PD078 - OPERATIONAL CAPACITY MANAGEMENT IN CLINICAL NUTRITION: STRATEGIES TO IMPROVE EFFICIENCY AND QUALITY OF CARE

PD078

OPERATIONAL CAPACITY MANAGEMENT IN CLINICAL NUTRITION: STRATEGIES TO IMPROVE EFFICIENCY AND QUALITY OF CARE

S. M. F. Piovacari^1,*, P. C. M. Oliveira¹, G. G. L. Bergamasco ¹, M. Shima ¹, B. J. Freitas ¹, M. M. D. G. Da Silva¹, M. R. Da Silva¹, I. R. T. C. Salame¹, A. S. C. Pinto¹, S. W. Rovedder ¹, B. G. da Costa¹, E. R. Mello², C. C. Veiga³, C. F. D. Santos⁴, A. M. R. Garcia⁵, M. L. F. de Souza⁵, P. B. D. P. Nogueira ¹, F. W. J. Soares²

¹Clinical Nutrition Department, ²Operational Excellence Department, ³Information Technology Department, ⁴Clinical Practice Department, ⁵Medical and Surgical Department, Hospital Israelita Albert Einstein, São Paulo , Brazil

Rationale: Since 2022, the dietitian workload has increased due to higher bed occupancy, patient turnover, and additional non-clinical assignments. In 2023, the Clinical Nutrition department included 43 dietitians and 15 nutrition technicians, and provided 113,717 nutritional consultations.Therefore, a review of the team’s operational capacity was required to align with patient flow, optimize nutritional care and interdisciplinary practice focused on the patient experience.

Methods: This study was conducted at a private hospital in Brazil, using Lean Six Sigma methodology and following the DMAIC cycle (Define, Measure, Analyze, Improve, Control), from July 2023 to August 2025. The intervention was the development of a new communication workflow between nursing staff and nutrition team (4:00PM–7:00AM) via the electronic medical record, focusing on reducing call volume and improving information security. Customer experience and indicators were monitored, along with the workload of the dietitian team.

Results: Pre-intervention time-motion analysis of the dietitian team showed a workload rate of 103%, above the institutional benchmark of 92%. Dietitians spent 85 minutes/day on non-clinical activities, including pantry-related tasks, and telephone calls, mainly with the interdisciplinary team (28,598 calls/month - 953/day, 1 min 08 sec each, highest volume between 4:00-10:00PM). Following the reassignment of pantry-related tasks and implementation of medical record-based communication, the dietitian workload decreased by 13 percentage points, dietitian satisfaction with workload (structure and process) increased by 44.2 points, and patient complaints dropped by 35%.

Conclusion: Automated communication enhanced efficiency, reduced rework, and improved patient safety and experience. This project highlights the value of data-driven management and continuous process improvement in hospital nutrition care.

Disclosure of Interest: None declared