Reflections on the Cancun Declaration 2008: the Right to Nutrition in Hospitals

Abstract

Overview: Ten years after the Declaration of Cancun, I am doing a critical analysis to evaluate if what was expressed in it has had repercussions on the improvement of the quality of in-hospital nutritional care in Latin America.
The question is: Does the patient receive optimal nutrition based on quality criteria (timeliness, efficiency, effectiveness and safety)? The evidence-based answer is a “significant” no. We can divide in 2 big sections the failures that nutritionally damage patients; the so-called latent failures that are failures in the system and the active ones that are those made by the different people that act directly on the patient’s attention. Therefore, actions to improve the nutritional security of the hospitalized patient should be focused on proactive and preventive change at both the systemic (system) and individual (people) levels. These actions may be regulated or self-regulated; however, our vision is that nutritional security in the health system will mean nothing without the collaboration and commitment of medical professionals. A cultural change is a precondition for focusing on actions to improve the safety of the patient’s nutritional care and also on a policy of outcomes. Secure patient nutrition care must be put on the political agenda. Simultaneously finding quality of nutritional care, operational efficiency and financial incentive linked to the outcome must be the goal. Trying to solve the problem independently is a waste of time and effort.