Published on March 18, 2010
Community Hospital ‘Best of the Best' in critical care nutrition
MONTEREY, Calif. - Community Hospital of the Monterey Peninsula earned a "Best of the Best" award - the only one received by a U.S. hospital - in an international research survey of the best practices for providing nutrition to critically ill patients.
The award is based on information collected in the annual International Nutrition Survey, sponsored by the clinical research group Critical Care Nutrition. Community Hospital ranked 7th among the nearly 152 institutions worldwide that took part in the survey and was the highest-ranking U.S. hospital and the only one to place in the top 10.
"This is significant because providing the appropriate nutrition improves recovery among critically ill patients," says Dr. Michael Smith, chief of the medical staff at Community Hospital. "These patients get out of the ICU quicker, go home sooner, and recover more fully."
Critical-care nutrition involves providing nutritional support to patients who can't eat any food or enough food because of an illness or surgery. Nutrition may be provided through tube feedings directly into the digestive tract or through an intravenous solution. Specially trained clinical staff members determine the amount, type, and delivery system for each patient, with the goals of improving health, minimizing infections, and enabling patients to live as normally as possible.
"It is challenging because there can be so much going on with these patients," Smith says. "They are on multiple medications, undergoing many tests, and may be so sick that their digestive system isn't working. Our nutrition support team takes everything into consideration to come up with the best individual nutritional support plan."
"We have been using this team approach for almost 30 years," he says, "and it's what's enabled us to be so successful, as demonstrated by the survey results."
Cheryl Sabillo, a registered dietitian and certified nutrition support clinician, directed Community Hospital's participation in the survey. Hospitals collected information on a minimum of 20 adult patients who were in intensive care units and on mechanical ventilators to help them breathe. The information collected included patient characteristics, type and amount of nutrition received, blood sugar levels, length of hospital stay, and recovery details.
Participating hospitals received a performance report highlighting strengths and weaknesses in comparison to other ICUs. The top 10 sites that met the award eligibility criteria received the "Best of the Best" award. As a "Best of the Best" winner, Community Hospital now becomes a model for other ICUs.
"The survey is really a quality improvement initiative," Sabillo says. "It is a systematic way to collect information from a variety of institutions in different countries on current nutrition practices. The results enable our clinical nutrition team to compare our practices to other practices. Such comparisons illuminate differences, highlight strengths and weaknesses, and, hopefully, lead to improvements."
As the international study is repeated annually, changes in nutrition practices over time can be monitored and informed decisions can be made regarding the direction of future research studies and collaborations.
Information from the 2009 survey will be published in a peer-reviewed journal. It also was presented at the American Society of Parenteral and Enteral Nutrition (ASPEN) Clinical Nutrition Week in Las Vegas in February. Community Hospital was represented at the conference by Sober, Sabillo, and Janna Dreisbach, a registered dietitian.
"All of the clinical dietitians and critical care doctors and nurses at Community Hospital consistently set their sights high," says Debbie Sober, director of the Intensive Care Unit (ICU). "They truly are the best of the best."
Community Hospital of the Monterey Peninsula, founded in 1934 and located at 23625 Holman Highway in Monterey, has grown and evolved in direct response to the changing healthcare needs of the people it serves. It is a nonprofit healthcare provider with 205 staffed acute-care hospital beds and 28 skilled-nursing beds, delivering a continuum of care from birth to end of life, and every stage in between. It serves the Monterey Peninsula and surrounding communities through 15 locations, including the main hospital, outpatient facilities, satellite laboratories, a mental health clinic, a short-term skilled nursing facility, Hospice of the Central Coast, and business offices. Find more information about Community Hospital of the Monterey Peninsula at http://www.chomp.org/