Background: Hospitalists experience high rates of burnout.  Little is understood about the best way to address hospitalist well-being and resilience in the workplace.  User-centered interviews at our institution identified inadequate access to nutritious food as one of several barriers to a rejuvenating hospitalist experience.  Despite a cafeteria with flexible hours and healthy options, interviewees cited [...]

Background: Food insecurity (FI), the lack of access to nutritious food to maintain an active lifestyle, is associated with poor health outcomes and morbidities in both children and adults. COVID-19 has exacerbated FI and disproportionately impacts communities of color and low-income households. Hospitalization can be an important time to address FI as a social determinant [...]

Background: In Japan, a “super-aged” society, the rate of end-stage dysphagia in the elderly is increasing. Artificial hydration and nutrition (AHN) can be used for such patients, although it may not improve mortality or quality of life. The many downsides of AHN are not always well explained to patients and their families, resulting in routine [...]

Background: Malnutrition, defined as deficiencies or excesses in nutrient intake, is associated with worse short and long-term outcomes compared to similar people without the diagnosis. The ASPEN or GLIM criteria are used to diagnose malnutrition, but these criteria are somewhat vague and measurement standards are typically not objective. The Inpatient Prospective Payment System considers severe [...]

Background: Coffee is a widely consumed beverage. Evidence suggests that coffee consumption is associated with a substantially lower risk of type 2 diabetes (1). However, there is paucity of literature on whether coffee consumption has any protective effect on people who already have diabetes. We sought to examine the association between caffeine consumption and hemoglobin [...]

Background: Obesity affects a large majority of the U.S. population, and hospitalizations may represent opportunities to intervene and promote weight loss.  We sought to determine if multidisciplinary patient-centered inpatient weight loss consults, post-discharge telephone text messages, and primary care follow up could result in weight loss. Methods: We conducted a feasibility study comparing 25 obese [...]

Background: Vitamin B9, also known as folate, is a water soluble vitamin found in vegetables, fruits and animal products that plays a key role in purine and pyrimidine synthesis, nucleoprotein synthesis and erythropoiesis. Deficiency can result from malabsorption, anti-epileptic and methotrexate use, pregnancy, hemolytic anemic, and alcoholism and is implicated in neural tube defects. Signs [...]

Background: Growth faltering or failure to thrive is a common cause of admission in infancy and early childhood. In the United States, approximately 2-10% of children experience lower-than-expected growth associated with malnutrition (Tang et al). Growth faltering accounts for 3-5% of pediatric hospitalizations (Mazze et al, 2019). Malnutrition is associated with complications of increased risk [...]

Background: Malnutrition affects up to 30% of inpatients, but is rarely diagnosed. This leads to under-treatment and poor patient outcomes including: infections, pressure ulcers, and poor wound healing. In the MS-DRG system, malnutrition is considered either a major complication/comorbidity (MCC) or a complication/comorbidity (CC), depending on specificity and severity. Therefore, missed diagnoses significantly impact patient [...]

Background: Many hospitalized adults arrive with pre-existing malnutrition, which is associated with high risk of adverse outcomes. As such, malnutrition is a common variable in cost and quality risk adjustment models based on hospital discharge diagnosis codes. Hospital dietitians assess patients for malnutrition and generally document the details of their evaluations. However, coding professionals cannot [...]