25
And This is Where the Subtitle Would Appear with More Info This is an Example of the Main Title of a Presentation: 9/8/2016 Nadine Braunstein, PhD, RD, LDN, CDE Chair, Legislative and Public Policy Committee Jeanne Blankenship, MS RDN Vice President, Policy Initiatives and Advocacy Malnutrition Advocacy Training

Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

  • Upload
    others

  • View
    15

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

And This is Where the Subtitle Would

Appear with More Info

This is an Example of the Main

Title of a Presentation:

9/8/2016

Nadine Braunstein, PhD, RD, LDN, CDE

Chair, Legislative and Public Policy Committee

Jeanne Blankenship, MS RDN

Vice President, Policy Initiatives and Advocacy

Malnutrition Advocacy Training

Page 2: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

Please use chat box

for questions

Page 3: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

Moderator

Nadine BraunsteinPhD, RD, LDN, CDE

Chair

Academy’s Legislative and Public Policy Committee

3

Page 4: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

Objectives

Participants will be able to:

1. Characterize the impact of malnutrition on health care quality.

2. Describe the four proposed malnutrition quality measures.

3. Communicate malnutrition messages to policy makers.

4

Page 5: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

Speaker

Jeanne BlankenshipMS, RDN

Vice PresidentPolicy Initiatives and AdvocacyAcademy of Nutrition and Dietetics

5

Page 6: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

6

• 36 million U.S. hospitalizations per year1

• 15% – 60% are malnourished2

• 3% are diagnosedwith malnutrition

2

• 4 million –19 million cases left undiagnosed and therefore untreated

= 1 million

hospitalizations

References1. HCUP Databases. Healthcare Cost and Utilization Project (HCUP). November 2014. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed 1/14/2015.2. White, J. V., Guenter, P., Jensen, G., Malone, A., & Schofield, M. (2012). Consensus statement of the academy of nutrition and dietetics/American Society for Parenteral and Enteral Nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). Journal of the Academy of Nutrition and Dietetics, 112(5), 730-738.

Malnutrition is Common, Yet Often Overlooked

Page 7: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

7

Malnutrition Reduces Overall Health and Contributes to Increased Readmission Rates

Malnutrition-associated outcomes include

depression of the immune system, impaired

wound healing, and muscle wasting1

Leads to higher readmissions rate1 relative to

well-nourished patients and increased mortality2

MALNUTRITION HAS AN IMPACT ON PATIENT RECOVERY AND

METRICS SUCH AS READMISSIONS AND MORTALITY

1 Alliance to Advance Patient Nutrition Staff. The Facts on Malnutrition: What every health care professional needs to know now about patient nutrition. Alliance to Advance Patient Nutrition. Available at:

http://static.abbottnutrition.com/cms-prod/malnutrition.com/img/Alliance_Malnutrition_Fact-Sheet_2014_v1.pdf. Published 2014. Accessed February 3, 2015.

2 Barker LA, Gout BS, and Crowe TC. Hospital malnutrition: Prevalence, identification, and impact on patients and the healthcare system. Int J of Environ Res and Public Health. 2011;8:514-527.

Page 8: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

8

Patients with Malnutrition: Die Sooner and Cost More

Lim et al, Clinical Nutrition, 2012

• Singapore Hospital

population

• 818 total patients

• 235 malnourished

• SGA used to assess

nutrition statusMalnutr.

Non-

Malnutr

Page 9: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

9

Malnutrition remains a common and costly healthcare problem

$157 BillionDisease-related malnutrition (DAM) annually imposes a significant economic burden on our society and our healthcare systems

$51.3 Billion The total annual burden from DAM borne by the elderly population

It is critical to quickly identify at-risk patients who can benefit from nutrition intervention

Page 10: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

10

Lack of consistent screening with a validated tool

Lack of diagnosis compared to published estimates

Lack of treatment of those identified as malnutrition

Lack of monitoring of status

= poor quality care

Malnutrition is a Quality Issue

Page 11: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

11

Quality Strategy Implementation Accomplishments and Next Steps

2013

Proposal and approval to

develop quality

measures

2014

Established as a measure steward with

NQF

2015

Established Collaborations

to develop and test

eMeasures

2016

Submit eMeasures

to CMS and NQF

2017

Target for inclusion in CMS Quality

Program

Project support provided by Abbott and Avalere Health

Developing malnutrition quality measures

for inclusion in CMS quality programs

Page 12: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

12

What is the Malnutrition Quality Improvement Initiative (MQII)?

