GLOBAL MALNUTRITION COMPOSITE SCORE

The Global Malnutrition Composite Score (GMCS) electronic clinical quality measure (eCQM), stewarded by the Academy of Nutrition and Dietetics, assesses the percentage of hospitalizations for adults aged 65 years and older prior to the start of the measurement period with a length of stay equal to or greater than 24 hours who received optimal malnutrition care during the current inpatient hospitalizations where care performed was appropriate to the patient's level of malnutrition risk and severity. 

The GMCS is the first nutrition-focused quality measure to be included in the Centers for Medicare and Medicaid (CMS) Hospital Inpatient Quality Reporting (IQR) Program in the FY 2023 Inpatient Prospective Payment System (IPPS) Final Rule. It was also endorsed by unanimous vote of the National Quality Forum (NQF) Consensus Standards Approval Committee (CSAC) in 2021.

The GMCS incentivizes screening all older adults for malnutrition risk at hospital admission, assessing those found to be malnourished and at risk for malnutrition, documenting diagnosed malnutrition, and developing a nutrition care plan with implementing intervention and treatment before discharge which then follows patients as they transition to the next point of care setting.

• The GMCS FAQs answer questions for key stakeholders in topics such as general information, reporting on the GMCS, implementing MQii, and provides resources. 
• The GMCS Specification Manual serves as a guide for practitioners to readily implement the malnutrition electronic clinical quality measures within their hospital systems. This manual provides an overview of the measures, specification of each measure including its rationale, available resources, and data element dictionary. 
• The Malnutrition Quality Improvement Initiative (MQii) is a project of the Academy of Nutrition and Dietetics, Avalere Health, and other stakeholders who collaborate to provide guidance and expertise for clinical malnutrition. The Academy of Nutrition and Dietetics and Abbott support the MQii. The primary goal is to advance evidence-based, high-quality, patient-driven care for hospitalized older adults who are malnourished or at-risk for malnutrition. The MQii Toolkit provides practical, interdisciplinary tools and resources to support hospitals establish best practices and adopt the eCQM to evaluate their success in meeting the standards of care. The MQii Learning Collaborative, a community of clinicians committed to improving delivery of malnutrition care in hospitals and health systems across the US, was established in 2016 and continues today with over 300 hospitals participating across the nation.
• Dialogue Proceedings for Advancing Patient-Centered Malnutrition Care Transitions
• Roundtable Proceedings for Advancing Health Equity Through Malnutrition Quality Measurement
• Quarterly Spotlights on Malnutrition educate RDNs and stakeholders on the GMCS and Quality Improvement: 
  • August 2022: Global Malnutrition Composite Score 
  • November 2022: Engaging with the Global Malnutrition Composite Score (GMCS)
  • February 2023: Gaining Stakeholder Buy-In for the Global Malnutrition Composite Score (GMCS)
  • May 2023: Understanding the Global Malnutrition Composite Score (GMCS) Measure: 2023 Annual Updates and Technical Components
  • August 2023 : Global Malnutrition Composite Score Town Hall
  • November 2023: Advancing Quality and Strengthening Interdisciplinary Collaboration (Part I)
  • February 2024: Value of Nutrition and Dietetics Credentialed Practitioners in Optimizing Quality Outcomes from the Interdisciplinary Team Perspective (Part II)
• Infographic: Hospital Value of the Global Malnutrition Composite Score (GMCS) Quality Measure
• The Journal of the Academy of Nutrition and Dietetics October 2022 Supplement highlights the connection between addressing malnutrition and food insecurity in quality care and health equity.
• Combinations of Measure Observations and Total Composite Score as Percentage
• GMCS Process Map
• GMCS Calculator 
• Freely available Nutrition Care Process terms
• Education Programs
  • Business Case for the Implementation of GMCS - Email quality@eatright.org to register or arrange a program for your group.
  • Malnutrition and Health Equity: Key Measures of Quality Care for Nutrition and Dietetics Practitioners

The table below lists the GMCS with the assigned NQF and CMS number and the downloadable specification file. Included is an HTML file detailing the measure specification, two XML files coded for hospital adoption into an electronic health record system, and an excel spreadsheet with corresponding informatics value sets.