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eCQMs Frequently Asked Questions

The availability of electronic clinical quality measures in the malnutrition space is a tremendous opportunity to advance patient/client nutrition care. The development of the eCQMs and tools to support implementation is one of the most innovative initiatives undertaken by the Academy of Nutrition and Dietetics, which is poised to support RDNs and NDTRs as they engage with interprofessional colleagues to implement these measures. Learn more about eCQMs by clicking on the frequently asked questions listed below:

Electronic clinical quality measures are quality measures that use data from your electronic health records and/or health information technology systems to measure healthcare quality. Measuring and reporting eCQMs helps to make sure that care is delivered safely, effectively, equitably, and timely. The Centers for Medicare & Medicaid Services oversee the selection process for eCQMs and use them in quality incentive programs for publicly reporting data about quality. CMS is considering malnutrition eCQMs as one set of measures available for voluntary quality reporting in the future.

Currently there are no malnutrition measures available for reporting. The malnutrition measures are unique because:

  • they can be collected electronically
  • they were developed with a set of implementation tools available to anyone who implements the malnutrition measures

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The Academy of Nutrition and Dietetics and Avalere Health (a healthcare advisory services firm) developed the eCQMs in an effort to address gaps in existing malnutrition care and to impact patient/clients outcomes., The eCQMs are evidence-based and focus on patient/client-driven centered care for hospitalized older adults (age 65 and older) who are malnourished or at-risk for malnutrition. Support for the MQii was provided by Abbott.

Hospitals implementing these eCQMs have been better able to use data-driven approaches to identify and treat malnutrition in their patient/client populations.

Malnutrition poses a significant burden on health systems and has devastating consequences for patients. As many as 33-54% of patients are at risk or malnourished upon hospital admission and yet data suggests that only 5-7% are diagnosed.

It is well documented that malnutrition is associated with adverse outcomes such as impaired wound healing, muscle-wasting and increased risk of complications and mortality resulting in longer hospital stays, readmissions, and increased costs.

These poor outcomes result in higher annual costs for the healthcare system. It is estimated that the economic burden of malnutrition is $157 billion annually, with $51.3 billion of that amount being associated with older adults.

These eCQMs are an effective tool for dietitians to document the burden of malnutrition within facilities as well as the positives outcomes that are realized when malnutrition is identified and treated. They present significant leadership opportunities for dietitians to assist in improving the quality of patient/client care.

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The eCQMs are driven by the Nutrition Care Process model allowing for the identification of areas where your hospital's workflow processes could be enhanced to ensure patients/clients are getting the best, most timely care.

Before the introduction of the eCQMs, tracking patients/clients as they moved along the NCP was very challenging. The use of eCQMs will also create an opportunity to determine where the NCP model in your facility can be strengthened and patient/client care can be improved.

By championing the implementation of these eCQMs at your facility, this is your opportunity to showcase the important role dietitians play in your institution and the benefit to patients/clients of providing high quality malnutrition care. It will also emphasize the critical role of the dietitian within the interprofessional clinical care team as we can help improve patient outcomes and achieve hospital quality performance targets for readmissions, hospital acquired conditions and costs through quality malnutrition care.

There are four key steps you can take to champion implementation of the eCQMs at your hospital. The Malnutrition Quality Improvement Initiative (MQii), a collaborative effort that supported creation of the eCQMs, has developed tools and resources to assist you in the key steps outlined below:

Step 1: Seek support from nutrition department colleagues, with your hospital's quality department, and your institution's leadership.

Step 2: Convene an interprofessional multidisciplinary team to partner with you on this effort as you seek to understand, map, and modify your existing clinical workflow.

Step 3: Work with your interprofessional team to implement or refine existing quality improvement activities to assess your clinical workflow and use the eCQMs to monitor improvement.

Step 4: Create a system to track and communicate gains and achievements made by you and your colleagues to improve the quality of malnutrition care.

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The most critical step will be to engage senior leaders at your facility. Equally important will be to engage support from your IT team. This is paramount to ensure the ability to successfully report on the malnutrition eCQMs. Collaborating with your IT team to ensure they understand why and how to support you in your requests.

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In the future, hospitals will be able to report on patient malnutrition screening, nutrition assessment, malnutrition diagnosis, and development of a nutrition care plan as part of their quality improvement initiatives. This is a critical step that will address important malnutrition care gaps and ensure malnourished patients are properly identified and treated. Treating malnutrition can support better outcomes regardless of underlying patient/client conditions.

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