Grand Rounds

CMTF is offering Grand Rounds to institutions across Canada to help improve malnutrition care in hospital and post discharge.

Recognizing and Tackling Malnutrition

Click here to see/download sample postcard  ENGLISH   FRENCH

What is the Content?

These rounds will review the latest evidence on the impact of hospital-based malnutrition and effective methods to detect, prevent and treat this debilitating condition in hospital and post discharge. The cutting-edge research that has been conducted by the Canadian Malnutrition Task Force over the last decade in the development, implementation and dissemination of evidence-based protocols, pathways and tools, will be highlighted.

What are the Learning Objectives?

By the end of the webinar, participants will learn about the: 

1. Key evidence on the impact of hospital malnutrition
2. Evidence based approaches that can be adopted in the hospital and community to minimize malnutrition risk
3. Tools and resources aimed at detecting, treating and preventing malnutrition that can easily be integrated into your practice

What is the Target Audience?

Physicians, researchers, fellows, residents, medical students, faculty from General Internal Medicine, Surgery, Gastroenterology, Geriatric medicine, Hospital medicine, Internal medicine & Family Medicine. Dietitians Nurse practitioners, Rehabilitation professionals, Pharmacists, Physicians Assistants, primary care practitioners and other health care providers in the community.

Who Will Be the Presenter?

One of the following leading experts from the CMTF Team will present the rounds, depending upon availability and target audience:

Dr. Leah Gramlich, University of Alberta                    Dr. Heather Keller, University of Waterloo

Dr. Johane Allard, University of Toronto                    Dr. Don Duerksen, University of Manitoba

Interested in having your institution host these Grand Rounds? CONTACT US

Past Rounds - Recognizing & Tackling Malnutrition

Title: “Malnutrition in Hospitalized Patients: Boosting Screening and Ensuring Patient Outcomes”
June 21, 2023, 9:00 - 10:00am ET - Department of Medicine Rounds, St. Joseph’s Health Centre, Toronto ON
Speaker: Dr. Christopher Wang, MD, FRCPC, Department of Medicine, Division of Gastroenterology, St. Joseph’s Health Centre, Toronto, ON
Total number of attendees:  49 (open to St. Joseph’s Health centre Staff only)

Questions and comments included:

• St. Joseph’s Health Centre has used the nutrition screening tool as part of the nursing assessment for more than 10 years.
• nutrition screening is now being done in all patients at St. Joseph’s by a dedicated diet technician
• hospital food acceptability is an issue due to limited food choices on menu, short times for delivery and no snacks (due to staffing restraints)
• need for culturally acceptable foods to be offered in hospitals
• there is heavy reliance on family members to bring in suitable foods for patients and restrictions on this can impact malnutrition

June 9, 2023, 12:00 - 1:00pm PT - Fraser Health BC, Internal Medicine Rounds
Speaker: Dr. Barbara Bielawska MD MSc FRCPC, Assistant Professor, University of Ottawa
Total number of attendees:  80 attendees
Questions and comments included:
- Fraser Health referral processes for dietitians re: patients with chylothorax
- How to expedite Fraser Health referrals for SLP swallowing assessments for high risk respiratory patients
- Concern re: fish oils supplements having lower EPA/DHA and more oxidants than label claims  (New Zealand Study https://www.nature.com/articles/srep07928)
- Should nutrition screening in the community be done and if so what tools?
- Treatment goals in the sarcopenic obese patient

November 16 2022, 7:00 - 8:00 am EST-Health Sciences North Grand Rounds, Sudbury
Speaker: Dr. Barbara Bielawska, MD MSc FRCPC, Assistant Professor University of Ottawa
Total number of attendees: 37
Questions and comments included:
- Multivitamins or Vitamin D could be prescribed for those at risk for poor food intake or malabsorption but still need better nutrition intake 
- Encouraging families to bring in patient’s preferred foods is encouraged. Easy access to snacks at the bedside is also recommended
- Costs for prescribed Oral Nutrition Supplements (ONS) can be covered IF sole source of nutrition 
- Food insecurity is a huge challenge that needs a multifaceted approach; lobbying for ONS costs coverage could be one small part of the solution 
- CMTFs SGA Video Collection is a great educational tool 

September 13, 2022, 8:00am - 9:00am ADT - Department of Medicine, Nova Scotia Health Authority

Speaker: Dr. Leah Gramlich, MD, FRCP, Professor Medicine, University of Alberta
Total number of attendees: 130

Pediatric Grand Rounds Malnutrition in Hospitalized children: screening, treatment & prevention 
September 8, 2022, 12:00pm - 1:00pm NDT - Discipline of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland
Speaker: Dr. Valerie Marchand, MD, FRCPC, Department of Paediatrics, Ste-Justine UHC, University of Montreal , Quebec
Total number of attendees: 54

