Thursday, October 30, 2014

The Strategy That Will Fix Health Care

This article combines two interesting things we have learned about this semester. It talks about healthcare providers working as a team and outcomes measurement to improve overall care. According the this article from the Harvard Business Review, with the future of health care hanging in the balance of "Obama-care" and other health care ideas, it is more important than ever to make sure that hospitals are "achieving the best outcomes at the lowest cost".
Cleveland Clinic has actually been a ground-breaker in taking large steps to make their outcomes as high as possible while still keeping cost to stockholders, insurance, and patients as low as possible. This was done by instituting IPUs. IPUs (Integrated Practice Units) should be made up of anyone who had a hand in the healthcare of the patient including but not limited to doctors, surgeons, dietitians, nurses, and pharmacists. The unit is usually in one place, or is very close to a central location so that the patient does not have to drive hours to get to an appointment.
The backbone to this concept is creating a new system. The article says something along the lines of instead of hiring people to help navigate a messy health care system, simply change the system to be easier on everyone. The new concept also stresses the importance of measuring outcomes. Most doctors have no idea what happens to their patients in the weeks of them leaving the hospital, but this could have serious consequences. Teams need to communicate to make sure that all are aware of any changes in the patients health. Finally, this concept focuses on making sure the right person is doing each job. To quote the article "Virginia Mason Hospital found that it costs $4 per minute for an orthopedic surgeon or other procedural specialist to perform a service, $2 for a general internist, and $1 or less for a nurse practitioner to physical therapist. In light of those cost differences, focusing the time of the most expensive staff members on work that utilizes their full skill set is hugely important".

I think that this is a concept that managers in different departments of hospitals should really be aware of and push for. It can only do them and their facility good to streamline care in a way that is beneficial and more cost efficient for everyone.


The Strategy That Will Fix Health Care. (2013, October 1). Retrieved October 30, 2014, from

How to Explain the Role of Dietitians to the Public

This article discusses the important role of dietitians in hospitals and food service. Although most of us are familiar with this, it is a great review of all the roles that an RD is able to take part in to help with patient care. This article would be a good resource to help explain the role of a dietitian to the general population when trying to promote services such as outpatient programs.
 Another unique aspect of this article is that it talks about methods this hospital uses to find potential employee for these positions such as college fairs and social media. As a clinical nutritional manager, it is important to pay attention to the hiring trends of dietitians. This article was found on job search site, which may not be the first place that a CNM may look for this information. But it is important for CNMS that play a role in hiring to see what information is available to those that are looking for jobs. The link below provides more information on the article:




Wednesday, October 29, 2014

Leadership: A recipe for success

     CNM's or leaders are often given a chance to broaden their skills in management. Barbara Pyper's article on Leadership: a recipe for success,  expands not only on how to be an excellent leader but the opportunities that are available to leaders. During the Kent State internship The Leadership Challenge is a large part of the curriculum and it was very nice to see others in the Nutrition and Dietetics field using this book. Leaders have responsibility to their employees and an excellent leader can use these 3 principles to be an excellent leader: 1) 100% responsibility, 2) responsiveness to others and 3) clarity. It is very important for leaders to take responsibility to solve goals, respond well to others with respect and to make sure that you are clear in your goals. Pyper goes over the top 15 leadership characteristics: 1) Honesty 2) Competent 3) Inspirational 4) Intellectual 5) Fair-Minded 6) Broad-minded 7)Creative 8) Integrity 9) Harness and Enable Talent 10) Visionary 11) Concerned 12) Results-Based 13) Effective Communicator 14) Courageous 15) Self Leadership
        There are many tools that can be used especially the Academy's professional leadership training that provides dietitians with a checklist for success. There are multiple opportunities for a leader to assess themselves to better their knowledge and skills to be a better leader. These opportunities are not only beneficial to the leader but also it is important to the employees that the leader is over.

