Identifying patients at nutritional risk and determining clinical productivity: essentials for an effective nutrition care program.

The primary purpose of this article is to establish procedures for identifying patients at nutritional risk, determining diagnosis-related groups, and measuring clinical productivity, therefore establishing staffing needs. Two studies were done to identify patients at nutritional risk: a 1-day survey of the medical/surgical units and a prospective-retrospective chart study. These studies determined which patients were at risk and the DRG category. Thirty percent of the DRGs had documented nutrition intervention. Clinical productivity was measured during a 4-week time management study. Staffing needs were determined from the data collected, from the percent of patients deemed at risk, and from an analysis of the time study. Dietitians were assigned to those patients identified as high risk and dietetic technicians assigned to patients at moderate nutritional risk. Although there is a need for standardization of nutrition care, it must be emphasized that each institution has special requirements because of its particular patient population and the philosophies of the dietary and medical staff.