while also reducing healthcare costs.
Nutritional intervention works. It has been found to reduce hospital length of stay by an average of two days and reduce probability of 30-day readmissions by 6.7 percent.
Usha Kollipara, director of nutritional services for the Parkland Health & Hospital System, said the system has reduced readmissions associated with heart failure by developing an assessment tool called the Parkland Sodium Knowledge Test that predicts the risk of readmission based on lack of dietary knowledge.
Susan Roberts, area director of clinical nutrition at Baylor Health Care System, said malnutrition is an ongoing problem in hospitalized patients and can, along with chronic diseases, such as congestive heart failure and diabetes, lead to poor quality of life, higher health care costs and an increased risk for readmission to the hospital.
Baylor is conducting a multi-site initiative to reduce readmissions. An interdisciplinary team—an advanced practice registered nurse, a social worker, a pharmacist, and a registered dietitian—works together to enhance the discharge process and monitor the patient after the discharge. The registered dietitian’s role is to identify patients at high risk for malnutrition.
“This type of model which includes a registered dietitian has been shown to be effective in reducing readmissions and improving quality of life in several research studies,” Roberts said.
Food also can move the needle on patient-satisfaction scores, which will be a component of Medicare value-based reimbursement. Several U.S. healthcare systems are adopting hotel-style “room service” where patients can order food anytime from a menu. Systems find they achieve significant cost savings from less unwanted food being tossed.
Texas Health Presbyterian Hospital in Dallas began room service in July 2012. The hospital brought in an Italian chef, said Farzeen Sukheswalla, the hospital’s manager of clinical nutrition, said, who “has done extensive testing with flavor profiles, along with keeping in mind the healthful benefits of the entrees [the hospital] offers.”
Steve Jacob is editor-at-large of D Healthcare Daily and author of Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at [email protected]