Living our values: Registered dietitian nutritionists

Approximately a 5-minute read

Key Takeaways:

• Registered dietitian nutritionists live out the organizational values of caring, inclusion, innovation, integrity and teamwork daily.
• RDNs work in two distinct areas of Michigan Medicine–-one within U-M Medical Group and ambulatory services, the other as part of Patient Food and Nutrition Services that serves Michigan Medicine inpatients
• RDNs at Michigan Medicine have earned affected positive change within the organization, received national attention and earned awards for their outstanding work.

Every day, registered dietitian nutritionists (RDNs) uphold Michigan Medicine’s core values of caring, inclusion, innovation, integrity and teamwork. As such, they are key to carrying out exceptional patient care, education and research.

In honor of RDN Day and National Nutrition Month, here is a closer look at how RDNs live out these organizational values.

Did you know?

RDNs work in two distinct areas of the health system. One team, which is part of the U-M Medical Group, serves ambulatory care operations. Another is part of Patient Food and Nutrition Services and serves Michigan Medicine inpatients. In their own ways, each area works to carry out Michigan Medicine’s core values.

Here’s how:

Caring

On a national scale, Courtney Iwanicki, R.D.N., has done outstanding work to improve cystic fibrosis nutrition care. Her work – along with the work of two colleagues, Emily Bair and Jessica Stoscup – has been recognized by becoming a finalist for the Evan Newport HOPE Awards each of the past three years, including winning an award in 2022.

“This award and the work of our RDNs exemplifies caring to its truest capacity, as our teams learn to walk alongside patients and families who need long-term, patient-centered care,” said Emily Collins, M.H.A., R.D.N., UMMG nutrition administrative manager. 

While many RDN team members were feeling isolated due to social distancing and other pandemic measures, Erin Zettell, M.P.H., R.D.N. created and implemented a social connection initiative. Zettel, who acts as the MHealthy representative for inpatient dietitians, realized the importance of coming together.

Even with a return to in-person work, Zettel has continued to connect the team outside of the standard workday. For instance, Zettel organized a cookie exchange and has facilitated interactions so that team members could learn perspectives of employees of different backgrounds and work environments.

Inclusion

Stacey Fogarty-Brown is one of two RDNs who work with Michigan Medicine’s pediatric patients with cystic fibrosis. Fogarty-Brown has traveled to Egypt with Samya Nasr, M.D., C.P.I., director of the U-M Cystic Fibrosis Center, to help improve care for patients overseas.

“Opportunities to talk about evidenced-based nutrition outside of the U.S. don’t come often and I didn’t want to miss the chance to make an impact in any way I could,” Fogarty-Brown said.

On campus, inclusion efforts have included Elizabeth Kosch, M.P.H., R.D.N., who volunteers with U-M Health’s Patient Education and Health Literacy Committee. Through this work, Kosch brings forward initiatives that can help team members communicate with patients in plain language.

Emily Haller, an RDN with the outpatient GI division, has worked to remove obstacles by leading a project to translate patient education materials into Spanish, Arabic, French, Italian and Hindi.

Finally, outpatient RDN Khrystine Hendy created a DE&I Book Club that convened for the first time in February, and also recently facilitated an implicit bias training for her team.

Innovation

Last July, Adult Hospitals’ Nutrition Services rolled out the use of a smart form with the goal of supporting efficiency, standardizing documentation and reducing multistep workflows. Moreover, the smart form allows RDNs to build and capture activity metrics for each patient. This can help to inform staffing decisions as well as identify areas of success. Pediatric RDNs are expected to begin using the form by FY24.

The team has also embraced video visits. Terrie Holewinski, R.D.N., works with the adult renal program and runs a Chronic Kidney Disease group four times a week. Holewinski’s work allows patients to be seen in a timelier manner, as her program creates space for up to 32 patients with CKD to be cared for weekly.

The group video visits have been well received by patients: “The group visit provided an excellent guide to planning one’s diet,” said one patient. “Terrie was proactive in reducing anxiety about the potential progression of kidney disease. She was very effective at helping us assess our current health condition, and she showed us how we could empower ourselves in order to mitigate the effects of the disease.”

Integrity

Patient needs are ever-evolving, and RDNs have been actively involved working with medical teams and food service partners to implement and update inpatient eating disorder protocols in both C&W and the Adult Hospitals. Monica German, R.D.N., and Elizabeth Kosch, M.P.H., R.D.N., have been leading these efforts.

Broadly, many RDNs on the outpatient team present their work locally and nationally to share best practices and improve care across the U.S.

Amber Spencley, R.D.N., for instance, helped plan and carry out the first Cardiovascular Wellness Day in February for American Heart Month. This was a free, virtual event for employees and community members to join. Michigan Medicine RDNs and their colleagues led discussions about nutrition, cooking, mindfulness and exercise – ensuring messages reached populations that could have been missed.

Teamwork

Rina Hisamatsu, primary care RDN at Domino’s Family Medicine, supports multiple clinics and programs, including the Japanese Family Health Program and the Integrative Family Medicine Program. Additionally, she is the nutrition resource for the Non-Pharma Pain Program and Back and Pain Center.

“Each program I’m involved in serves a unique population with specialized cases, cultural differences and individual qualities that are unique to the clinic,” Hisamatsu said. “This requires the ability to adapt quickly and efficiently while ensuring patient safety and helping everyone to achieve their health goals.”

Elsewhere, ambulatory and inpatient Nutrition Services partner with the U-M School of Public Health to precept future dietetics professionals. In fact, this year the team will provide 30 SPH dietetic interns with both outpatient primary care and specialty clinic rotations opportunities in outpatient cardiology, allergy, oncology, nephrology, diabetes and pediatrics, and with a five-week inpatient clinical nutrition rotation. For inpatient rotations, each intern will spend time in general care, a specialty and an ICU.

“Working with dietetic interns from the School of Public Health is valuable in that it helps us sharpen our skills as clinicians while we teach others, especially in terms of applying evidence-based interventions and communicating our reasoning,” said Kosch. “We are able to help educate future master’s level dietitians and, in turn, further advance our profession.”

In honor of RDN Day, please thank the RDNs in your area for all they do!