COMMITMENTS & NEXT STEPS

TURKISH SOCIETY OF CLINICAL NUTRITION

TURKISH SOCIETY OFCLINICAL NUTRITION

Meltem HALIL

General Secretary of KEPAN

Geriatrics Society of Turkey

Learnings from yesterday

• Compose national prevalence data of DRM– Per health care setting if possible

• Show the economic burden of DRM on health care system, develop national pharmacoeconomy data

Learnings from yesterday

• Use media– Become popular– Public service announcement– press

• Convince politicians that DRM is also one of their problem, they have to pay for screening and treatment of DRM, to make them face with public

Learnings from yesterday

• Use patients and patient societies to reinforce health care professionals to screen MN

• To ensure multi-stakeholder invovement

Optimal nutritional care for all

Education

Public health

Implementation

Undergrad Postgrad

Nutrition DayHospital ICU Oncology Care home

Public awareness

National nutrition plan

Hospital Care home CommunityTrained Staff

Screening

Care plan

Medicalnutrition

Stakeholder groups

Multi-stakeholder

PEN

Ger Medicine

Paediatricians

Patients

Dietitians

Nurses

Pharmacists

General practice

Hospital

Health insurance

Industry

Politicians

Media

Policy and standards

Screeningpolicy

Standards/quality indicators

Audit

Hospital Care home Community

Guidelines

Screening

Hospital Care home Community

Intervention

Dietitians

Medics

Nurses

Pharmacists

Economic data

Cost DRM

Value ofintervention

Presence Engagement

Prevalence DRM

Hospital Care home Community

Reimbursement Hospital Care home Community

Malnutrition

Services

ONS

Tube

PN

TURKEY

Malnutrition risk for Inpatients > 65 yrs Malnutrition risk: 33.5 % Malnutrition :13.5%Malnutrition for Pediatric population:2-6 years children: malnutrition risk: 31.8%Age <5 years: malnutrition: 24 %

Priority actionsShort and mid term targets

• Create and implement a screening policy for inpatient in clinics with collaboration of authority (Public Hospital Alliance)

• Making screening and nutritional treatment as a part of Quality Indicators of Public Hospitals

Priority actionsShort and mid term targets

• Show the burden of malnutrition to healthcare system and increase awareness of benefit of medical nutrition

• Nutritional screening results has to be involved in patient records for reimbursement

• Keep on going current reimbursement status

Priority actions-Long term

• Create and implement a screening policy for outpatients with collaboration of authority (Public Hospital Alliance)

• Implement regular screening for care home residents

• Establish a care home policy for nutritional support

• Involve GP’s

KPI’s;

• Number of hospitals that have screening policy– For the first year 29 hospital

• To compare the number of patients that have DRM between hospitals that have policy or not

• Provide nutrition as a quality indicator of a hospital– Provide audit by the authority

• Increase the number of hospitals having nutrition teams

KPI’s;

• Number of relevant societies involved in the project (1 year)– Family practitioners’ society– Oncologic society– Neurology– Home care– Nursing society– Pediatric gastroenterology– Society of celiac disease

• Number of stakeholders from government (1 year)– Ministry of family and social policy– Department of public health

KPI’s; prevention of malnutrition/public awareness

• Involve GP’s • Involve patient organizations

• To maintain the continuity of nutrition in media to aware public– Public service announcement

KPI; training

• Number of LLL courses (12 live modules/year)• Specific training programs for each

professional groups (GP, nurse, neurology)• Specific training programs for Pharmacist in

hospitals