Israel

OUR VISION

All people at all times should have access to sufficient, safe, nutritious food to maintain a healthy and active life”. World Food Summit of 1996

Why ONCA?

It’s a credible multi-stakeholder platform with international visibility where 18 countries are fully aligned in one unique mission and good practices sharing.

ONCA helped to engage with health authorities, medical societies, patient associations and other relevant stakeholders. Currently, ONCA campaign involves PEN society, 12 patient association alliance “Nutrition for all”, MoH, health authorities, medical societies, payers, national industry group and it’s growing: every new stakeholder tackled engages and embraces ONCA.

The Objectives of the Israeli program

To raise awareness and implement better nutritional care for all the population.

• Israel officially joined ONCA campaign in November 2014 with the aim of implementing the ONCA united vision locally:

Procedures

• Official launch took place on the 16 of May 2015, during a large meeting with the presence and signature of the Minister of Health: All stakeholders signed the Israeli charter.
• A nationwide consensus meeting of all stakeholders held in June 2015 under the auspices of the Ministry of Health (MOH). Four round tables with representatives of various disciplines and organizations were created.
• The Israeli action plan for the following years was planned:

Achievements

• National professional guidelines and care pathways for follow up care for risk of disease-related malnutrition were created by the MOH.
• Reimbursement of tube feeding formulas for the dietary management of disease-related malnutrition for all ages added to the food basket.
• Reimbursement for ONS for the dietary management of disease-related malnutrition in cancer patients aged 0-13 ,to be continued to 19.
• Routine screening for risk of disease-related malnutrition in hospitals and in the community including follow up care written into the national policy. The screening implementation/follow up care for risk of disease-related malnutrition is audited on a routine basis The screening tools are already in the computerized information systems
• Adding the nutritional status and nutrition plan by the dietitian to the physician’s discharge letter in all hospitals for the continuity of care
• Creating teaching materials (an interactive tutorial) for nurses, physicians, dietitians, paramedics on how to perform screening in all health care settings 2019.
• National standards/care quality indicators for screening / follow up care for risk of disease-related malnutrition are in the community and in the hospital.
• Computerized nutritional information within the medical and discharge files that is connected to all the nutrition net-food
• Continued education to dietitians on nutritional focused physical assessment as part of the nutritional assessment.
• Creating unified terminology in textures of foods and drinks (IDDSI) to prevent dysphagia and malnutrition among all health care professionals.
• Improving the nutritional quality of food served to patients in hospital settings.
• Meeting with patient organizations(groups) and working on creating awareness of their nutritional needs
• Writing booklets on METS nutritional challenges with the patients. Publishing a booklet (A practical guide for caregivers and family members of persons with Dementia) named- Eating and Living with Dignity.
• Policy creation for the continuity of treatment- care sequence.
• Participating in a national committee for food security, creating a national food security basket and research networking.
• A national program for reformulation of industrial food.
• A committee for nutrition fortification regulation and monitoring
• Nutrition Day in \ few hospitals every year.
• National program, to lower salt in the Industrial food products (30% reduction in salt in most food categories by 2017).
• FOP’s and reformulation of industrial products starting January 2020.

In the community clinics

• Screening for malnutrition only in home care.
• BMI screening of all the patients every 2 years by the age 65 and every 5 years between the ages of 20-65.

Eating and Living With Dignity

Eating and Living With Dignity A Practical Guide for Caregivers and Family Members of Persons with Dementia:

An interactive tutorial for teaching nutritional screening

1. https://www.health.gov.il/Services/educ/Pages/nutrition.aspx
2. https://www.health.gov.il/Subjects/MedicalAndHealthProfessions/nutrition_community_lomda1/story_html5.aspx
3. https://www.health.gov.il/Subjects/MedicalAndHealthProfessions/nutrition_general_hospitals_lomda1/story_html5.aspx

An obligatory directive for identifying patients in need of nutritional care in the community and in hospitals

Early detection of nutritional risk situations and immediate nutritional intervention may improve patients’ quality of life, enable growth potential and development, and reduce chronic morbidity, medical complications and mortality.
Nutritional risk situations include conditions and illnesses that can cause nutritional imbalances during the life cycle: from pregnancy, through childhood to adulthood and old age.

The Ministry of Health has recently published a regulatory directive for identifying patients in need of nutritional care in the community and in hospitals. The objective of the directive is to set standards for identifying situations of nutritional risk and direct referral by the patient to a dietician in the community.

Patients in need of nutritional care in hospitals and in the community will be detected either by a validated nutritional screening tool or by the medical staff.

Direct referral by the patient to a dietician in the community will be at least for the following conditions: diabetes, pre-diabetes and obesity in adults and children.