Quality, Data and Outcomes

• Identifying measures that capture malnutrition screening, assessment, diagnosis, treatment, monitoring and evaluation across the nutrition care pathway.
• Reviewing international evidence and commonly used malnutrition outcome measures.
• Working with subject matter experts and MCANZ workstreams to refine and validate recommended indicators.
• Developing approaches for data collection, management, and implementation that support national adoption of agreed measures.
• Recommending a minimum set of audit standards to support monitoring of a National Malnutrition Policy.
• Ensuring outcome measures are meaningful and relevant to the population of Aotearoa New Zealand.

If adopted and implemented, the workstream's recommendations are intended to:

• Establish meaningful indicators for measuring malnutrition prevalence, care practices and outcomes across in scope healthcare settings.
• Enable benchmarking and comparison of malnutrition-related practices and outcomes.
• Promote more consistent and evidence-informed malnutrition care through monitoring against agreed standards and targets.
• Support continuous quality improvement through reliable data and meaningful outcome measurement.
• Enable the consistent collection and reporting of national malnutrition data.
• Support evidence-informed decisions and service development.
• Generate insights that help identify and reduce inequities in malnutrition care and outcomes for Māori, Pacific peoples and all New Zealanders.

• Public and private hospital services across primary, secondary and tertiary care.
• Community services and aged residential care.
• Universities and dietetic training providers.
• National malnutrition policy development and implementation.
• Measures relating to the structure, process and outcomes of malnutrition care.
• Cost and cost-analysis measures associated with malnutrition care.
• Other contracted services, including rehabilitation services and mental health and addiction services.

• Adults receiving care for eating disorders.

Recent progress includes:

• Completion of an international review of malnutrition measures, outcomes, and possible data points.
• Summary of most utilised malnutrition measures across the nutrition care pathway.

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Summary of frequently used international quality measures for malnutrition across the Nutrition Care Process pathway

Screening

• Malnutrition screening rate
• Rescreening compliance

Assessment

• Use of validated assessment tool
• Time to assessment

Diagnosis

• Malnutrition rates / prevalence
• Use of validated malnutrition diagnostic tool

Care plan / Intervention / Treatment

• Use of Nutrition care plan documents
• Nutrition care treatment meets complete nutritional needs

Monitoring & evaluation

• Monitoring of food intake
• Resolution of nutrition diagnosis statements
• Track / shorten hospital length of stay
• 30-day readmission rate

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Next Steps

• Create well defined, feasible measures in collaboration with each workstream.
• Each measure will need a clear definition of who is included, what is being measured, when it is measured and where the information comes from. Where possible, results should also be compared across different population groups, healthcare settings and regions to help identify inequities.
• Develop practical platform(s) and reporting mechanisms.

The MCANZ workstreams are guided by a Steering Group, which provides strategic oversight and helps ensure the work reflects clinical, community and health system needs across Aotearoa New Zealand.

Workstream Chair

• Laura Cheadle, MSc Nutrition and Dietetics, NZRD

Members

• Maz Black NZRD, PGDipDiet
• Jo Stewart, NZRD, Dip HSc, PGDip Community Nutrition.
• Lisa Henderson, NZRD, MSc

Past member: Dr. Catherine Wall, PhD, NZRD