Grand River Hospital is working together with Grand River Hospital Foundation and our community supporters to lead the way in bringing health innovations to our community. In this type of collaboration, everyone has a role to play to help enhance the hospital experience for local patients, staff, and health care students. Providing the highest level of care to patients and investing in the best resources and tools for staff and students are also important in bringing our vision — a world class health system supporting healthier lives — to life. 

In 2022, dietitian and professional practice lead Hannah Marcus was working to understand how her team could better personalize care to meet the nutritional needs of patients in Grand River Hospital's intensive care unit, and throughout the hospital. And, when Hannah learned about donated funding available to the clinical nutrition program from Grand River Hospital Foundation, she put together a case for support to purchase the Hospital's first indirect calorimeter.

An indirect calorimeter is a non-invasive medical device that dietitians use to measure the amount of energy a person's body expends while at rest. This information is important in helping them make accurate and personalized recommendations about a patient’s nutritional needs. 

Currently, dietitians use calculations called predictive equations that determine patients’ estimated energy requirements when an indirect calorimeter is not available. However, this method of determining a patient’s energy needs is much less precise. It can also be really challenging for dietitians to accurately determine the needs of certain patient groups using this method; it's a skill that often requires years of experience.

“There are more than 200 predictive equations, and in many cases those generally work, but there is a whole subgroup of patients in the ICU and across the organization where it’s really difficult to figure out what they need [using these equations]. We’re not really clear on what their true metabolic rate is, and as a result, we’re either overfeeding or underfeeding them,” explained Hannah Marcus, Professional Practice Lead, Clinical Nutrition, Grand River Hospital. 

An indirect calorimeter, on the other hand, determines a patient's precise energy requirements based on the rates of oxygen they take in and carbon dioxide they produce. This invaluable tool, when combined with a comprehensive nutrition assessment, helps us ensure we are accurately meeting patients’ nutritional needs, which in turn can help prevent malnutrition and promote wound healing; it is also known to reduce a patient’s length of stay in the hospital and to lead to better outcomes for patients. 

Until recently, however, indirect calorimeters were not typically found in community hospitals like Grand River, as previous versions of these devices were inaccessible and too expensive for community hospitals to afford. But as new versions have become more accessible, reliable, and easy to use, our clinical nutrition team saw an opportunity to step up as a leader in our community.

As the first community hospital in our area to adopt this important piece of equipment, Grand River Hospital is positioning itself not only as a leader in patient care but also as a place where students are eager to come to learn. Having the newest tools and resources like the indirect calorimeter will help us attract and recruit top students and staff to our clinical nutrition program, ultimately building on our 51+ year history of training dietetic students. It also elevates the quality of education we can provide to our students, which enhances their competence, confidence, and skill set. 

However, it would not have been possible to invest in this type of equipment without the support of our community and Grand River Hospital Foundation. Even as newer indirect calorimeters become more affordable, this type of leading-edge equipment, while incredibly impactful, is often still not within reach for many community hospitals. 

This is in part because of how hospitals’ medical equipment is funded in our health system. Our hospitals and communities are actually responsible for certain costs like medical equipment and a portion of associated renovation or construction costs, while other costs are funded by the government. This means hospitals often must turn to their foundations and community supporters to be able to afford to invest in these kinds of innovative tools. 

Farm Boy is a long-time supporter of Grand River Hospital Foundation that is dedicated to making a difference, with a charitable focus on nutrition education and support that encourages wholesome eating. When the clinical nutrition team learned of funding donated by Farm Boy and our community members that aligned with their program, they worked closely with Grand River Hospital Foundation to determine the most impactful way to use these funds. By working together, they ultimately brought indirect calorimetry to the Hospital, and our region, for the very first time.

“Donations from [our supporters] really bring the Hospital up to the standard that it’s able to operate at,” said Jason Da Maren, Registered Dietitian, Grand River Hospital. “Staff are really grateful for donations in support of the equipment we need to provide the highest level of care for our community.”

As a part of our commitment to creating a world class health system, Grand River Hospital and Foundation are dedicated to investing in the future of local care. Having the community’s support is incredibly important because it helps us invest in education, new equipment, innovation, and more as we plan for our future — this then elevates the care we can provide and the hospital experience for patients and their families, staff, and students alike. Innovation ultimately takes all of us, and as the first hospital in our area to have an indirect calorimeter, we are proud to have come together to bring this leading-edge technology to our community.