Questions and comments included:
- Lack of malnutrition screening in Newfoundland, challenges, and opportunities for improvement 
- What supports are available to train Dietitians/Clinicians to conduct Pediatric Subjective Global Assessment?
- Challenges of tracking longitudinal growth charts in an electronic format
- Data on increased workload to the Dietitian that is required because of implementing the malnutrition screen
- Financial implications associated with malnutrition screening and hiring additional staff

June 17, 2022, 12:00pm - 1:00pm - Department of Medicine, Halton Health Care, Ontario
Speaker: Dr. Barb Bielawska, MD, MSc, FRCPC
Total number of attendees: 26

Questions and comments included:
- increased awareness of malnutrition in Canadian hospitals
- quality of hospital food is a barrier to better nutrition
- poor food choices and food expenses may contribute to risk of malnutrition
- highlighted role of registered dietitians and need for referrals
- CRP, albumin, and prealbumin are markers of inflammation vs. markers of nutritional status

Recording available at:  https://vimeo.com/728835286/01740eade0

April 27, 2022 - Division of Family Practice Hospitalists, Pasqua Hospital, Saskatchewan Health Authority (by invite only)
Speaker: Dr. Don Duerksen 
Total number of attendees: 25

Questions and comments included:
- use of Subjective Global Assessment & bloodwork to support diagnosis
- use of enteral nutrition when po intake is poor
- lack of access to services in the community  
- interest in resources and patient tools & high protein, high energy diet

January 20, 2022, 8:30am - 10:00am MST - Family Medicine Rounds, University of Alberta, Edmonton
Speaker: Dr. Leah Gramlich
Total number of attendees: 110

Generated interest for:
- Family MDs being aware of malnutrition and identifying patients
- including nutrition status in hospital discharge summary plan
- CMTF Primary Care Malnutrition Toolkit


Questions included:
- Quantity of ONS consumed by patients with poor oral intake
- access to resources and programs within AHS for those with malnutrition 
- recommended blood work to support malnutrition diagnosis 

January 13, 2022, 8:00am - 9:00am ET - Medicine Grand Rounds, Hamilton Health Sciences, Ontario
Speaker: Dr. Leah Gramlich
Total number of attendees: 74

Questions and comments included:
- Protein requirements and quality of protein 
- Appropriateness of initiating enteral nutrition in those in whom goals of care are not defined 
- Hamilton Health Sciences RDs efforts at implementing best evidences related to malnutrition (Med Pass and INPAC adoption)

Recording available at:  https://www.youtube.com/channel/UCvF2UX6pA0Yr8IEgA1O5AKQ

November 2, 2021, 12:00pm - 1:00pm ET - Department of Medicine Grand Rounds, Ottawa
Speaker: Dr. Leah Gramlich, MD, FRCPC
Total number of attendees: 103

Generated interest for:
- de-escalating use of medications that suppress appetite. 
- continued work on improving nutrition screening and assessment practices
- training in nutrition care-request from a hospital in Trinidad and Tobago

Recording available at: https://vimeo.com/641955585/08c33f8635

For Health Professionals in Newfoundland and Labrador ONLY
October 22, 2021, 12:00pm - 1:00pm NLT - Medical Grand Rounds, Memorial University, Newfoundland
Speaker: Dr. Donald Duerksen, MD, FRCPC
Total number of attendees: 102

Generated interest for:
-impact of disease related malnutrition
-the double burden of obesity & malnutrition
-food first approaches to address malnutrition in a hospital setting

September 23, 2021, 12:00pm - 1:00pm ET - CHUM (Centre hospitalier de l'Université de Montréal)  
Speaker: Dr. Johane P. Allard, FRCPC, AGAF/CACF
Total number of attendees: 102

Recording available at: https://vimeo.com/646646061

March 2, 2021, 7:00pm - 8:00pm MST - Primary Care Rounds, Office of Lifelong Learning, University of Alberta, Edmonton
Speaker: Dr. Leah Gramlich, MD, FRCPC
Total number of attendees: 176

Poll responses in session:
- 83% thought malnutrition was a significant concern in their primary care setting 
- 60% to 70% needed information on how to identify patients or what to do if a patient is at risk
- 60% have limited or no access to a registered dietitian or did not have enough time 
 

April 29, 2021, 8:00am - 9:00am MST - Medicine Grand Rounds, Royal Alexandra Hospital, Edmonton
Speaker: Dr. Leah Gramlich, MD, FRCPC
Total number of attendees: 104

Recording available at: https://drive.google.com/file/d/19tWG1NFG09ipl15ZpSM_NxBly1wNT0Zd/view