Supporting wellness with a nutrition-focused quality improvement program
Improving quality of life for older adults within the seven dimensions of wellness is an important focus of the International Council on Active Aging. Nutrition plays a key role in several of those dimensions, particularly physical health.
Indeed, individuals diagnosed with moderate to severe malnutrition have poorer health outcomes and can incur up to 38% higher costs than their well-nourished counterparts. Malnutrition or the risk of malnutrition is found in 20%-30% of older adults in a community setting, but it can be found in more than 70% of some older adult populations who have certain chronic diseases or conditions.
Improved screening and interventions for malnutrition through a quality improvement program (QIP) can boost the wellness of older adults. QIPs consist of systematic and continuous actions that lead to measurable improvement for targeted areas and groups, such as healthcare services and the health status of particular patient groups. Abbott recently collaborated with the University of Southern California (USC) to conduct a real-world QIP to evaluate the effectiveness of a nutrition-care program in outpatient centers.
The purpose of the 90-day, nutrition-focused QIP was to improve care, reduce healthcare resource use and lower costs. It was implemented across three USC outpatient centers and included 600 patients over 45 years old. Physicians, physician assistants and registered dietitian nutritionists—healthcare providers who are part of USC’s outpatient clinic care team—implemented a new nutrition-care process that included three simple steps:
- Screening and assessing all patients ages 45 and over for malnutrition or its risk;
- Implementing a personalized nutrition care plan that included condition-specific oral nutrition supplements (ONS); and
- Providing nutrition education to patients and caregivers on the importance of nutrition and ONS compliance.
The USC healthcare providers were able to integrate the QIP’s three steps within the patients’ routine visits, so the plan required no additional visits or staffing to execute. The QIP model utilizes tools such as the malnutrition screening tool, allowing providers to quickly and easily determine whether individuals are at nutritional risk and to create a plan to ensure those patients receive the necessary nutrition to support healing and recovery.
Reducing costs and improving experience
This real-world study found that providing comprehensive nutrition care, including use of ONS, could help improve patients’ overall health and quality of life. This improvement led to increased patient satisfaction and helped mitigate the risk of hospitalizations, resulting in overall cost savings.
Key results showed:
- More than 81% of patients were satisfied with the nutrition care they received.
- There was an 11.6% decrease in the percentage of individuals using healthcare resources over the 90-day time period of the study, helping providers better manage their patients’ care while also reducing costs.
- Providing nutrition interventions led to a net savings of almost $500 per patient.
Nutrition-focused QIPs, like this study, demonstrate the effectiveness of providing comprehensive nutrition care. Prioritizing nutrition across different settings—including outpatient clinics—can help improve health outcomes and quality of care.
The patient-focused approach benefits individuals by giving them the best opportunities for fast recoveries and a return to healthy, high-quality lives. And it benefits healthcare systems by increasing cost savings and decreasing economic burdens.
The goal for QIPs is to be sustainable, scalable and reproducible at any health system or outpatient clinic, whether in a rural community or a large city. The Abbott/USC nutrition-focused QIP builds on the work of the Malnutrition Quality Improvement Initiative, which is expanding beyond its initial work of advancing evidence-based, high-quality, patient-driven care for hospitalized older adults who were malnourished or at-risk for malnutrition.
As health systems and providers face added pressures from rising health costs, value-based interventions—particularly those promoting active aging—become increasingly important in acute and post-acute care. Recently, the Centers for Medicare and Medicaid Services (CMS) finalized a new improvement activity addressing the screening and management of malnutrition and food insecurity as part of the 2022 Physician Fee Schedule Final Rule. Implementing nutrition-focused QIPs can help support this improvement activity. QIPs provide real-world evidence of how effective strategies, policies and practices can help mitigate malnutrition and meet objectives of the healthcare triple aim: improving the experience of care, improving the health of populations and reducing per capita costs of healthcare.
Cory Brunton, MS, BSN, RN, is a senior analyst of Global Health Economics, Outcomes Research and Policy for the Abbott Nutrition Division of Abbott in Columbus, Ohio.
Note: This information is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from research. The view expressed here are not necessarily those of the ICAA, we encourage you to make your own health and business decisions based upon your research and in partnership with a qualified professional.