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Objective: The objectives for this project were to: (1) identify and agree upon “critical standards” that must be “fully” or “substantially compliant” for a maximum 8-year reaccreditation, (2) compare recent compliance for each critical standard for all accredited programs, and (3) identify which standards have lower compliance levels compared to others. Methods: This qualitative study uses thematic analysis. The 37 European Council on Chiropractic Education (ECCE) standards were assessed by the Quality Assurance Committee (QAC) to identify “critical standards” requiring “fully” or “substantially compliant” ratings for the maximum 8-year accreditation time period. These were approved by the entire ECCE. A table identifying specific criteria for each compliance level then was created. The most recent evaluation reports for all accredited programs were reviewed to record compliance levels for each critical standard and identify the number falling below the status of “substantially compliant”. Specific standards with the highest proportion falling below “substantially compliant” also were identified. Results: Eighteen of 37 standards were deemed critical. Two of 10 accredited programs had 0 “critical standards” below “substantially compliant” and two programs had three below this level. The most common standard to fall below “substantially compliant” was “faculty recruitment” with three programs (30%) at “partially compliant.” Conclusion: Identification and approval of “critical standards” requiring at least substantial compliance and the compliance criteria table facilitate implementation of the flexible 8-year reaccreditation period, providing the flexibility needed to work collaboratively with national accrediting agencies. “Faculty recruitment” standard had the highest percentage of programs rated as “partially” compliant.

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The purpose of the policy was to support the change in procedure to identify and document malnutrition in adult patients admitted to Indiana University Health Methodist Hospital.Retrospective data analysis was used to identify the current state of patients diagnosed with malnutrition at Indiana University Health. Once the new policy was complete and initiated a second data analysis was completed to see if there was a change in the incidence and specificty of the malnutrition diagnosis on patients discharge from IU health Methodist and university hospitals.Intial results indicated that less than 1% of patients discharged form Indiana University Health Methodist in August of 2013 were coded for severe malnutrition or moderate malnutrition. This is significantly less than the predicted 30% of patients in acute care settings. After implementation of the malnturition policy, the incidence of malnutrition diagnosis from August 2014 increase more than 500% to 5%of patients discharged from Indiana University Health Methodist Hospital August 2013 August 2014 %Change Severe Protein Calorie Malnutrition 13/2668 (0.5%) 83/2682 (3.1%) +538% Moderate Malnutrition 9/2668 (0.34%) 52/2682 (1.9%) +477% Although there is still a long way to go in improving the diagnosis of patients with malnutrition, the first month of implementation showed the new policy and procedure to be much more effective in identifying and documenting malnutrition in adult patients hospitalized at Indiana University Health.