A nutrition-focused QIP will be implemented with a primary assessment of QIP feasibility, patient health and economic outcomes as well as patient and provider experience data. A 2-phased QIP study group will be prospectively enrolled from outpatient clinics affiliated with the USC health system and compared with historical and concurrent control groups.

QIP Group

Inclusion Criteria:

• Poor nutritional status
• 2 or more chronic conditions (other than those listed as exclusions)
• Estimated life expectancy of 90 days or greater
• Able to consume foods and beverages orally
• Literate and willing to sign informed consent form

Exclusion Criteria:

• Pregnant
• Normal nutritional status
• Unable to consume foods and beverages orally
• Estimated life expectancy of less than 90 days
• Severe dementia or delirium and no dedicated caregiver to assure compliance with QIP study requirements
• Uncontrolled eating disorder, significant neurological or psychiatric disorder (including substance abuse), or other conditions that may interfere with study product consumption or compliance
• Known allergy or intolerance to any ingredient found in ONS products recommended in QIP

Retrospective and Concurrent groups eligibility are reflective of the QIP eligibility criteria however, the timeframe differs.

Patients seen in participating outpatient centers of the USC health system.