Flavor Harvest@HOME

By Katherine Susman | Categories: | Comments Off on Flavor Harvest@HOME

Bank Of America
Allen Foundation
AARP
Blue Cross Blue Shield
Culinary Solutions by LeeSar

Patients 65 or older are often at risk for malnutrition, and some studies have indicated as many as 1 in 3 patients are at risk for malnutrition upon admission, this critical fact is very important to Lee Health since 45% of its patients are 65 or older, where the financial risk to Lee County is significant if the need for nutrition intervention in some form is not identified correctly or initiated early on in the provision of care. Without treatment approximately 2/3 of these individuals will experience a further decline in their health status, and malnourished patients are 2 to 3 times more likely to develop surgical site infection or post-operative pneumonia.
In late 2013 when we assessed our treatment of malnourished patients it was identified that only 1.3% were diagnosed with malnourishment, since we have a significant level of our patient population is considered elderly, we recognized that we were not addressing this medical need and had to change. Initially, the program was piloted at one hospital, once outcomes were validated it was expanded leading us in 2017 offer this program at all acute and post acute facilities we manage. The primary goal of the program is to assist patients in their recovery by facilitating their transition from Acute Care to Self Care through the provision of appropriate nutrition, which when properly administered has proven to improve recovery, limit costs, and reduce readmission rates.

Flavor Harvest@Home is an in home medical nutrition therapy program designed to provide nutritional support for the home bound patients who are either diagnosed and/or at risk for becoming malnourished. Flavor Harvest@Home provides therapeutically appropriate meals to home bound patients recently discharged from the hospital delivered to their doorstep for 4 weeks free of charge. A full array of therapeutic meals covering all meal periods, snacks and beverages are available to patients through either direct intervention by their caregiver, through a nutrition call center. Flavor Harvest@Home is part of the projects 4 component nutritional intervention plan designed to improve patient recovery times. Incorporating many of the Alliance for Advanced Nutrition’s multidisciplinary Nutrition intervention framework, the program includes: (1) nutrient dense food and/or nutrition home meal delivery, (2) nutrition education for clinical providers for better identification of malnourishment risk, improved screening tools and increased nutrition assessment, (3) nutritional counseling with patients and families, and (4) coordination of nutritional care during and after hospital discharge. The Flavor Harvest@Home project is designed to measure the effectiveness of an enhanced interdisciplinary nutrition intervention program on targeted hospital patients with a state of malnutrition or at risk for malnutrition.
Readmission rates in the program participants continue to show improvement and in 2015 through March 2017, 1,259 patients have qualified for the program. To date over 1500 patients have completed the full 4 weeks of meals. This model does require additional clinical staff to expand the service (Registered Dietitians), coordination with providers on identification tools, culinary staff to prepare meals and a resource for home delivery.

This program is a multidisciplinary effort the has required coordination with clinical professionals, Registered Dietitians, providers, Food Service staff and 3rd party contractors. Nursing screens the patients for primary indicators, RD’s assess the patient for malnourishment, RD recommends immediate solutions plus notes in chart the state of malnourishment for the physician who is then at liberty to order the program. Once identified, meals are delivered to the patients home for 4 weeks at no charge, during which time the patient has full access to a Clinical RD for consultation if needed.

• Expansion of FH@Home
o Average age of patients 71, even mix of male and female
o Majority of patients are Medicare eligible
o Oct 2016 – July 2017 – 10 months
 2 campuses CCH and GCMC
 Patients at risk for malnutrition = 1981 patients
 Participation in FH@Home
• 4 weeks of meals = 496 patients
• 1-3 weeks of meals = 163
• Never started program = 345

o Aug 2017 – May 2018 – 10 months
 All 4 acute care facilities CCH, GCMC, HPMC, LMH
• Patients at risk for malnutrition = 3358 patients
• 59 % increase in identification of malnutrition by expanding process to all 4 facilities
• Participation in FH@Home
o 4 weeks of meals = 1075 patients or 32%
o 1-3 weeks of meals = 307
o Never started program = 796
 Largest volume at GCMC and CCH and HPMC falls close behind
 Current volumes to date far exceed those projected by almost 100%, clearly defining the need
 Current patients diagnosed per month average around 350
• Total Oct 2016 – May 2018 – 20 Months

# of patients at risk for malnutrition 5339
# of patients received 4 weeks of meals 1571
# of patients received 1-3 weeks of meals 470
Total Participation of FH@Home 2041
% Total participation 38%