NHRMC Implements Program to Help Malnourished Patients after Discharge

February 20, 2019
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New Hanover Regional Medical Center’s Nutrition Services team has initiated a program to help malnourished patients bridge the gap between the nutrition they receive in the hospital and what is experienced once they return home. This initiative aims to provide nutrition to malnourished patients who have limited access to food.

When a patient is diagnosed with malnutrition by a Registered Dietitian (RD) at NHRMC, nutrition interventions are put in place to meet the patient’s specific medical nutrition needs. During their hospital stay, many patients start to improve and are then discharged with instructions on how to properly nourish themselves to maintain or rebuild strength and lean muscle mass.

“We identified a gap in nutrition care once our patients were discharged,” said Angela Lago, NHRMC’s Manager of Clinical Nutrition. “After our malnourished patients left the hospital, we didn’t know if they had access to nutritious food, if family was able to help them obtain or prepare meals, if they were able to retain and implement the nutrition education they received, or if they were following the nutrition care plan that was created specifically to help them heal.”

Often, the answer was that there was insufficient support at home to keep these patients on the path to healing.

To bridge this gap, Scott Whisnant, Administrator of Community Relations, secured a Duke Endowment Grant, which allowed NHRMC to hire its first Clinical Outreach Dietitian, Skip Allen. Skip receives referrals from the NHRMC dietitians and visits malnourished patients in their homes to reinforce their nutrition plan of care and ensure they get connected to the resources they need to continue recovering at home.  

“Our goal is to help prevent avoidable readmissions,” Lago said. “We want patients to thrive after they leave our facility.”  

When patients don’t have access to food (also known as Food Insecurity) and they are diagnosed with malnutrition, they may not heal or regain strength or regain functional ability to perform everyday tasks.

NHRMC’s malnutrition initiative includes a discharge nutrition food box to help food insecure patients continue their recovery. The NHRMC Nutrition Services team selected items for the food boxes, which include peanut butter, lean protein, granola bars, whole wheat bread, fruit and other staple items. Each box contains enough food to provide 2,000 calories per day for up to two weeks. The food boxes were specifically designed to require little to no preparation, so patients with limited mobility and energy can easily prepare a meal or snack.

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“The boxes contain the recommended daily amounts of calcium, protein and other essential nutrients,” said Wayne Strauss, NHRMC’s Director of Food & Nutrition Services. “By eating these items, patients will receive important nutrients to help them continue to gain strength and muscle mass.”

“Nutrition is imperative for continued improvement in overall health and wellness,” Lago said. “We cannot expect our patients to bounce back from a trauma, stroke, fall, surgery or any other medical condition if their nutrition is inadequate. Nutrition is connected to everything.”

About 20 percent of NHRMC patients are estimated to be malnourished, so the health care system has shown support for the program by adding several positions to the Clinical Nutrition team to assist with early identification and treatment of malnourished patients. To date, the initiative has only focused on patients over 18 years of age, however there are plans to serve our pediatric patients as well. Strauss and Lago are confident that outcomes will support the expansion of the Clinical Outreach Dietitian role to proactively lead our community to outstanding health.

Pictured at top: Skip Allen, Angela Lago, Wayne Strauss

Based in Charlotte and established in 1924 by industrialist and philanthropist James B. Duke, The Duke Endowment is a private foundation that strengthens communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits. Since its founding, it has distributed more than $3.7 billion in grants. The Endowment shares a name with Duke University and Duke Energy, but all are separate organizations.