Implementation of a systematic method for the identification, tracking, and treatment of malnutrition in pediatric patients with acute lymphoblastic leukemia.

184Background: It is estimated that the prevalence of malnutrition in children with cancer may be as high as 50%. Optimization of nutritional status is known to be associated with improved tolerance of cancer therapy, decreased infection risk, increased quality of life and increased survival. There are established methods for improving nutrition, but we have observed barriers to the identification of at risk patients, adherence to recommended interventions and continued surveillance. Methods: We identified patients in the intensive phases of therapy for acute lymphoblastic leukemia/lymphoblastic lymphoma. Using improvement science methods, we developed a standardized approach to the identification, treatment and tracking of patients at risk for malnutrition. We utilized quality improvement techniques to identify the problems with the current system and implement change. These changes included standardization of an algorithm for nutritional treatment and follow up, creation of a daily electronic report for...