The Dutch approach

1. Raise a multidisciplinary steering group, which represents all disciplines involved in screening and treatment of malnutrition and which has authority
2. Create awareness for the problem of disease related malnutrition by collecting prevalence data 
3. Quick and easy screening tools, connected to a treatment plan
4. Screening as a mandatory quality indicator
5. Evidence based, validated tools and cost-effectiveness research
6. Ministry of Health as a key stakeholder to strengthen the message
7. Implementation projects in all health care settings:
   
   
   • Start pilot projects to implement screening and treatment of malnutrition in.
   • Evaluate and adjust where necessary
   • Use the field to develop tools and a toolkit
   • Disseminate the project over more institutions and organizations.
   • Make sure projects team are multidisciplinary and have authority
   • A website to communicatie between participating teams and organizations with
8. Toolkits with tools, ready-to-use presentations and best practices, downloadable, free accessible to everyone
9. Multidisciplinary project teams in all institutions
10. Training programs and workshops

We have, through this project, ensured that

• Political involvement and malnutrition is mentioned in the different political programmes agreement
• Mandatory screening and treatment is undertaken in all health-care settings
• Ongoing collection and feedback of malnutrition data
• Malnutrition is included in the main list of quality indicators in Dutch health care
• Protein and energy goals for malnourished patients are defined
• Malnutrition is recognised as being as important a healthcare problem as obesity 
• Malnutrition is defined as one of the four topics in the National Safety Management System for all Dutch hospitals
• The risk of malnutrition has become an official indication for reimbursement of medical nutrition in basic health insurance plans

• Awareness of  the prevalence rates of malnutrition by annual measurement of care problems
• The Dutch Malnutrition Steering Group is recognized as the authority on malnutrition in the Netherlands because there is  
• A Multidisciplinary approach
• The Involvement of the Ministry of Health and other political interests / politicians
• Mandatory screening in all health care settings
• Mandatory reporting about best practice in hospitals
• An  interactive website and ready-to-use products
• Toolkits to facilitate implementation