Get to Know: Vivian Kong, Registered Dietitian, Cancer Care Clinic

By Bridget Burling

What does your role entail?

I am a Registered Dietitian in the Cancer Care Clinic. My role in the clinic is to support patients with any nutrition concerns or questions during their entire cancer journey. I typically meet the patients when they are first diagnosed, and I support them through their treatment, their survivorship, and in some cases through their palliation. In each step of the cancer continuum, there are different nutrition concerns.

Describe the new screening process you implemented:

I implemented a nutrition screening process using a tool called Nutriscore, for patients with cancer. With our clinic’s fully digital processes, I am able to apply the screening tool with real-time data as patients are being assessed in the clinic. When a patient is identified to be at nutrition risk, a referral to the dietitian is auto-generated. This tool has made my job more efficient, especially during the pandemic, because I can screen the patient without meeting them face-to-face. Since this nutrition risk screening tool is validated, I am confident that I am seeing the right patient at the right time with very little wait time for nutritional therapy. We are the first hospital in the province to use this tool.

How has Nutriscore impacted screening for patients?

At first, I was doing most of the screening, but thanks to our nursing champion Vondell Klein, we have successfully included the nurses to participate in the screening process since January. This step is logical because the nurses see the patients every time. So, this process is now built into the nurse’s workflow to generate referrals to the dietitian. Addressing cancer-related malnutrition is a shared responsibility within our inter-disciplinary team.

How is our Cancer Care Clinic different than other hospitals?

We are fortunate to have dedicated full-time allied staff within the Cancer Care Clinic, which is rare for a community hospital setting. As a team, we empower patients to participate and make an informed decision on their cancer journey.

How has your work helped other hospitals?

I have been working very closely with our region’s Person-Centered Care Lead, Ruth Barker. Ruth works at the Stronach Regional Cancer Centre (SRCC) and has Patient Education and Symptom Management in her portfolio. Within the Central Region, five hospitals provide cancer treatment: Humber River Health, Mackenzie Health, Markham-Stouffville, North York General and South Lake/SRCC. One of the regional priorities to improving patient symptom screening and symptom management is to ensure that nutrition screening is incorporated as a regional standard. Together with Ruth Barker, we have consulted each of the cancer centres in the Central Region to implement a nutrition risk screening process by end of 2021, based on Humber River’s success.

Besides sharing our learnings with our regional partners, our implementation of a nutrition risk screening process has sparked interest in various cancer centres in North America. I have received consultation requests for implementing a nutrition risk screening process from Grand River Cancer Centre, Simcoe Muskoka Regional Cancer Program, Trillium Health Partners and Cleveland Clinic, Ohio.

Our use of real-time data and inter-professional approach to nutrition risk screening in cancer care was presented at the Institute for Health care Improvement (IHI) Forum in December 2019 and at the Canadian Association of Nurses in Oncology Conference in November 2020. The feedback we received from these platforms validated our efforts in addressing malnutrition for patients with cancer in our clinic.

Click here to learn more about the work Vivian Kong and her colleagues have produced based on these findings.