Pyper, B (2013). Leadership: A Recipe for Success. Future Dimensions in Clinical Nutrition Practice. 
This article was found on the Academy's Clinical Nutrition Manager listserv

- LN

Tuesday, October 28, 2014

Continuous Quality Improvement Process

In 2001, the University of Mississippi decided to work on improving quality in school nutrition services in the area. They wanted to get away from old and outdated procedures, improve and empower their employees work process, and really blow away customers with their product. To do this, they created a six step process called the Continuous Quality Improvement Process (CQI).
To use the CQI process, a team needs to be assembled. This team should include each part of the food service team (school nutrition managers, supervisors, and staff). As time goes on, others can be added to the team. They recommend principles, students, teachers, parents, or custodians as possible members.
In this six step process, the team needs to figure out what can be improved on and what really needs to be changed. The following questions are suggested to find areas of improvement:
-What is the problem?
- When does the problem occur?
- Where does the problem occur?
- Why does the problem occur?
- Who does the problem affect or who is involved in the problem?
- How is this a problem?
By asking these questions, the team can evaluate what problems are most relevant, what the current focus should be, and what issues can be dealt with later. Then, the cause of the problem needs to be addressed and an action plan needs to be developed and implemented. Results need to be evaluated to see if the process is working. However, this is not the end. In the CQI process, results need to be analyzed on a cyclic basis to ensure that the process is still up to date and working optimally.
I think that this article is an amazing tool for anyone who is looking to be a manager in school food service. It gives great tools that can be used such as techniques for brainstorming, how to create fishbone and cause and effect diagrams, and an action plan chart as well as step by step instructions to use the process.


Continuous Quality Improvement Process; Tailored for the School Nutrition Environment. (2001).    
        Retrieved October 28, 2014, from

Friday, October 24, 2014

Using Telehealth to Ease COPD Symptoms

New research from Duke University shows telehealth sessions may help reduce symptoms associated with chronic obstructive pulmonary disease, or COPD, and improve quality of life. The study, INSPIRE-II, was conducted over a 5 year period at Duke University Health System and The Ohio State University. One group of 147 patients with COPD was provided with counseling by a psychologist over the phone on stress management and relaxation techniques. A second (control) group of 151 patients with COPD received only medication and nutrition counseling. According to the article on the website Pharmacy Times, “by the conclusion of the study, those who received information on managing reactions to stressful events reported improvements in depression, anxiety, fatigue, and shortness of breath compared with control subjects” (Pharmacy Times, 2014).

The article goes on to say that there was no difference in hospitalization or deaths caused by COPD between the two groups of patients.

Although this study did not explore telehealth directly related to dietetics, it is still promising to see that telehealth was effective in delivering healthcare. Telehealth is a relatively new concept, so it is great for healthcare practitioners who are adopting this technique to approach it with an evidence-based background.

Pharmacy Times. (9, October 2014). Telehealth stress management intervention may reduce COPD symptoms. Retrieved from


New Recommendations for Diabetes Screening

Earlier in October, the United States Preventative Services Task Force amended its recommendations on screening for diabetes. Under the new recommendations, screening for diabetes and prediabetes would be performed on all adults over age 45. The recommendations also encouraged uniform insurance coverage for these screenings in order to help families have access to such life-changing services.

It's no secret that detecting diabetes early enough can help patients get the diet and lifestyle education they need, which could possibly reverse the course of the disease. Early detection and medical nutrition therapy from Certified Diabetes Educators has also been proven to save significant taxpayer dollars and cut health care spending.

This focus on preventative medicine is a trend that isn't going to go away anytime soon, and dietitians are fortunate to be on the forefront of providing such preventative care.

As future clinical nutrition managers and clinical dietitians, justifying our jobs is something we're constantly going to have to be able to do. In the coming years, I think we're going to see more and more research on the many ways that preventative care can save lives and money, and this research is only going to encourage hospital administrators, physicians and other healthcare professionals to value and utilize dietitian services in a multitude of ways.

- AP

October 24th is Food Day

Today is Food Day, the 4th annual celebration of real food and a day to encourage a push for improved food policies. Food Day was started by the Center for Science in the Public Interest, but it has since expanded to include organizations from all sectors that are interested in food and nutrition.

The 2014 Food Day advisory board includes senators and members of the House of Representatives, chefs, professors, public health officials, and Pat Babjak, the CEO of the Academy of Nutrition and Dietetics. 

This year, some of Food Day's national priorities aim to promote safe and healthier diets and to reduce hunger, which are two things that future dietitians should have no problem getting behind. We always encourage patients and clients to choose whole foods over processed meals and dietary supplements, which is one of the hallmarks of Food Day. Additionally, it's a good reminder for us to stay involved in public policy, as laws and regulations can have a resounding impact on the ways we're able to practice and the foods that we eat daily.

Events like Food Day are a great way for dietitians and CNMs to get involved in their communities, not only as a way to promote healthy eating, but to make themselves known to the community as the leading experts on health and wellness.

- AP