Impact of a Nutrition Quality Improvement Program on Outcomes of Malnourished Patients

Study Overview
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Brief Summary
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A nutrition-focused QIP will be implemented as standard of care at select branches of the home health division of the health care system. The QIP will be comprised of three groups of patients, Group 1 will consist of hospitalized, at-risk/malnourished patients being discharged to home health, Group 2 will consist of outpatients at-risk/malnourished patients enrolled in home health and Group 3 will consist of SNF, at-risk/malnourished patients being discharged to home health. Groups will be followed for 90 days post enrollment. The QIP groups will be compared to historical controls, concurrent controls, and matched concurrent controls across other sites within the health system.

Official Title
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Assessing the Impact of a Comprehensive Nutrition-Focused Quality Improvement Program (QIP) on Health and Economic Outcomes of Malnourished Adult Patients Across the Continuum of Care

Conditions
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Malnutrition

Intervention / Treatment
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* Other: Quality Improvement Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admitted to home health from within the healthcare system's hospitals, skilled nursing facility (SNF) or outpatient clinics Patient is screened positive for malnutrition during hospital stay and/or by home health nutrition screening tool upon enrollment into home health Patient is able to consume foods and beverages orally and the physician has not indicated otherwise Exclusion Criteria: Enrollment to home health from a hospital, SNF or outpatient clinic not affiliated with the healthcare system Patient is pregnant Patient is intubated, receiving tube feeding or parenteral nutrition Patient has severe dementia or delirium History of significant psychiatric disorder Any other disorder that may interfere with QIP product consumption or compliance with QIP protocol procedures as per the admitting clinicians Subject has stated an allergy or intolerance to any of the ONS ingredients Patients receiving hospice care

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Quality Improvement Program<br>This group will consist of hospitalized and SNF, at-risk/malnourished patients being discharged to home health and outpatients at-risk/malnourished patients enrolled in home health. | Other: Quality Improvement Program<br>* Nutrition screening, Nutrition consult, Oral Nutritional Supplement will be implemented in the Home Health branches as standard of care.<br>|
| Control<br>This group will consist of historical controls, concurrent controls, and matched concurrent controls across other sites within the health system. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital readmissions or admissions |  | Enrollment to Home Health to 90 Days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Healthcare resource utilization and costs |  | Enrollment to Home Health to 90 Days |