MONDAY, OCTOBER 20
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; ResearchImpact of a Multidisciplinary Nutrition Program on Length of Stay, Episode Costs andReadmission Rates
Author(s): A. Meehan1, C. Loose1, J. Partridge2, S. Goates2, J. Nelson2, J. Bell2; 1Akron GeneralMedical Center, Akron, OH, 2Abbott Nutrition, Columbus, OH
Learning Outcome: The participant will be able to describe methods for creating innovativeopportunities for clinical integration and maintain collaborative relationships with allhealth care disciplines to promote and attain optimal levels of wellness across the lifespan.
Background: Malnutrition is an under recognized problem among hospitalized patientsand increases risk of poor outcomes, including increased length of stay, healthcare costs,complication rates, readmission rates, and mortality. The purpose of the multidisciplinarynutrition program is to 1) promote early identification and initiation of nutrition with medpass for patients at risk for malnutrition and 2) reduce length of stay, episode costs andreadmission rates. In a retrospective study using the Premier Research Database, Philipsonet al. demonstrated that use of oral nutrition supplements decreases length of stay, episodecosts and 30-day readmission risk in adult inpatients with any primary diagnosis.
Methods: The study builds from Philipson and is a real-world; retrospective cohort study todetermine differences in outcomes between patient comparison groups using data fromAkron General Medical Records. The control group was the patient cohort prior to initia-tion of nutrition with med pass and the experimental group was the patient cohort postinitiation of nutrition with med pass. Unadjusted descriptive analysis was used to char-acterize each of the cohorts and adjusted analysis included direct and/or propensity scorematching.
Results: Since implementing the program, time between a nurse identifying a patient witha nutritional need and initiation of an intervention decreased from 2.3 days to less than 24hours. Based on the preliminary results, the impact the intervention has on hospitaloutcomes is presently being evaluated using the methods described.
Conclusion: Early intervention with nutrition may lead to improvements in health out-comes, quality of care and healthcare spending.
Funding Disclosure: NoneState Affiliate Mobilizes to Educate and Inform Members and Providers aboutNew Models for Providing Care: Patient Centered Medical Home, AccountableCare Organizations and Comprehensive Primary Care Initiative
Author(s): S.M. Linja1, M.E. Hartman-Cunningham2, M.R.Williams3, K.E. Ruszel4,S.J. Safaii5, E.M. Long6; 1S&SNutritionNetwork, Inc., Boise, ID, 2IdahoAcademyofNutrition and Dietetics, Boise, ID, 3Shoshone Family Medical Center/PrimaryCare, Shoshone, ID, 4Family Medicine Residency of Idaho, Boise, ID, 5MargaretRitchie School of Family and Consumer Sciences, University of Idaho, Moscow,ID, 6Community and Environmental Health, Boise State University, Boise, ID
Learning Outcome: Participants will be able to describe the comprehensivestrategy used by a state affiliate to educate members and providers aboutchanges in healthcare models and integration of RDNs into these systems.
The Affordable Care Act (ACA) shifts the focus of healthcare from diseasetreatment to prevention of chronic disease. Registered Dietitian Nutritionists(RDNs) must advocate for the federal and state regulations that identify di-etitians as health care experts who can provide medical nutrition therapy andnutrition counseling leading to improved patient outcomes. The law statesthat RDNs may be included in patient-centered medical homes, an arrange-ment designed to coordinate a multidisciplinary team. Steps taken to addressthese policies in our state include: board appointed committee of members;membership survey; Strengths/ Weakness/ Opportunities/ Threats (SWOT)analysis; key informant interviews with legislators, primary care physicians,insurance providers, and state Medicaid administrators; community pre-sentations; white paper summarizing insurance, Medicare and Medicaidreimbursement for RDN services in our state; website, social media and e-mail updates for members; state-wide media campaign; and a pilot projecttracking patient behavioral and nutritional measures. Our work has increasedawareness of these policies and regulations among our membership andother stakeholders. Our strategy includes documenting the cost-effectivenessof RDN services, obtaining reimbursement for RDN services, educatingmembers and providers, marketing the RDN as the provider with the edu-cation and training to provide nutrition services, and addressing the need forRDNs in primary care settings, initially focusing on Federally Qualified HealthClinics and Rural Health Clinics.
