When people are sick in the hospital, they sometimes don’t eat enough and become malnourished, which can slow their recovery. A Canadian hospital tested a new system called INPAC to help doctors and nutrition experts identify and treat malnourished patients. The study looked at 158 patients in 2017 and 122 patients in 2019 to see how well the system worked. Good news: every single malnourished patient got a nutrition plan while in the hospital. However, only about half of patients got a follow-up nutrition plan when they left the hospital. The most common treatments were giving patients special nutrition drinks and having trained helpers assist with meals.

The Quick Take

  • What they studied: Whether a new nutrition care system (called INPAC) helped hospitals identify and treat patients who weren’t eating enough while in the hospital
  • Who participated: 280 patients total across two years (158 in 2017 and 122 in 2019) who were admitted to nine different hospital units in Canada and identified as malnourished
  • Key finding: All malnourished patients received a nutrition care plan during their hospital stay, but only about 43% in 2019 (compared to 29% in 2017) received a plan to continue after going home
  • What it means for you: If you or a loved one is hospitalized and not eating well, hospitals using this system will create a nutrition plan to help. However, you should ask about follow-up nutrition care before leaving the hospital, since not all patients receive discharge plans

The Research Details

Researchers looked back at medical records from a Canadian hospital to see how they treated malnourished patients in 2017 and again in 2019. They examined records from nine different hospital units and tracked what nutrition treatments each patient received while in the hospital and what plans were made for after discharge. This type of study, called a retrospective chart audit, is like reviewing a history book to see what happened rather than watching events happen in real time. The researchers used a specific system called INPAC (Integrated Nutrition Pathway for Acute Care) that gives doctors and dietitians step-by-step instructions for identifying and treating malnutrition.

The study compared results from two different years to see if the hospital improved its nutrition care over time. In 2017, they found 158 malnourished patients, and in 2019, they found 122 malnourished patients. For each patient, researchers documented what nutrition treatments they received, such as special nutrition drinks, help from trained nutrition assistants, or referrals to nutrition clinics after leaving the hospital.

This research matters because malnutrition in hospitals is a serious problem that doctors often miss or don’t treat properly. When hospitalized patients don’t get enough nutrition, they recover more slowly, stay in the hospital longer, and have more complications. By studying how a structured system like INPAC works in a real hospital, researchers can understand whether these organized approaches actually help patients. The comparison between 2017 and 2019 shows whether hospitals improve their nutrition care over time, which helps other hospitals learn what works best.

This study has some strengths and some limitations. The strength is that it looked at real patient records from a real hospital, so the findings apply to actual medical practice. The researchers tracked all malnourished patients identified in the hospital, not just a sample, which is thorough. However, the study only looked at one hospital in Canada, so results might be different in other hospitals or countries. The study didn’t measure whether patients actually got healthier or recovered faster—it only tracked what treatments they received. Additionally, the study didn’t compare this hospital to other hospitals without the INPAC system, so we can’t be certain the system itself caused the improvements seen between 2017 and 2019.

What the Results Show

The most important finding was that the hospital successfully identified and created nutrition care plans for every single malnourished patient during their hospital stay in both 2017 and 2019. This is excellent because it shows the INPAC system helped doctors catch malnutrition cases that might have been missed before.

However, there was a gap in care after patients left the hospital. In 2017, only 29% of malnourished patients (46 out of 158) received a nutrition care plan for after discharge. This improved in 2019 to 43% (53 out of 122), which is better but still means more than half of patients didn’t have a plan to continue their nutrition care at home.

The most common treatment during hospitalization was giving patients oral nutritional supplements—special drinks designed to provide extra calories and nutrients—which was used for about 67% of patients in both years. By 2019, having trained nutrition assistants help patients with meals became equally popular, used for about 66% of patients.

When patients were discharged, the most common follow-up care was referring them to an outpatient nutrition clinic. This increased from 44% of patients in 2017 to 66% of patients in 2019, showing the hospital improved at planning for continued nutrition care after discharge.

