A Dietician’s Steps to Implementing a Nutrition Care Process

While the nutrition care process is a systematic way of collecting and organizing information, it will likely vary from patient to patient. I use this process to create the general framework but am mindful to avoid rigid rules. The specific needs of the patient always come first. Plans are flexible and no two are alike.

In my practice, developing a tailored nutrition plan includes the following steps:

1. Exploratory Phone Call: Since creating tailored nutrition plan takes time and commitment, I like to have a brief phone conversation with potential patients to gauge motivation and determine if our partnership will be beneficial.  I learn their reason for seeking nutrition guidance and some background information. 
2. First Appointment: During our initial meeting, I encourage the patient to expand on the information provided on the intake forms and perform a nutrition-focused physical exam, if the patient is agreeable. The patient and I work together to develop the initial treatment goals in list form. The initial treatment goals include the modified diet plan, recommended supplements, labs or other testing, and lifestyle modification. I also provide resources for my patient to be able to implement their plan. 
3. Accountability: To help keep patients accountable, I always plan the first follow-up visit during the initial meeting. Patients seem to be more responsive when they have a specific timeframe to implement the initial nutrition plan. For example, if I place a patient on an elimination meal plan for four weeks, they are more motivated to get started as opposed to simply placing them on an elimination plan with no set timeframe for implementation. 
4. Support: I am available to help my patients troubleshoot any issues they may experience via phone or my online platform. My charting platform and app include a chat feature, allowing patients to submit questions and receive answers quickly. They can also submit lab testing for my review and document their progress. It helps me stay engaged with my patients, but also provides an important resource for clarification and accountability for the patient.
5. Follow-Up: Three days before our scheduled follow-up appointment, I send my patient follow-up forms to complete. If the forms are not completed, I reschedule our appointment. Prior to the appointment, I review the information provided and compare it to the initial tailored plan. During the follow-up appointment, I review each goal specifically to see what worked well and what needs to change. Depending on the situation, we then create our next list of specific nutrition and lifestyle goals. I repeat the process of providing a follow-up appointment depending on the needs of the patient.

Editor’s Note: This is an excerpt from the e-book, Components of a Successful Nutrition Protocol. To read the full text, click here.