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The consequences of malnutrition in hospitalized patients are serious and older adults are particularly vulnerable. This narrative introduces the special supplement issue of the Journal of the Academy of Nutrition and Dietetics and its focus on the Malnutrition Quality Improvement Initiative (MQii). The MQii provides an opportunity to improve overall quality of patient care, enhance clinical outcomes, and reduce costs.
Quality improvement is integral to today’s healthcare model, and registered dietitian nutritionists (RDNs) play an important role to lead malnutrition quality improvement. This article discusses the opportunity RDNs have to achieve meaningful change in malnutrition care and ensure the health and vitality of current and future generations in America.
The MQii is a national nutrition-focused quality improvement initiative. This narrative outlines the initiative’s collaborative journey from 2013-2019 to improve care and outcomes for hospitalized adults age 65 and older, with a series of nutrition-focused quality improvement (QI) innovations. The vision and future directions of the MQii and its applications in 2020 and beyond are also described, including improving patient care and outcomes in other populations and across other care settings.
The MQii toolkit was designed to support hospitals seeking to implement malnutrition quality improvement. This article introduces the MQii toolkit, describes the process by which it was designed and improved, and orients clinical care teams to its use.
The MQii is based on a dual-pronged approach consisting of a quality improvement toolkit and malnutrition electronic continuous quality improvement measures (eCQMs) that support delivery of high-quality malnutrition care by providers. This article describes the processes of a large pilot hospital to validate the four malnutrition eCQMs.
The University of Pittsburgh Medical Center (UPMC) piloted the MQii at two institutions within their healthcare system after recognizing a need to improve identification and management of malnourished adult patients. This article discusses the UPMC experience implementing the MQii and associated improvements.
The RDNs at Legacy Salmon Creek Medical Center developed a program for post-discharge nutrition care with a goal of decreasing 30-day hospital readmission rates. This article discusses the implementation and results of this pilot program, including results that indicated a high level of patient satisfaction and a decrease in the rate of readmissions.
Frameworks like the MQii need clinical leadership to achieve success. This article highlights the success of four clinical nutrition leaders, and it describes how these leaders demonstrated and supported leadership opportunities for clinical nutrition staff through implementation of the MQii.
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