In the early months of 2020, Europe was confronted by a pandemic that originated in China, which initially affected its territories in different ways. Parts of northern Italy were among the regions most affected. At the same time, Ticino, a small canton of Switzerland geographically wedged into Italian territory, had an incidence rate comparable to that of hard-hit Lombardy. Home to 350,000 inhabitants and separated from the rest of Switzerland by the Alps, Ticino had to face the first part of the pandemic with little available knowledge. The cantonal authorities decided to transform two active hospitals into COVID centres, concentrating all coronavirus patients there. Since the virus was new and there were no clear guidelines for managing it, the nutritional team on site had to reorganise to provide patient care, adapting their strategy to accommodate the evolution of the pandemic and growing medical knowledge. This paper explains how one of these teams developed a model to deal with the first wave of COVID, maintaining it during the second and current third wave of the pandemic.

Background: Nutritional therapy improves prognosis by reducing morbidity and mortality in malnourished hospitalised patients. To determine the occurrence of hospital malnutrition, it is essential to verify healthcare organisations’ ability to identify at-risk patients, considering that malnutrition is often hard to recognise without adequate screening. Methods: The aim of this study is to analyse the temporal evolution in hospitalised patients’ malnutrition, documented as diagnosis discharge letters, over an 11-year period (2014–2024) in four acute care hospitals, with a combined mean of 38,000 inpatients per year. Binomial regression and interrupted time series analysis were used to evaluate temporal evolution in the identification of malnutrition, particularly in relation to the introduction of a nutritional service in 2017. Results: Malnutrition diagnoses increased steadily across hospitals and within internal medicine and surgery departments. Interrupted time series analysis showed a significant rise in diagnostic odds post-intervention, especially in internal medicine. A plateau was observed in the last 3 years, with a mean prevalence of malnutrition of 18.2% for internal medicine (95% CI: 13.6–22.9) and 4.1% for surgery (95% CI: 0.5–7.6). Without the nutritional service, these results likely only would have been reached by 2031 in internal medicine and 2024 in surgery, suggesting an advancement of about eight years in medical wards. Conclusions: The introduction of a nutritional team has probably accelerated and improved the ability to quickly identify and therefore treat malnourished inpatients.