Fighting malnutrition in Greece: from idleness to action Key Actions to achieve awareness (and new legislation)
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1 Fighting malnutrition in Greece: from idleness to action Key Actions to achieve awareness (and new legislation) Michael Chourdakis, MD RD MPH PhD Lecturer of Medical Nutrition School of Medicine, Aristotle University of Thessaloniki Happy about your patients? 1
2 Lack of awareness Health care givers State Lack of awareness Health care givers State 2
3 The initiative Increasing awareness Adoption of new legislation Targets Increase awareness towards malnutrition To provide Greek caregivers (doctors, dieticians, nurses, pharmacists) with educational material (e.g. guidelines, modules) in Greek, in a user-friendly and cost-free way Changes in the legislation To persuade politicians to incorporate changes in the Greek legislation regarding Clinical Nutrition issues, that would be mandatory to be followed in every public hospital. 3
4 Adoption of new legislation 4
5 SENPE, MNI Grant 2011 PASYNOD Hellenic Society of Hospital Dietitians Mr. Christos Papavaggelis Mr. Panagiotis Sakellariou HDA GRESPEN Hellenic Dietetic Association Dr. Liana Poulia Ms. Alexandra Koulieri GRESPEN Various members 5
6 Draft of the legislation Ministry of Health involvement FINAL RESULT HDA, PASYNOD, GRESPEN meetings 1 st & 3 rd Health District authorities involvement Consultant: Dr. Anna Papageorgiou Head: Dr. Aris Mousionis Vice: Mr. Syggelakis Clinical nutrition depts. Nutritional Screening to be performed Dietitians gain access to medical records New legislation Guidelines (Nat & Int.) to be followed Nutritional Support Team Specific postdischarge care 6
7 Clinical Nutrition in Public Hospitals: New Legislation Clinical Nutrition Department NS Team Access to medical file for RD Screening Assessment Collaboration with: Ministry of Health Medical Association Dietetics Association 7
8 Referral to dietitian Establish the procedure how to refer a patient/when to consult a dietitian (preferably: <24 h after admission) Establish when the dietetic intervention should have been started (preferably: <48 h after admission) Provide written diagnosis and treatment goals of the dietitian in the medical chart Take care of transfer of dietetic treatment after discharge from hospital Increasing awareness 8
9 UPDATED website NEW material in Greek Continuous educational activities Website (gr/eng/esp) en.grespen.org esp.grespen.org Material in Greek Continuous educational activities 9
10 10
11 New website Material in Greek Continuous educational activities 11
12 ESPEN Guidelines (EN, PN, Paed) ESPEN- ASPEN- Canadian Guidelines comparison Information al material in Greek ESPEN Blue Book LLL e-modules 12
13 New website Material in Greek Continuous educational activities 22 LLL s within 23 months 13 new TTT-LLL teachers ( ) Collaboration with >13 societies >200 new LLL registered users from Greece ( ) >400 participants at LLL s in Greece 2 nd worldwide in LLL webpage hits (2011) 3 rd worldwide in LLL webpage hits (2012) 13
14 Collaborations Hellenic Society for General Medicine Hellenic Society for Atherosclerosis Hellenic Society for Lipidology, Atherosclerosis and Vascular Disease Collaborations Hellenic Dietetic Association Hellenic Society for Pharmacology and Clinical Pharmacology Hellenic Society for Anesthesiology and Intensive Medicine of Northern Greece Hellenic Foundation for Gastroenterology and Nutrition (2013) 14
15 Collaborations Medical Society of Athens (2013) POLSPEN Croatian Medical Association Croatian Society for CLINICAL NUTRITION Universities (Thessaloniki, Athens) Additional actions Memorandum of Collaboration with the 1 st and 3 rd Health district of the National Health System Part of the Belgrade s Fight against Malnutrition Declaration ESPEN Course to be held in Greece in 2017 Host of the Adriatic Club in April
16 Next steps (September 2012) Translation of new legislation into clinical practice Maintenance of increased awareness Malnutrition screening score as indicator for reimbursement at hospitals Reimbursement for treating the malnourished living at home 16
17 17
18 Happy about your patients? Changes observed? 18
19 Another 6 (+7 ) New editions too Additional 3 (+?) +15% 19
20 20
21 21
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24 Educating future doctors Tailor-made education (hands-on) 24
25 Physicians Dietitians Nurses Pharmacists Next steps (September 2012) Translation of new legislation into clinical practice Maintenance of increased awareness Malnutrition screening score as indicator for reimbursement at hospitals Reimbursement for treating the malnourished living at home 25
26 1sr Clinical Nutrition Congress International Conference"Fight Against Malnutrition" 9 th Clinical Course of the Adriatic Club of Clinical Nutrition 26
27 27
28 Fighting malnutrition in Greece: from idleness to action Key Actions to achieve awareness (and new legislation) THANK YOU for your attention Michael Chourdakis, MD RD MPH PhD Lecturer of Medical Nutrition School of Medicine, Aristotle University of Thessaloniki 28
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