Funding Disclosure: NoneA-56 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICSHydroponic Gardening: Promoting Victory for School Nutrition
Author: E. Johnson; Eastern Michigan University, Decatur, GA
Learning Outcome: Identify four reasons why a hydroponic system is a sus-tainable growing method.
Local food sourcing and on-site school gardens, as part of Farm to Schoolprograms, have improved dietary quality by increasing access to nutritiousfoods, encouraging meal participation, and positively influencing dietarybehaviors outside of school. However, barriers to overcome include cost,procurement, labor, food safety, and consistent supply. Urban Agriculturemethods can produce large amounts of food locally as demonstrated byVictory gardens during World War II. These community gardens, planted inpublic areas such as schoolyards, produced 40% of the vegetables grown inthe U.S. and supplemented school meals. Literature on Urban Agriculture andsustainable methods was reviewed and analyzed for cost-effective ap-proaches to safely and consistently bring more local produce to schools. Ahydroponic systemwas found to be an excellent way to introduce sustainableUrban Agriculture methods to school gardens. Hydroponic growing can beuseful because of its high yield of clean, nutritious produce, particularly leafygreens. It is estimated that a low maintenance 12x 24 greenhouse couldproduce approximately 2000 heads of greens during the school year, using noelectricity, with a startup cost of around $10 per square foot. Much higheryields are achievable if electricity and vertical installation are used. Thispresentation provides design and implementation strategies for adding anon-circulating hydroponic system to a school garden, with estimated costsand funding sources, and potential nutritional benefits. This emerging areadeserves more attention to quantify its role in the nutritional and educationalenvironment in schools.
Funding Disclosure: NoneAthens Locavores - Past and Present: Development of a Documentary Film toTeach Principles of Local Eating in a Rural Appalachian Ohio Community
Author(s): L.H. Cohen, D.H. Holben; Applied Health Sciences and Wellness,Ohio University, Athens, OH
Learning Outcome: After this presentation, the learner will be able to describethe principles and benefits of eating locally-grown foods from a ruralAppalachian Ohio community and to relate the current movement to his-torical perspectives of eating locally.
Background: Two hundred years ago eating local was a necessity for mostcommunity members, and some historic figures captured ideas and princi-ples of eating local in journals that were meticulously kept. Today, eatinglocal is a growing movement. Research supports that locavores of the 21stcentury choose to eat closer to home for nutrition-, health-, economic-, andsocial-related reasons.
Purpose of the Documentary: This documentary film was developed to teachviewers about the principles and benefits of eating locally-grown foods froma rural Appalachian Ohio community, while tying the current movement tohistorical perspectives of eating local in the region.
Methods: Fifteen leaders of the local food movement from rural AppalachianOhio were interviewed regarding historic and general principles and benefitsof eating locally-grown foods, including historians on the topic. A series ofquestions were asked to each interviewee. An audio and filming crewcaptured each interview, along with B-roll, supplemental footage for thedocumentary. The interviews were edited to capture the ideas in an infor-mative and entertaining fashion.
Documentary Film Usage: This documentary film was used for local events,including a universitys Founders Day celebration, as well as two, senior-leveluniversity courses (Nutrition in the Community; Thomas Jefferson - Gardenerand Gastronome).
Conclusions: Development and usage of a documentary film to teach bothhistoric and general principles about the topic can effectively engage bothuniversity students and community members. Usage of such a film jointlybenefits both food producers and consumers of local foods in a region.
Funding Disclosure: NoneSeptember 2014 Suppl 2Abstracts Volume 114 Number 9
Impact of a Multidisciplinary Nutrition Program on Length of Stay, Episode Costs and Readmission RatesLearning OutcomeBackgroundMethodsResultsConclusionFunding Disclosure
State Affiliate Mobilizes to Educate and Inform Members and Providers about New Models for Providing Care: Patient Centered ...Learning OutcomeFunding Disclosure
Hydroponic Gardening: Promoting Victory for School NutritionLearning OutcomeFunding Disclosure
Athens Locavores - Past and Present: Development of a Documentary Film to Teach Principles of Local Eating in a Rural Appal ...Learning OutcomeBackgroundPurpose of the DocumentaryMethodsDocumentary Film UsageConclusionsFunding Disclosure