Q. What’s so different about Dietary Difference?
A. Dietary Difference provides exceptional, full-spectrum Nutrition Care Management services meeting all state and federal guidelines for LTC facilities. The Dietary Difference Consulting System ensures that your consultant has been trained to follow our proprietary protocols that are designed to streamline their work and leave more of their time available for collaboration with your staff and residents. Our hands-on approach is based on the theory that relationships improve outcomes. Our consultants build relationships with your staff, your residents, and their families, with a focus on service. Our job is to make everyone’s life a little easier, including yours! We take the time to learn about your facility’s culture and unique needs, then orient our consultant to your facility so they are prepared to fit seamlessly into your team as an active, accountable, indispensable member.
Q. What can we expect from the start-up transition?
A. A member of our management team will meet with your administrator and director of nursing to determine your priorities and what you feel are your greatest challenges. Within the first few weeks of service we will conduct several audits:
- A comprehensive Kitchen Sanitation Inspection
- Menus and FNS budget
- Resident weight histories and significant weight changes
- Tube feed formula and supplement use
- Diet orders and tray card accuracy
- Any other areas you feel require our attention
We will initiate our weight and supplements protocols (see below) and bring in your consultant dietitian. A Dietary Difference manager will work with your FNS manager/chef and our consultant until we feel that the transition is established.
Q. What is your weight protocol?
A. The way we manage weights is unique in our industry, and is the foundation of our approach to nutrition care management. A significant weight change is often the first indicator of a change in health status. Additionally, inaccurate weights can skew your quality measures.
Our first step is to do an assessment of each resident’s prior six month weight history, striking out obviously questionable weights so they are no longer used for comparison. We calibrate every scale, initiating scale maintenance as needed.
Ongoing weight management in your building consists of three parts:
- Monthly Weight Monitoring. Your consultant will supervise your staff in obtaining monthly weights to ensure they are accurate and completed in a timely manner. Post-dialysis weights will be obtained for comparison. Any questionable weights will be redone for confirmation. You will receive a monthly report detailing a six-month weight history, weight changes at 30/90/180 days, ideal body weight and BMI status for every resident in your building. Your consultant will provide this report as soon as weights are completed in a format that may be shared with doctors, nurse practitioners and other interested members of your interdisciplinary team.
- Significant Weight Change Report. You will also receive a monthly report detailing the rationale for each weight change, current and new interventions and documentation dates so you can be sure of compliance with state regulations.
- Weekly Weights. Your most at-risk residents will be weighed weekly, including all tube fed residents, newly admitted/readmitted residents, those with acute significant weight changes or other conditions requiring monitoring. This enables your consultant to determine the effectiveness of interventions and helps identify problems with appetite, diet tolerance and fluid overload.
Once established, this protocol can actually reduce the number of significant weight changes and results in a higher quality of overall nutrition care.
Q. Our supplement use is out of control and is too expensive. What can you do about it?
A. This is one of our key areas of focus. We phase out products that are ineffective or not well liked by your resident population, streamlining your formulary. We order high-calorie enteral formulas for tube feeding, and a high -protein powdered product for skin support. We taste-trial supplements with residents before ordering to ensure acceptance, and review each resident’s supplement orders at least quarterly to determine ongoing need. With this approach and ongoing attention to minimizing supplement use with a food-first philosophy, we are able to achieve significant cost reductions.
Q. How much does it cost / how much can we save?
A. Our service is unparalleled in the industry, yet we can meet or beat the prices quoted by our competitors. If your dietitian is an employee, we can transform you current expense into an investment. With implementation of our 6-Point Cost Reduction Program, a 60-150 bed facility can save $1,500-$6,000 per month.
Q. What about Surveys and Quality Measures?
A. Our clients have had a near-perfect record for the past 10 years. We provide as little or as much assistance as you require and guarantee support when surveyors are on-site. We can assist in developing and executing QAPI programs, based on the specific needs of your facility. Our weight loss quality measures are consistently among the lowest in the state, well below the national average.
For more information or to schedule an appointment, call Lynn at 513-675-2720