Cost-Effective Nutritional Interventions in a Chronic Disease Facility

Abstract

LEARNING OUTCOME: To identity opportunities for decreasing cost, while maintaining the quality of nutritional care. Our hospital is a 200 bed chronic disease and rehabilitation facility with 5 long-term units. The clinical nutrition staff was faced with the challenge of “ensuring quality of care is sustained and enhanced while reducing the cost of providing care” as per the hospital goal. The standard of practice on these units was all patients were scheduled for a bi-annual nutritional reassessment for which labs were automatically ordered. Our aim was to prioritize care based on degree of nutritional risk instead of automatically providing nutritional inventions to all patients. The steps used to work toward cost-efficiency were prioritizing patients, educating staff and coordinating schedules. The nutrition policies and standards were revised so the frequency of intervention would be determined through the interdisciplinary process. Ongoing education about the most cost-effective lab ordering practices was provided to the Nutrition Support Committee and medical staff. Each dietitian (RD) then worked on coordinating patient reassessment schedules to maximize use of existing lab work. The process has been ongoing for three years with the following results: 115 fewer “automatic” reassessments, therefore, saving $3897.35, in lab costs that would have been associated with them. Patients’ schedules were adjusted to take advantage of existing lab work with a savings of $1660.61, over the three years. The percentage of time labs were ordered specifically for the nutritional reassessment over the last three years were as follows: 53%, 52%, and 60%, respectively. This project has promoted interdisciplinary coordination of services by the RD to ensure patients receive quality nutritional care while controlling costs.