The study showed that the hospital’s approach to nutrition care evolved between 2017 and 2019. The increased use of nutrition assistants to help patients eat suggests the hospital recognized that sometimes patients need hands-on help, not just special drinks. The improvement in discharge planning from 29% to 43% indicates the hospital became more aware of the importance of continuing nutrition care after patients go home. The fact that referrals to outpatient clinics nearly doubled (from 44% to 66%) shows the hospital increasingly connected patients with ongoing nutrition support in the community.

This study builds on previous research showing that malnutrition is common in hospitals and often goes unrecognized. Earlier studies found that structured nutrition care systems help identify malnourished patients more consistently. This Canadian hospital study confirms that using a systematic approach like INPAC can achieve 100% identification and care planning during hospitalization. However, the finding that only about half of patients receive discharge planning aligns with previous research showing that hospitals often struggle with follow-up care after patients leave. The study suggests that while hospitals have improved at treating malnutrition during hospital stays, there’s still room for improvement in helping patients maintain good nutrition after going home.

This study has several important limitations. First, it only looked at one hospital in Canada, so the results might not apply to hospitals in other countries or even other Canadian hospitals with different resources or patient populations. Second, the study didn’t measure whether patients actually got healthier or recovered faster—it only tracked what treatments they received. We don’t know if the nutrition plans actually worked to improve patients’ health. Third, the study didn’t compare this hospital to other hospitals that don’t use the INPAC system, so we can’t be completely sure that INPAC itself caused the improvements. Fourth, the number of malnourished patients identified decreased from 158 to 122 between the two years, which could mean the hospital got better at identifying malnutrition, or it could mean fewer patients were malnourished in 2019—the study doesn’t explain why. Finally, the study didn’t follow patients after they left the hospital to see if those who received discharge plans actually did better than those who didn’t.

The Bottom Line

If you or a family member is hospitalized and not eating well, ask the hospital staff about malnutrition screening and nutrition care planning. Request that a dietitian (nutrition specialist) create a nutrition plan before discharge. Ask specifically about follow-up nutrition care after leaving the hospital, such as referrals to outpatient nutrition clinics or follow-up appointments. These recommendations are based on this study showing that hospitals can successfully provide nutrition care during hospitalization, but patients should advocate for discharge planning since not all hospitals automatically provide it. Confidence level: Moderate—this is based on one hospital’s experience, but the findings align with general nutrition care best practices.

This research is most relevant for: (1) hospitalized patients who aren’t eating well or have lost weight, (2) family members of hospitalized patients who want to ensure their loved one receives proper nutrition care, (3) hospital staff and dietitians looking to improve nutrition care systems, and (4) people recovering from surgery or serious illness who need extra nutrition support. This research is less relevant for generally healthy people eating well at home, though good nutrition is important for everyone.

Improvements in nutrition status typically take weeks to months, not days. During hospitalization, nutrition support helps prevent further decline and may improve strength within 1-2 weeks. After discharge, patients who follow nutrition plans may see improvements in energy levels and recovery within 2-4 weeks. However, full recovery from malnutrition can take several months depending on how severe it was and the patient’s overall health.

Want to Apply This Research?

  • Track daily calorie and protein intake using the app’s food logging feature. Set a daily goal based on your hospital discharge nutrition plan (ask your dietitian for specific numbers). Log meals and snacks to ensure you’re meeting nutrition targets. This helps you and your healthcare team monitor whether you’re recovering properly.
  • Set a reminder in the app to eat three meals plus two snacks daily. If your discharge plan recommends nutrition supplements, set reminders to drink them at specific times. Use the app to track which foods help you feel strongest and which ones you tolerate best. Share your nutrition log with your dietitian at follow-up appointments to adjust your plan if needed.
  • Use the app to track your weight weekly (same time, same scale) and note any changes in energy levels or strength. Log any eating difficulties or side effects that make it hard to eat. Before your follow-up nutrition clinic appointment, review your app data to discuss with your dietitian what’s working and what needs adjustment. This creates a clear record of your recovery progress.

This research describes how one Canadian hospital managed malnutrition in hospitalized patients. These findings should not replace personalized medical advice from your doctor or registered dietitian. If you are hospitalized or concerned about malnutrition, speak with your healthcare team about your individual nutrition needs and care plan. This study did not measure whether nutrition interventions improved patient health outcomes, so individual results may vary. Always consult with qualified healthcare professionals before making changes to your nutrition care or medical treatment.