The problem
Good nutrition and mealtime care are essential in hospitals to support health and recovery. Poor nutrient and fluid intake is common in hospital, contributing to hospital-acquired malnutrition, sarcopenia, delirium and dehydration, which in turn leads to longer hospital stays, readmissions, and higher healthcare costs.
Summary of the research
Over 15 years, we have led a multi-disciplinary research program to improve how nutrition and mealtime care is delivered in hospitals. This includes:
- Eat Walk Engage program development and evaluation – we led initial studies to develop nutrition intervention (Eat), shown to increased energy and protein intake by 20%. When integrated with interventions focused on mobility and cognitive engagement, the Eat Walk Engage program has been proven to reduce delirium risk by 47%, with additional benefits in discharge outcomes and mortality.
- Development of novel tools and surveys to measure mealtime care from the staff and patient perspectives. These are currently in use across Queensland hospitals and internationally to support mealtime improvement initiatives.
- Led the first prospective study on hospital-acquired malnutrition in Australia.
- Recognised leaders in implementation science in nutrition and dietetics, evidenced by invitation to contribute a paper on the i-PARIHS framework.
The impact
| Clinical impact: | Eat Walk Engage has improved care for over 40,000 patients annually across 42 wards in 18 Queensland hospitals. It has led to better nutrition care, reduced delirium, and improved discharge outcomes. |
| Economic impact: | Independent modelling showed a 5:1 return on investment, saving >800 acute bed days and reducing subacute admissions. This evidence supported Queensland Health’s $5M annual investment, with further expansion funding. |
| Policy & practice influence: | Eat Walk Engage is cited in 17 international guidelines and policies, including NICE and European nutrition standards. It is recognised as an example of best practice in Australia’s National Safety and Quality Health Care Standards. |
| International reach: | EWE has been adopted in Ireland and trialled in other Australian states, with interest in expanding to new settings like ICUs. |
| Academic contribution: | Our research program has produced 39 peer-reviewed publications, cited over 1,000 times across 56 countries, with significant contributions to both nutrition and implementation science. |
Our researchers
Adrienne Young, Alison Mudge, Merrilyn Banks, Elise Treleaven, Angela Byrnes, Liliana Botero