Show Me The Outcomes

Abstract

LEARNING OUTCOME: To identify a method for gathering and reporting medical nutrition therapy outcomes data which are important to health care payors In order to prove the value of nutrition services to health care payors, outcomes of the nutrition intervention must be documented. To achieve reproducible outcomes, standard care practices must be followed by the dietitians providing the nutrition Intervention. Many protocols are currently available to put into practice. Few, if any, have been validated in a large ambulatory care population or targeted to the needs of the health care payors. Taking samples of these protocols, we developed standardized guidelines for the provision of nutrition care for the top diagnoses for which patients are referred including: diabetes-NIDDM, IDDM, GDM; cardiovascular disease-hypertension, hyperlipidemias; inflammatory bowel disease; food allergies; obesity; cancer. The guidelines are written to correspond with our data entry form for outcomes documentation. The dietitian also uses this form as a basis for creating the patient's report which is sent to the physician and case manager. We are currently validating these guidelines using our potential client base which includes 88,0000 covered lives under one employer contract as well as national and regional contracts with home and long term care agencies. In addition, we have developed symptom management pathways for diarrhea, constipation, nausea and vomiting and drug nutrient interactions. These guidelines and symptom management pathways have been used successfully with clients seen through home health care agencies or those directly referred through currently held managed care contracts. The outcomes measured are processed in our computerized database management system and reported to these agencies on a monthly or quarterly basis by specific categories such as diagnosis, age, physician, or referral source. Outcomes can only be demonstrated when standardized guidelines are utilized. When outcomes are demonstrated, the importance of nutrition services can be demonstrated and valued in dollars.