Standards of care: an innovative approach.

Clinical nutrition services at the Henderson General Division of Hamilton Civic Hospitals has taken a unique approach to standards of care. The Henderson General Division Standards of Care (HGDSC) focus on important issues in the evaluation of care including the goals, intensity and outcome of care. The HGDSC are based on populations defined by the level of nutrition care required and can easily be applied to patients with multiple medical and nutritional concerns. The standards operate under the premise that the process and intensity of care are determined by the goals of care. Thus, the standards assist in the delivery of equitable care to patients of similar nutritional risk. The goal-oriented focus of the standards is a benefit as the impact of nutrition care can be measured using the goals of care as expected outcomes. Outcome measures are considered important in the measurement of quality care since they focus on the patient's health status after intervention. The changing focus of health care in hospitals makes the identification of valid process criteria a priority for clinical dietitians. The purpose of this article is to provide insight into the unique features of the HGDSC and to explore the benefits of standards that focus on the goals and outcomes of nutrition care.