Malnutrition Matters

Malnutrition Matters
Last Updated on March 18, 2024

The Case for MQii

Malnutrition, sometimes referred to as “poor nutrition,” is the inadequate intake of nutrients, particularly protein, over time and can occur in people who are both underweight or overweight (including obese). It is a highly burdensome condition that places a great burden on patients, providers, and the broader healthcare system. The MQii seeks to address this problem through identification and appropriate treatment malnourished individuals. More details on the prevalence and burden of malnutrition are outlined below.

Malnutrition Is A Highly Preventable Condition

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Malnutrition affects 20–50% of patients, who are at risk of becoming or are malnourished.1

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Malnutrition is typically only diagnosed in 8% of hospitalized patients, leaving many potentially undiagnosed and untreated.2

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Up to 31% of malnourished patients and 38% of well-nourished patients experience nutritional decline during their hospitals stays.3

Malnutrition Poses a Significant Burden to Patients and Hospitals

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maximum likelihood of in-hospital death compared to general patient population.2

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higher likelihood of 30-day readmissions, with septicemia as the leading diagnosis upon readmission.2

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higher costs for a malnourished patient hospital stay compared to non-malnourished patients.4

Addressing Malnutrition Can Improve Patient Outcomes and Lower Costs

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reduction in 30-day readmission rates for a multi-hospital ACO that optimized its malnutrition care.5

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in cost savings generated by a 4-hospital system that implemented a nutrition-focused quality improvement program.6

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relative reduction in readmission risk for malnourished patients with a nutrition care plan vs those patients without a care plan.7

What is my role?

Select the category that best describes your role to find the resources and support you need.

As the “voice” of the patient, you are important to help ensure that the care that patients receive is safe, effective, and of the highest quality. Given that many patients admitted to the hospital are malnourished or at-risk of malnutrition upon arrival, and that many others experience nutritional decline during their stay, you can be a strong advocate for appropriate, patient-centered malnutrition support for hospitalized patients. This, in turn, can help keep patients healthier, reduce their length of stay, lower their chance of readmission, and help prevent infections and other hospital-acquired conditions.

What Can I Do About It?

Engage with hospital leaders, quality improvement staff, or patient and family advisory councils to encourage attention to and support for optimal, patient-centered malnutrition care throughout a patient’s stay. Help facility leadership and staff understand the importance of malnutrition care for good patient outcomes and, in turn, overall hospital quality. Encourage the creation of a patient-centered malnutrition quality improvement project to address current gaps in the hospital’s malnutrition care.

Many healthcare professionals play a critical role in delivering quality malnutrition care including pharmacists, physician assistants, social workers, case managers, discharge planners, speech pathologists, wound care providers, and physical therapists. For example, pharmacists are vital to providing parenteral nutrition and preventing drug-food interactions by thoroughly screening the patients’ medication profile to ensure delivery of safe and effective nutrition care to patients. Similarly, discharge planners must ensure that malnutrition-related components (e.g., malnutrition status, diagnosis, patient education on importance of malnutrition in overall recovery) are included in the discharge plan to effectively coordinate transitions of care.

What Can I Do About It?

You can champion the importance of team-based, timely, and coordinated malnutrition care in your hospital by raising awareness among your staff and colleagues around the impact of this condition and supporting a malnutrition quality improvement project. By elevating appropriate, patient-centered malnutrition care, you can enhance the quality and safety of care patients receive in your facility and as they transfer to alternate sites of care, differentiating your organization from other hospitals.

As a hospital leader, you set the direction for the hospital to ensure it provides best-in-class care. You play a critical role in overseeing the organization’s delivery of high quality, effective, and safe care. Such care should include recognition and support for patients who are malnourished or at-risk of malnutrition – as these patients are much more likely to be readmitted, have longer lengths of stay, and are at higher risk for hospital-acquired infections resulting in increased costs of care.

What Can I Do About It?

You can champion the importance of optimal malnutrition care in your hospital, both raising awareness among your staff around the impact of this condition and encouraging a project to support malnutrition quality improvement. By elevating appropriate, patient-centered malnutrition care, you can enhance the quality and safety of care patients receive in your facility, reduce costs associated with complications, length of stay, and readmissions, and further differentiate your organization from other hospitals.

As the “owner” of quality and safety in your hospital, you provide important leadership for clinicians and executives in your hospital to understand barriers to optimal patient care. By recognizing the adverse impact malnutrition has on hospitalized patients – including higher rates of healthcare-associated infections, pressure ulcers, falls, and poor wound healing – you can help facilitate quality improvement efforts around malnutrition and show your facility’s support for addressing this care gap.

What Can I Do About It?

As a quality leader, you can embrace malnutrition as an area of focus for your hospital. Help generate hospital executives’ support, educate staff around the impact and importance of appropriate malnutrition care, and demonstrate your institution’s leadership in this space. You can also help providers and other hospital staff interested in malnutrition quality improvement (QI) build a project team and identify the resources necessary to support a malnutrition QI project.

As the first provider to see a patient in the hospital, you are the “first line of defense” in recognizing patients who are malnourished or at-risk of malnutrition. You are also critical in ensuring that patients subsequently get the care they need, including effective malnutrition support, and play a vital role in communicating malnutrition care needs to next-in-line providers, whether in the hospital or during the patient’s discharge. Early recognition and malnutrition care for patients can reduce the likelihood of pressure ulcers, falls, and infections – thereby keeping your patients safer and healthier.

What Can I Do About It?

Nurses have long been the cornerstone of hospital-based quality improvement efforts. Help your hospital and other providers within your institution recognize the importance of malnutrition care and encourage them to pursue a malnutrition quality improvement project to enhance the culture of patient safety, reduce patient lengths of stay, and lower readmission rates.

As the professional who is the expert about patient malnutrition, you are a vital resource on the impact of malnutrition on patient outcomes – as well as a leader to implement quality malnutrition care and coordination among all hospital clinicians. You are critical to providing timely and effective assessment, recognition, and treatment of malnutrition for malnourished or at-risk patients.

What Can I Do About It?

Being a leader and advocating for timely and effective malnutrition care can help keep hospitalized patients safer and healthier, while enhancing the role of the dietitian in the hospital care team. Partner with other clinicians in your hospital to raise awareness about malnutrition and generate support for a project to advance the quality of malnutrition care provided in your institution.

As the professional responsible for diagnosing and overseeing the patient’s full course of care in the hospital, you are critical to ensuring that malnutrition is recognized, treated, and communicated to next-in-line providers for patients who are malnourished and at-risk of malnutrition. By doing so, you can give patients the best chance at a rapid recovery – since malnutrition can contribute to infections, falls, pressure ulcers, and longer lengths of stay.

What Can I Do About It?

As the physician you are vital to create momentum for quality improvement among care providers and hospital leadership. Become a malnutrition champion today to help other clinicians understand the impact of malnutrition on the hospitalized patient and support implementation of best practices for patient care.

Malnutrition Evidence Library

The evidence library contains references and links to the most recent and relevant scientific articles reflecting the evidence that supports the malnutrition care workflow, malnutrition quality measures and the need for malnutrition quality improvement more broadly. The articles span a myriad of topics, and are ordered by most recently updated. 5 articles are displayed here; please  click ‘See All’ below to navigate to the entire evidence library.



The Malnutrition Quality Improvement Initiative

MQii Learning Collaborative

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