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Impact of a Nutrition-Focused Quality Improvement Intervention on Hospital Length of Stay

Siegel, Sharon, RD, LD; Fan, Linlin, PhD; Goldman, Amanda, MS, RD, LD, FAND; Higgins, Joseph, MS, RD, LD; Goates, Scott, PhD, MBA; Partridge, Jamie, PhD, MBA

doi: 10.1097/NCQ.0000000000000382
Original Article: PDF Only

Background: Despite its high prevalence, malnutrition in hospitalized patients often goes unrecognized and undertreated.

Local Problem: A hospital system sought to improve nutrition care by implementing a quality improvement initiative. Nurses screened patients upon admission using the Malnutrition Screening Tool and initiated oral nutrition supplements for patients at risk.

Methods: We retrospectively reviewed the medical records of 20 697 adult patients to determine whether early initiation of nutrition therapy had reduced hospital length of stay and 30-day readmission rates.

Results: We found the average time from hospital admission to oral nutrition supplement initiation was reduced by 20 hours (20.8%) after the quality improvement initiative was introduced (P < .01). Length of stay decreased 0.88 days (P < .05) more for patients at nutritional risk than patients not at nutritional risk; the probability of 30-day hospital readmission did not differ between groups.

Conclusion: These results highlight the importance of adequate nutrition screening, diagnosis, and treatment for hospitalized patients.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Clinical Nutrition, Sodexo Healthcare, Gaithersburg, Maryland (Ms Siegel and Mr Higgins); Department of Agricultural Economics, Mississippi State University, Starkville, Mississippi (Dr Fan); Catholic Heath Initiatives, Denver, Colorado (Ms Goldman); and Health Economics and Outcomes Research, Abbott Nutrition Research and Development, Columbus, Ohio (Drs Goates and Partridge).

Correspondence: Jamie Partridge, PhD, MBA, Abbott Nutrition R&D, Bldg ES1 East, 2900 Easton Square Place, Columbus, OH 43219 (

We thank Suela Sulo, PhD, for her support with the project.

Sharon Siegel and Joseph Higgins are employed by Sodexo Healthcare. Linlin Fan is currently employed by Mississippi State University, was employed as an intern at Abbott at the time of this study. Amanda Goldman is employed by Catholic Health Initiatives. Jamie Partridge and Scott Goates are employed by Abbott. The authors have no other conflicts of interest or financial conflicts.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: October 22, 2018

Published ahead of print: December 12, 2018

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