12

MQII Objectives

● Develop malnutrition quality measures “that matter”

● Improve malnutrition care with an interdisciplinary care team

roadmap (toolkit)

● Advance tools that can be integrated into EHR systems to improve

care quality

The MQII is focused on older adults (ages 65 and older) given the

significant impact malnutrition has on this patient population and the

opportunity to improve care among these patients

Page 13: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

13

Screening

Nutrition

screening using a

validated tool for

all patients age 65

years and older

with a hospital

admission

Assessment

Nutrition

assessment using

a validated tool for

all patients

identified as at-

risk for

malnutrition

Treatment

Establishment and

implementation of

a nutrition

treatment plan for

all patients

identified as

malnourished or at-

risk for malnutrition

Diagnosis

Documentation of

nutrition diagnosis

for all patients

identified as

malnourished

The Joint Commission

Malnutrition Care Workflow

The MQII Offers a Solution to Enhance the Quality of Malnutrition Care

The MQII is rooted in patient-driven nutrition efforts that incorporate

patient preferences and risk factors

Monitoring &

Evaluation

Implementation of

processes,

including discharge

planning, that

support ongoing

monitoring of

patients identified

as malnourished or

at-risk for

malnutrition

Page 14: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

14

Malnutrition Electronic Clinical Quality Measures (eCQMs)

● eMeasure #1: Completion of a Malnutrition Screening within 24 Hours

● eMeasure #2: Completion of a Nutrition Assessment for Patients Identified

as At-Risk for Malnutrition within 24 hours of a Malnutrition Screening

● eMeasure #3: Nutrition Care Plan for Patients Identified as Malnourshed

after a Completed Nutrition Assessment

● eMeasure #4: Appropriate Documentation of a Malnutrition Diagnosis

Page 15: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

15

Key Milestones

March 2016

MQII Demonstration Site & Learning Collaborative

April 2016

Solicit Feedback from CMS

June 2016

Submit eMeasuresto NQF for Endorsement*

Submit eMeasuresto CMS for MUC^ List

August 2016

Update Toolkit

September 2016

Publish eMeasuresand Toolkit

*NQF Endorsement Timeline TBD^MUC List – Measures Under Consideration

October 2016

Advance Adoption of Measures

March 2017

Solicit Feedback from CMS

Page 16: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

16

Advocating for Malnutrition Quality Measures through CMS and NQF Pathways

April 2016

CMS draft Hospital Inpatient Rule

Public Comments Solicited: Recommend CMS include malnutrition measures

June – Sept 2016

CMS selects quality measures for future incentive programs and submits for NQF MAP~ review.

NQF Solicits Measures for Endorsement*

Academy Submits Measures to CMS for MUC^ List in Juneand to NQF for endorsement in July.

Oct. 2016 – Feb. 2017

NQF MAP publishes report to HHS with recommendations for CMS future measures.

Public Comments Solicited: Recommend MAP support malnutrition measures

April 2017

CMS draft Hospital Inpatient Rule

Public Comments Solicited: Recommend CMS include malnutrition measures

August 2017

CMS issues Final Hospital Inpatient Rule

*Target Implementation by October 2017

*NQF Endorsement Timeline TBD~MAP – Measure Application Partnership^MUC List – Measures Under Consideration

Page 17: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

17

Malnutrition Advocacy

• Malnutrition Advocacy Day

September 26, 2016 in Washington, D.C.

• Congressional Briefing – 9:30 to 10:30 a.m.

• Hill Visits

• ANDPAC Reception – 3 -- 5 p.m.

• Malnutrition In District Meetings

September and October 2016

• Public Policy Panel leaders organize local visits

Page 18: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

18

Malnutrition Advocacy

• Action Alert Planned

– Anticipated launch on 9/13/2016

– Supports advocacy day and in district meetings

– PPCs will get approved communication content

• Social Media

– Watch for information in PPWN

Page 19: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

19

Preparing for Meetings• Review

1. Malnutrition Advocacy Leave Behind Infographic

2. www.DefeatMalnutrition.Today

3. http://www.eatrightpro.org/resources/practice/practice-resources/malnutrition

• Read1. Malnutrition Care – Preparing for the Next Level of Quality

2. CMS “Dear Colleague” Letter

3. ASPEN and Academy Consensus Statement Regarding Malnutrition

• Act1. Complete the Action Alert

Page 20: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

20

Meeting Agenda1. Provide an overview of malnutrition

– Use the leave behind to guide your conversation

2. Summarize the Malnutrition Quality Improvement Initiative

– Talking points available 9/13

– Leave a copy of the article

3. Ask for the member of Congress to sign onto the “dear colleague” letter to CMS

– House and Senate versions

– Leave a copy of the letter

Page 21: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

21

Advocacy Day in D.C.

• Congressional briefing will provide overview

• Meetings will be scheduled by the coalition

• Groups will include new and seasoned advocates

• Coalition members will represent multiple organizations and professions

• Common “ask”

Page 22: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

22

Advocacy In District

• Complete the Action Alert

• Schedule meetings with members of Congress

– PPCs will coordinate meetings and track

– Meetings conduct in September and October

• Follow the meeting outline

• Submit a report to the Academy

– The report will be sent to the PPCs

Page 23: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

Questions?

9/8/2016

Page 24: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

Live Event CPEU Certificate:• certificate emailed • evaluation survey

Recorded Event CPEU Certificate:Contact [email protected]

24

Page 25: Malnutrition Advocacy Training...Malnutrition Advocacy • Malnutrition Advocacy Day September 26, 2016 in Washington, D.C. •Congressional Briefing –9:30 to 10:30 a.m. •Hill

9/8/2016

Jeanne Blankenship., MS, RDNVice President, Policy Initiatives and Advocacy

[email protected]

Teresa Nece, MS, RDN, LD, SNSDirector, Grassroots Advocacy

[email protected]

Thank You!If you have questions contact: