Quality Improvement Program (QIP) to Reduce 30-Day Readmission in Malnourished Hospitalized Patients

Study Overview
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Brief Summary
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Newly admitted patients will be screened for risk of malnutrition. Patients will receive either the feeding protocol or current oral nutrition supplement (ONS) practice, pending location. Patients will continue the nutrition plan taking the supplement post discharge. Study team will follow-up with telephone calls to help support post-discharge ONS compliance. Quality and service utilization data will be gathered for analysis.

Official Title
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Does a Rapid, Comprehensive Oral Nutritional Supplementation Quality Improvement Program (QIP) Reduce 30-Day Readmission in Malnourished Hospitalized Patients?

Conditions
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Malnutrition

Intervention / Treatment
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* Other: ONS QIP
* Other: ONS Standard Feeding


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient is ≥ 18 years of age. Patient is screened for malnutrition with an MST score ≥ 2 (see Appendix C). Patient has length of stay of hospital stay > 2 days. Patient is able to consume foods and beverages orally. Patient receives Ensure, Nepro or Glucerna during the course of his or her hospital stay in connection with the QIP. Exclusion Criteria: Patient is pregnant. Patient is intubated, receiving tube feeding or parenteral nutrition. Patient unable to provide HIPAA authorization and informed consent. Patient is discharged to hospice care. Patient has a condition that would preclude ingestion / absorption of the oral nutritional supplements, including allergic response to any ONS ingredient. Patient has severe dementia or delirium, brain metastases, eating disorder, history of significant neurological or psychiatric disorder. Patient has stated an allergy or intolerance to any of the ingredients in the study products.

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 |
| --- | --- |
| ONS QIP<br>Two (2) hospitals will administer the new rapid, comprehensive oral nutritional supplementation (ONS) QIP. | Other: ONS QIP<br>* Rapid comprehensive ONS, dietary consult, follow up phone calls<br>|
| ONS Standard Feeding<br>Two (2) hospitals will use their current standard ONS feeding protocol. | Other: ONS Standard Feeding<br>* Standard of care<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-discharge readmissions | Non-elective readmission 30 days post discharge. | November 2014 - April 2015, 30 days post discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital length of stay | Length of stay in the hospital will be calculated by looking at the admission and discharge dates. | October 2014 - March 2015, up to 6 months |