Implementation of a malnutrition diagnosis sticker: The impact on identification and revenue.

Abstract

The Australian Commission on Safety and Quality in Health Care defines malnutrition as a deficiency of nutrients associated with adverse outcomes including delayed wound healing, muscle wastage as well as increased length of stay, treatment costs and mortality. The 2017 multi-site Epworth malnutrition prevalence audit (n=616) revealed 26% of patients were at risk of malnutrition group wide. 62% of patients at risk of malnutrition and 50% of patients diagnosed with malnutrition had not been referred to dietetics for assessment or intervention. These short fallings contribute to considerable patient risk, negative patient outcomes and significant financial losses for Epworth through missed reimbursements, all of which could be mitigated. In May 2018, 51 health professionals (10 Doctors, 3 Allied Health and 38 Nursing staff) at Epworth Richmond were surveyed regarding their understanding and identification of malnutrition. 100% of responders felt that knowing their patient was malnourished would change their practice. On average, effectiveness of communication was rated 3/5 and 81% were not able to correctly identify when patients were diagnosed with malnutrition. Following these results, the Epworth Malnutrition sticker was developed (in collaboration with Health Information Services (HIS)) to improve the communication of malnutrition diagnosis with patient care providers and assist HIS coders to assign a code for malnutrition so that Epworth is appropriately reimbursed financially.