Dietitian - Inpatient

Major Responsibilities

• Daily, provides ongoing Medical Nutrition Therapy (MNT) care for entire hospital inpatient census, through screening, prioritizing, assessing, and recommending interventions. Adapts daily workflow to accommodate fluctuations in patient load due to daily census variations, consults, acuity, staffing challenges. Develops and implements a plan of care for patients based on an expert assessment of life cycle- and diagnosis-specific nutritional needs. Assessment includes reviews of medical history and laboratory data, patient interviews, and physical examinations to determine the current nutritional status of inpatients and/or outpatients. Based on the assessment, the Clinical Dietitian develops and implements individualized nutrition plan of care interventions. Documents medical nutrition therapy plan of care in the electronic medical record supporting system clinical documentation and coding standards to maximize reimbursement rates.
• Prescribes enteral and parenteral nutrition support orders by assessing the patient and calculating macronutrients and/or micronutrients, fluid, and electrolytes. Evaluates patient tolerance and effectiveness of formulas and manages initiation or modifications to enteral/parenteral regimen orders. The Clinical Dietitian demonstrates extensive knowledge of specialized nutrition support (parenteral and enteral) and triages issues and concerns through collaboration with physicians and pharmacy. Constant, secure communication with system level Pharmacy Integrated Clinical Services (PICS) team to manage and order Total Parental Nutrition (TPN) infusions for critically ill patients in the hospital.
• The Clinical Dietitian prescribes orders for therapeutic diets, oral nutrition supplements, and nutrition support regimens, including vitamins/minerals, fluid management, and lab work as indicated within the scope of the Medical Nutrition Therapy (MNT) protocol. Utilizes order-writing privileges to implement nutrition related orders. Collaborates with Food and Nutrition patient services team to ensure patient intake aligns with nutrition prescription and interdisciplinary plan of care. Partners with site patient services team to identify and recommend appropriate clinical nutrition formula and supplement substitutions during supply chain disruptions to reduce and eliminate significant disruptions to patient care. Partners with physicians, nursing, and nutrition patient services to ensure diet restrictions, allergy restrictions, supplement preferences and tube feedings are consistent with patient needs and personal, religious, and cultural preferences. Develops patient-specific menus for patients admitted with complex dietary needs (e.g., multiple food allergies, numerous diet restrictions, and/or low-use, high risk diet orders).
• Leads efforts to identify, treat and prevent malnutrition. Performs Nutrition Focused Physical Examinations of high-risk patients to evaluate the loss of specific muscles and subcutaneous body fat to determine the presence of and degree of malnutrition. Communicates findings to the medical team through medical record documentation to ensure maximized reimbursement. Provides medical nutrition therapy education to patients identified with moderate or severe malnutrition to improve patient outcomes and to positively impact inpatient readmission rates.
• Routinely documents elements of the Global Malnutrition Composite Score (GMCS) for Medicare and Medicaid Services’ (CMS) Nutrition Electronic Quality Indicators. Participates in Quality Assessment Performance Improvement (QAPI) efforts to ensure nutrition care is safe and effective for patients. Maintains regulatory readiness. Supports department clinical initiatives to ensure compliance with safety initiatives, policies, and procedures, DNV regulations, and department standards.
• Identifies and documents billable nutrition diagnosis with supporting documentation. May provide clinical support to various hospital-based outpatient medical destination programs (e.g., cancer center, transplant clinic, digestive health programs, bariatric, cardiac rehab, heart failure, etc.) Enters charges for outpatient nutrition charge capture in electronic medical record.
• Supports partnerships with local didactic programs by precepting dietetic graduate students in clinical nutrition and/or foodservice management. Directs and monitors interns’ progress both daily and at designated touchpoints and provides feedback for growth and development. Communicates regularly with didactic program coordinator. Also, precepts medical residents and provides nutrition orientation as applicable. Provides nutrition lectures to medical residents for internal medicine, trauma, NICU/Peds, and family practice, as applicable.
• Collaborates routinely with discharge planners, home health, physicians, pharmacy, and other interdisciplinary teams to address the full scope of the system-established priority points protocol for inpatient care. Participates in interdisciplinary team rounds, meetings, and care conferences to coordinate and collaborate on nutrition goals. Assists with transition to home or outside facilities by partnering with Care Management and/or Home Health to coordinate home enteral and/or parenteral nutrition needs.
• Provides medical nutrition therapy education to patients on prescribed diet, per established priority system, to improve patient knowledge/understanding of nutrition, diet therapy and compliance on prescribed diet. Education is provided to inpatients, outpatients and family members through individual counseling and classes. May provide nutrition in-services to teammates, as applicable.
• Provides clinical input into system clinical nutrition initiatives and practice changes. Participates in system subgroups/projects, as assigned, to develop and implement evidence-based nutrition practices, clinical initiatives and/or practice changes. Partners with system patient services and clinical teams to deploy system changes and updates regarding CBORD, EPIC, menus, emergency preparedness, downtime processes, formulary, clinical procedures, and policies. Liaisons between clinical nutrition and inpatient nursing and physicians to champion system clinical nutrition initiatives (e.g., new dysphagia standards, malnutrition coding practice changes, enteral nutrition equipment changes, malnutrition nurse screening changes, safety protocol changes, etc.) Assists (via in-person or remote coverage) other sites throughout the State, as needed, to provide clinical nutrition coverage to assure equitable patient care.

Licensure, Registration, and/or Certification Required

• Dietitian certification issued by the Commission of Dietetic Registration (CDR)
• Dietitian (RD) registration with the Academy of Nutrition and Dietetics
• Licensure by the Department of Financial and Professional Regulation (IL only)
• Certification by the Department of Safety and Professional Services (WI only)

Education Required

• Minimum of Bachelor's Degree (if CDR registration eligibility is obtained prior to January 1, 2024) or Minimum of Graduate Degree (master’s, practice doctorate, or doctoral) (if initial CDR registration is obtained on or after January 1, 2024)
• Successful completion of Accreditation Council for Education in Nutrition and Dietetics (ACEND) accredited supervised practice program.

Experience Required:

Didactic experience in clinical nutrition from an ACEND approved program.

Knowledge, Skills & Abilities Required:

• Advanced knowledge in clinical nutrition and Nutrition Focused Physical Exams
• Ability to respond to the needs of a diverse patient population.
• Excellent communication and interpersonal skills.
• Excellent organization, decision-making, time management, and problem-solving skills

Physical Requirements and Working Conditions:

• Must be able to sit, stand, walk, lift, squat, bend, reach above shoulders and twist frequently during the work shift.
• Will occasionally be required to lift 25 pounds.
• Must have functional vision, hearing, speech, and touch.
• May need to travel between work sites; therefore, may have exposure to weather-related hazards.
• May need to work remotely and assist other sites as needed.
• Operates all equipment necessary to perform the job.
• Exposed to a normal office environment.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbents may be required to perform other related duties.