Dietitian - Inpatient

About the Role

Provides ongoing Medical Nutrition Therapy (MNT) care for the entire hospital inpatient census through screening, prioritizing, assessing, and recommending interventions. Adapts daily workflow to accommodate fluctuations in patient load due to census variations, consults, acuity, and staffing challenges.

Responsibilities

• Develops and implements a plan of care for patients based on an expert assessment of life cycle- and diagnosis-specific nutritional needs, including reviews of medical history, laboratory data, patient interviews, and physical examinations.
• 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, micronutrients, fluid, and electrolytes. Evaluates patient tolerance and effectiveness of formulas and manages modifications to enteral/parenteral regimen orders.
• Demonstrates extensive knowledge of specialized nutrition support (parenteral and enteral) and collaborates with physicians and pharmacy to triage issues and concerns.
• Communicates with the system-level Pharmacy Integrated Clinical Services (PICS) team to manage and order Total Parenteral Nutrition (TPN) infusions for critically ill patients.
• Prescribes orders for therapeutic diets, oral nutrition supplements, and nutrition support regimens, including vitamins/minerals, fluid management, and lab work within the scope of the MNT protocol.
• Utilizes order-writing privileges to implement nutrition-related orders and collaborates with the Food and Nutrition patient services team to align patient intake with the nutrition prescription.
• Partners with the patient services team to recommend appropriate clinical nutrition formula and supplement substitutions during supply chain disruptions.
• Ensures diet restrictions, allergy restrictions, supplement preferences, and tube feedings align with patient needs and personal, religious, and cultural preferences.
• Develops patient-specific menus for complex dietary needs, such as multiple food allergies or numerous diet restrictions.
• Leads efforts to identify, treat, and prevent malnutrition, performing Nutrition Focused Physical Examinations of high-risk patients to evaluate muscle loss and subcutaneous body fat.
• Communicates malnutrition findings to the medical team through medical record documentation to ensure maximized reimbursement.
• Provides medical nutrition therapy education to patients with moderate or severe malnutrition to improve outcomes and reduce inpatient readmission rates.
• Documents elements of the Global Malnutrition Composite Score (GMCS) for CMS Nutrition Electronic Quality Indicators and participates in Quality Assessment Performance Improvement (QAPI) efforts.
• Identifies and documents billable nutrition diagnoses with supporting documentation and may provide clinical support to hospital-based outpatient programs (e.g., cancer center, transplant clinic, digestive health programs).
• Enters charges for outpatient nutrition charge capture in the electronic medical record.
• Precepts dietetic graduate students, medical residents, and provides nutrition orientation and lectures as applicable.
• Collaborates with discharge planners, home health, physicians, pharmacy, and interdisciplinary teams to address priority points protocol for inpatient care and participates in team rounds and care conferences.
• Assists with transition to home or outside facilities by coordinating home enteral and/or parenteral nutrition needs with Care Management and/or Home Health.
• Provides medical nutrition therapy education to patients, outpatients, and family members on prescribed diets through individual counseling and classes.
• Provides clinical input into system clinical nutrition initiatives and participates in system subgroups/projects to develop evidence-based nutrition practices.
• 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/physicians to champion system clinical nutrition initiatives (e.g., dysphagia standards, malnutrition coding changes).
• Assists other sites throughout the state, as needed, to provide clinical nutrition coverage and ensure equitable patient care.

Requirements

• 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) or Certification by the Department of Safety and Professional Services (WI only).
• 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 an Accreditation Council for Education in Nutrition and Dietetics (ACEND) accredited supervised practice program.

Qualifications

• Didactic experience in clinical nutrition from an ACEND-approved program.
• Advanced knowledge in clinical nutrition and Nutrition Focused Physical Exams.
• Ability to respond to the needs of a diverse patient population.
• Excellent communication, interpersonal, 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; exposure to weather-related hazards possible.
• 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.