News: Nutritional intervention improves readmission rate, length of stay for surgical patients

Surgical patients who received nutritional intervention during their hospital stay saw their 30-day readmission rate cut nearly in half, falling from 19.6% to 10.4%, a recent study published in the Journal of Parenteral and Enteral Nutrition, found according to HealthLeaders Media.

“Malnourished hospitalized surgical and medical patients experienced improved readmission rates and length of stay,” the researchers wrote. “However, surgical patients saw a significantly greater reduction in the readmission rate.”

The length of stay (LOS) for surgical patients also improved with nutritional intervention, with LOS for surgical patients dropping 2.7 days, from 9.3 days to 6.6 days, HealthLeaders Media reported. Medical patients also saw a 2.1-day LOS drop, from 7.1 to 5.0 days.

According to a 2016 study published in the American Journal of Clinical Nutrition, as many as 50% of patients are malnourished or at risk of malnutrition when they’re admitted to the hospital. Surgical patients face an even higher risk, the researchers wrote.

The researchers of the new study say that surgical patients face four primary nutrition-related risks during their hospitalization:

• Delayed wound healing
• Postoperative complications such as surgical site infections
• Longer LOS
• Higher readmissions

For the study, the nutrition-focused quality improvement program had four primary elements, HealthLeaders Media reported:

• Malnutrition screening
• For malnourished patients or patients at risk of being malnourished, oral nutrition supplements were provided in less than 48 hours
• Nutrition information was provided for both the patient and caregivers
• The EHR triggered dietitian consultations and specified oral nutrition supplements depending on a patient’s condition

Based on the study’s results, the researchers urged surgeons to embrace nutritional interventions for their patients, HealthLeaders Media reported.

“We particularly call surgeons to action—to raise awareness of the importance of nutrition on surgical outcomes, to partner with hospital administration to obtain appropriate support for nutrition care processes, and to expand nutrition education and training in residency and continuing medical education programs,” they wrote.

Malnutrition and related complications often represent an area of documentation improvement opportunities for CDI professionals. Often, CDI departments work between coding, dietitians, and physicians to develop documentation sheets and/or adjust information within the EHR to better capture the patient’s current status and put follow-up procedures in play. Understanding the additional risks related to poor nutritional status for patient outcomes may help CDI professionals make an even stronger case for capturing this documentation in real time.

Editor’s note: This article originally appeared in HealthLeaders Media. To read the study in its entirety, click here. To read the 2016 study that estimated 50% of hospitalized patients were at risk for malnutrition, click here. To listen to a recent episode of ACDIS Radio related to malnutrition and the Office of Inspector General, click here. To register for a three-hour ACDIS Live! webinar on the topic of malnutrition audits and denials, click here.