title: Clinical dietetics changes due to cost-reduction activities in healthcare systems.
abstract: OBJECTIVE
  This study was designed to assess changes in clinical dietetics due to cost-reduction activities in healthcare systems.
  
  
  METHODS
  1,200 ADA members who indicated that they were employed by acute care hospitals in ADA Area 2 states.
  
  
  METHODS
  A questionnaire about changes in clinical dietetics staffing and clinical dietitians' activities and responsibilities was developed based on qualitative research. Descriptive statistics, t tests, analysis of variance, chi2 tests, and correlations were calculated.
  
  
  RESULTS
  A total of 342 usable questionnaires (28.5%) were returned. More than one third (37.9%) of respondents reported reductions in the number of clinical dietitians, and 32.2% reported increases in the number of part-time clinical dietitians. Most respondents indicated that they were more involved with high-risk patient interventions, had limited time for inpatient instruction, and experienced an increased patient caseload. Although 45.4% of respondents reported diminished job satisfaction due to recent changes in healthcare systems, some changes, such as increased high-risk patient intervention and referrals, were positively correlated with perceived job satisfaction.
  
  
  CONCLUSIONS
  Thorough review of current clinical dietetics activities/responsibilities and planning before cost-reduction, restructuring activities may maximize staff utilization without decreased job satisfaction of clinical dietetics staff.
authors.affiliation: Department of Nutrition and Food Sciences at Texas Woman's University, Denton, USA. jkwon@twu.edu
authors.forename: J
authors.initials: J
authors.lastname: Kwon
authors.forename: S A
authors.initials: SA
authors.lastname: Gilmore
authors.forename: M J
authors.initials: MJ
authors.lastname: Oakland
authors.forename: M C
authors.initials: MC
authors.lastname: Shelley
mesh_terms: D002983:Clinical Competence; D003363:Cost Control; D004046:Dietetics / Q000191:economics*; D005521:Food Service, Hospital; D006801:Humans; D007325:Institutional Practice; D007588:Job Satisfaction; D007857:Leadership; D020415:Personnel Downsizing / Q000191:economics*; D010561:Personnel Staffing and Scheduling; D013312:Stress, Physiological; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D000078329:Workforce; D016526:Workload