The Missing Link: Improving Cancer Outcomes Through a Structured Nutritional Quality Improvement Program

Area of Science:

• Oncology
• Quality Improvement
• Nutritional Science

Background:

• Malnutrition and weight instability are prevalent and under-recognized issues in cancer patients undergoing active treatment.
• Treatment toxicities, metabolic changes, and psychological distress contribute to reduced intake and unintentional weight loss, negatively impacting treatment tolerance, survival, and outcomes.
• A pre-intervention review at AFHSR revealed a significant gap in systematic nutritional screening and management.

Purpose of the Study:

• To implement and evaluate a structured quality improvement program to enhance nutritional care and improve weight stability in cancer patients.
• To address the identified care gap in systematic nutritional screening, referral, and proactive management of nutrition-related symptoms.

Main Methods:

• A structured quality improvement approach using root cause analysis and Pareto analysis to identify and prioritize modifiable causes of weight loss.
• Implementation of iterative FOCUS-PDSA (Plan-Do-Study-Act) cycles, including nutritional screening, education, individualized counseling, oral nutritional supplementation, and pharmacologic management.
• Data analysis using IBM SPSS Statistics to assess weight stability, process capability, and patient satisfaction.

Main Results:

• A total of 141 patients were enrolled; 106 (75%) maintained stable body weight, and control charts showed improvement in weight stability from approximately 80% to a mean of 93.6%.
• The intervention demonstrated high process capability (Cp=2.809, Cpk=2.541) for weight stability, with capable and well-centered processes for analyzing >3% weight loss and gain.
• Patient satisfaction with nutritional education, oral supplementation, and the overall nutrition service was high.

Conclusions:

• A structured, multidisciplinary nutritional support program significantly improved and sustained weight stability in patients receiving active cancer treatment.
• The intervention achieved statistical control, high process capability, and consistent adherence, proving its value as a cost-effective and sustainable quality improvement strategy.
• Enhanced nutritional care positively impacts patient outcomes and tolerance during cancer therapy.