Quality Initiatives

The Academy aims for RDNs to support and incorporate organizational quality initiatives, with internal and external stakeholders including projects and deliverables for measures, improvement, and standards in all practice settings and RDN leadership roles.

Global Malnutrition Composite Score

The Academy's stewarded quality measure, Global Malnutrition Composite Score encourages accountability to advance screening, assessment, diagnosis, and developing a care plan for hospitalized adult patients found to be malnourished and at risk for malnutrition. The GMCS combines components of the four malnutrition electronic clinical quality measures to score hospitals on identifying and treating malnutrition and improving care before transitioning patients to the next appropriate setting. Review the eCQMs FAQs to learn more about why the malnutrition measure matters to your hospital.

In December 2020, the Centers for Medicare and Medicaid Services published the final 2020 Measures Under Consideration List with the inclusion of the MUC20-0032 Global Malnutrition Composite Score.

Then, on June 24, 2021, the GMCS was endorsed by unanimous vote of the National Quality Forum Consensus Standards Approval Committee. NQF endorsement indicates a measure is "best in class" and brings the GMCS one step closer to a CMS federal program adoption.

CMS Improvement Activity

The improvement activity, "Implement Food Insecurity and Nutrition Risk Identification and Treatment Protocols," was included in the CY 2022 Physician Fee Schedule Proposed Rule July 13, 2021.  (See pgs. 1695-96) for participation in the Merit-based Incentive Payment System (MIPS).

The CMS classifies the improvement activity as Subcategory Achieving Health Equity and focuses on creating/improving and implementing protocols to identify and provide support to patients with or at risk for food insecurity and patients with or at risk for poor nutritional status. Implementation actions include: using the Malnutrition Quality Improvement Initiative (MQii) quality measure and MQii Toolkit; updating clinical decision support resources within the electronic health record; applying requirements for staff training on food security and nutrition; and engaging with community partners to facilitate referrals.

Activities must be focused on patients at greatest risk for food insecurity and/or malnutrition, i.e., patients with low income who live in areas with limited access to affordable fresh food, or who are isolated or have limited mobility.

Practice Tips Addressing Food and Nutrition Insecurity for RDNs and NDTRs are available that discuss a variety of practice settings, regardless of MIPS participation. (See PRACTICE TIPS: Addressing Food and Nutrition Insecurity and review the steps to identify and address Food Insecurity and Malnutrition.)

Member External Collaborations

To promote the RDN as the nutrition expert, the Academy facilitates external quality measures and standards' collaborations with members. Read more about current quality measure and standards collaborations.

NQF Action Team on Virtual Healthcare Quality

The Academy joined colleagues and leaders from the National Quality Forum member organizations in the Action Team on Virtual Healthcare Quality, a forum to promote high quality virtual care by identifying key facets of measuring and improving virtual healthcare quality and sharing best practices. The Action Team released an Issue Brief outlining their recommendations.