Hospital nutrition programs may shorten patient stays, reduce readmissions by as much as 27 percent

While proper nutrition is vital to staying healthy, its importance is being felt by hospitals and health systems, as well. A new study by Advocate Health Care and Abbott found that optimizing nutrition care in the hospital could help reduce 30-day readmission rates by 27 percent and the average hospital stay by almost two days for malnourished patients.

Across the United States, one in three people enter the hospital malnourished, which can often go unrecognized and undertreated. To help improve care for malnourished patients, Advocate implemented two versions of a nutrition care program -- basic and enhanced -- at four of its Chicagoland hospitals. Both programs required care teams to conduct patient malnutrition risk screenings using a validated tool on the hospitals' electronic medical records system, and provide nutrition treatment and support for malnourished or at-risk patients. The enhanced program included more immediate treatment upon hospital admission and follow-up calls to confirm their continued nutrition treatment after leaving the hospital.

Researchers at the four hospitals followed more than 1,200 adults at-risk of malnutrition during their stay to assess the impact of the nutrition programs on the patients' chances of hospital readmissions, as well as their lengths of hospital stays.

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When compared to the hospitals' previous readmission rates and lengths of stay for malnourished patients, researchers found that using either of the nutrition care programs had an impact, on average, of reducing the risk of patient readmissions from 22.1 percent to 16.1 percent, a 27 percent reduction; and shortening the risk of a patient's length of stay from 7.2 days to 5.4 days, a 25 percent reduction.

As hospitals look for ways to improve patient care and reduce readmissions, this study builds on existing research that confirms nutrition can be a simple, cost-effective tool. While nutrition screenings are considered standard-of-care in the hospital, not all of them use a validated screening tool or implement treatment immediately if someone is considered at-risk. Additionally, when people leave the hospital, many times they do not receive education or follow-up to ensure they are following a nutrition plan to aid their recovery.

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Published online Dec. 6 in the Journal of Parenteral and Enteral Nutrition, the study was a multi-site, two-group, pre-post study to evaluate two nutrition Quality Improvement Programs. wo hospitals implemented a basic program, which included screening patients for malnutrition using a validated tool and providing treatment (oral nutrition supplements) and nutrition support within 24-48 hours of admission.

Two other hospitals implemented an enhanced program, which provided oral nutrition supplements and nutrition support within 24 hours through the hospitals' electronic medical records; they also added post-discharge support including instructions, coupons and follow-up phone calls to confirm patients continued taking their oral nutrition supplement.

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The study's primary outcome was 30-day unplanned readmissions, with a secondary outcome of hospital length of stay. A total of 1,269 participants aged 18 or over at risk of malnutrition were enrolled between Oct. 13, 2014 and April 2, 2015.

The study was funded by Abbott, which had no role in data collection or analysis.

Twitter: @JELagasse