Clinical outcomes are measurable changes in health, function or quality of life that result from our care. Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.
About the Dietetics service
The Dietetics service at Great Ormond Street Hospital (GOSH) works in partnership with all of the hospital’s specialist clinical services. The service works with children and young people and their families who have a condition where nutrition and special diets can be used as treatment. Many of these conditions result in:
poor oral intake
inability to swallow
increased requirements for energy (calories) and nutrients
Our specialist assessment identifies the most appropriate dietary management, and we work with patients and families on how to carry out this at home. We also monitor children and young people’s growth and development ensuring the prescribed diet meets their needs. We work with GPs, health visitors, school nurses and local health workers who can provide support at home.
Clinical outcome measures
Blood, Cells and Cancer Dietetics team
The Blood, Cells and Cancer Dietetics team works in close partnership with the clinical specialties haematology and oncology, bone marrow transplant (BMT), immunology, dermatology, rheumatology, and infectious diseases. Children and young people with conditions treated by these specialities have a higher risk of malnutrition (eg caused as an effect of cancer or the side effects of the treatment) and may have complex nutritional needs. The team assess the nutritional and dietary needs of patients and work to support their growth and long term health.
Nutrition and Dietetic Patient Outcomes Questionnaires (NDPOQ)
Here, we provide our outcomes from the perspective of parents and carers, and young people themselves (aged 8 and over). The NDPOQ is a validated self-reported questionnaire developed for use with patients and their carers to inform the quality of the nutrition and dietetic care they receive. The NDPOQ gives us information about how our dietetic service assists with health-related knowledge and empowerment, and the effects of our care on daily living. Below is a summary of results from across all specialties within the Blood, Cells and Cancer Dietetics team during 2019. The NDPOQ-Young person questionnaire was available for children and young people aged 8 and over, and the NDPOQ-Parent version for all parents and carers with a child receiving specialist nutrition and dietetic care.
Figure 1 Blood, Cells and Cancer Dietetics service NDPOQ results 2019, understanding
Figure 2 Blood, Cells and Cancer Dietetics service NDPOQ results 2019, management
Figure 3 Blood, Cells and Cancer Dietetics service NDPOQ results 2019, weight
Figure 4 Blood, Cells and Cancer Dietetics service NDPOQ results 2019, general well-being
In total 83 questionnaires were completed during two phases in September and December 2019, 68 NDPOQ-Parent questionnaires and 15 NDPOQ-Young person questionnaires.
The results show that 87% (59/68) of parents and carers strongly agreed or agreed that the advice and support from the Blood, Cells and Cancer Dietetic team helped them get a better understanding of their child’s condition. The same proportion of young people, 87% (13/15), also strongly agreed or agreed that it helped them get a better understanding of their condition. 87% (59/68) of parents and carers report they felt the dietetic care was tailored to their lifestyle and 81% (55/68) felt the dietitian helped them manage their child’s weight. Overall, 90% (61/68) of parents and carers and 73% (11/15) of young people felt the dietitian helped their or their child’s well-being improve.
In summary, the results showed a positive experience relating to the dietetic input their child received and patient experience. Specifically, the results showed that adults/parents had a more positive experience in relation to the dietetic care provided to their children than young people directly.
Going forward, an effort to review how dietitians interact with young people will be considered. Further in depth qualitative information would be valuable to deepen the interpretation of these results. Further work will be considered and explored to benchmark with other Trusts.
This information was published in July 2020, and will be updated in two years.