# Rapid Intervention to Support Eating Issues (RISE) Program: Using Quality Improvement to Reduce Medical Hospitalization in Malnourished Youth

## TL;DR

The RISE program helps malnourished adolescents avoid hospitalization by providing structured outpatient care focused on eating disorder recovery.

## Contribution

The RISE program introduces a program-led, structured outpatient model to reduce hospitalization for malnourished youth with eating disorders.

## Key findings

- Only 3.7% of participants required hospitalization during the program.
- Participants gained an average of 2.7 kg over 8 weeks.
- Calorie intake increased significantly from 43.3% to 76.0% of recommended levels.

## Abstract

Program‐led and focused models may overcome structural barriers to accessing ED care, such as limited availability, for youth with EDs by prioritizing strategic, evidence‐based care delivered through a structured approach. The Rapid Intervention to Support Eating Issues (RISE) pilot aimed to promote weight restoration and prevent hospitalization among malnourished adolescents at risk for hospitalization. We used a “home hospital” approach, integrating medical oversight, family‐based treatment principles, and nutritional support via structured outpatient care.

Participants completed 4–5 visits with adolescent medicine and nutrition over 8 weeks. They received psychoeducation and support in implementing home hospital. Vital signs, anthropometrics, dietary intake, ED behaviors, and cognitions were assessed.

A total of 27 patients participated. Patients experienced low hospitalization rates (n = 1 throughout; 3.7%) and significant weight gain (Mend of treatment = +2.7 kg from baseline, 95% CI: 2.6–4.7). There were statistically significant increases in calorie intake (Mbaseline = 43.3% of recommendation; Mend of treatment 
= 76.0% of recommendation; dz = 0.98, 95% CI: 0.45–1.50) and decreases in the report of disordered weight control behaviors (n reporting at baseline = 10 [37%], n reporting at end of treatment = 3 [11.1%]; paired RD = −1.00, 95% CI: −1.00–−0.33).

This program‐led and focused intervention produced meaningful outcomes and circumvented hospitalization for youth at high risk in a short time frame. This approach offers promise for scalable, early ED care that leverages programmatic expertise, consistent with evolving models of mental health service delivery.