Chapter 23 Scope of Practice for the RDN and NDTR Figure 23.1 Quality of Outcomes

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Source: Reprinted with perission from Price JA, Kent S, Cox SA, McCauley SM, Parekh J, Klein CJ. Using Academy Standards of Excellence in Nutrition and Dietetics for organization self-assessment and quality improvement. J Acad Nutr Diet. 2014;114(8):1277-1292.

(PDCA) Cycle; Plan-Do-Study-Act (PDSA) Cycle; Lean-Kaizen; Six Sigma; Lean Six Sigma; Consumer Assessment of Healthcare Providers and Services (CAHPS); GAP Analysis; and Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis as well as Performance Improvement (Provider Account- ability) and Outcomes Based Management Systems (ie, participate in public reporting of data on quality of care, document resident/patient/client attainment of nutrition goals, utilize Academy of Nutrition and Dietetics Health Informatics Infrastructure [ANDHII]) (12).

Organizations can use the standards of excellence to advance practice through self-assessment and quality improvement. The Standards of Excellence are a guide for organizations to use when evaluating per- formance and identifying areas in need of improve- ment. The Standards of Excellence Indicators (12) are a self-assessment tool to evaluate an organization’s status in meeting the criteria. Strictly adhering to the

Standards of Excellence does not by itself constitute best care and service. It is the responsibility of the organization and its RDNs; nutrition and dietetics technicians, registered (NDTRs); and nutrition and dietetics practitioners to recognize and interpret situa- tions and to know what standards apply and in what ways they apply. Organizations can choose not to apply every indicator and achieve every outcome all at once; organizations are not limited to the indicators and examples of outcomes provided, and all indicators may not be applicable to all organizations. The Standards of Excellence are not all-inclusive and might evolve as nutrition and dietetics practice evolves (12).

COMPETENCE IN PRACTICE RDN and NDTR performance and the quality of the care, treatment, and services they provide stems from competence in practice. Competence is “a principle of professional practice, identifying the ability of the