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Fuleihan K, Stillman K, Hakimian J, Sarkar K, Ballesteros JM, Almario CV, Shirazipour CH. Identifying solutions to minimize meal tray waste: A mixed-method approach. Clin Nutr ESPEN 2024; 62:43-56. [PMID: 38901948 DOI: 10.1016/j.clnesp.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 04/19/2024] [Accepted: 05/06/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND & AIMS Over $150,000 are lost annually due to meal tray waste in a large hospital in the United States. This study aims to explore the root causes of meal tray waste within a decentralized foodservice model and strategies to mitigate waste. METHODS A mixed methods sequential explanatory design was used by first identifying hospital units high and low in meal tray waste using recorded food management data from January 2021 through September 2022, then conducting observations, mobile-interviews (n = 16), and in-depth interviews with hospital foodservice staff (n = 6) and nurses (n = 6) in each unit. Lastly, hospital and topic experts (n = 10) were engaged in strategizing solutions to reduce meal tray waste. RESULTS Findings indicate meal tray waste is increased when patients discharge and when standard trays (i.e., also known as house trays, which include items not requested by patients) are provided. Meal tray waste points to the unpredictability in a hospital that often arises due to patient circumstances, lack of coordination between nursing and foodservice staff, patients' food preferences, and the need for system and workflow improvements in a decentralized foodservice model. CONCLUSIONS Findings highlight considerations that may be applicable across diverse medical institutions seeking to reduce meal tray waste. Hospitals should choose the best foodservice model that suits their institution to manage operations efficiently, focusing on reducing waste, cost optimization, patient satisfaction, and sustainability.
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Affiliation(s)
- Kimberly Fuleihan
- Department of Enterprise Information Systems, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Kaytlena Stillman
- Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Joshua Hakimian
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
| | - Korak Sarkar
- Ochsner BioDesign Lab, Ochsner Health, New Orleans, LA, USA.
| | - Jan Michael Ballesteros
- Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Christopher V Almario
- Outcomes Research and Education (CS-CORE), Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Celina H Shirazipour
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
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Kweon YR, Jang KS, Back M, Lee M. Development and Psychometric Test of the Inpatients Experiences Measurement Scale (IEMS). Patient Prefer Adherence 2024; 18:1359-1372. [PMID: 38953018 PMCID: PMC11216549 DOI: 10.2147/ppa.s457746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/20/2024] [Indexed: 07/03/2024] Open
Abstract
Purpose In South Korea, hospitalized patients' experiences significantly impact satisfaction and treatment outcomes. This study developed and evaluated the Inpatients Experience Measurement Scale (IEMS) for its psychometric properties. Patients and Methods Participants from three hospitals were recruited using convenience sampling. Scale item generation involved patient interviews and a Delphi survey with experts. Psychometric testing used Exploratory Factor Analysis (EFA) with 150 participants and Confirmatory Factor Analysis (CFA) with 151 participants. Results A total of 301 patients participated, resulting in a 20-item scale across four factors: "Care Quality and Information Provision", "Patient Safety and Dietary Services", "Facility and Comfort Infrastructure", and "Comprehensive Patient Support Services". Rated on a 5-point Likert scale, the scale showed a high Content Validity Index (CVI) over 0.80. EFA explained 61.43% of the variance. The four-factor model was validated using CFA with favorable fit indices. The IEMS demonstrated strong convergent validity, supported by high composite reliability (CR) and average variance extracted (AVE) values. Significant correlations with the Patient Satisfaction Scale reinforced its convergent validity. Discriminant validity was confirmed, and all reliability measures exceeded the minimum threshold of 0.80. Conclusion The IEMS effectively captures inpatients' experiences, demonstrating robust reliability and validity. This scale is a valuable tool for assessing patient experiences, facilitating enhancements in patient care and satisfaction within hospital settings.
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Affiliation(s)
- Young-Ran Kweon
- Department of Nursing, Chonnam National University, Gwangju, South Korea
| | - Keum-Seong Jang
- Department of Nursing, Chonnam National University, Gwangju, South Korea
| | | | - Mikyoung Lee
- Department of Nursing, Kwangju Women’s University, Gwangju, South Korea
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Ellick J, Pashley A, Cave D, Nelson O, Wright O. 'On-Demand' snack service in a rehabilitation setting: Impact on satisfaction, intake, waste and costs. Nutr Diet 2024. [PMID: 38763892 DOI: 10.1111/1747-0080.12881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 02/15/2024] [Accepted: 04/24/2024] [Indexed: 05/21/2024]
Abstract
AIM To evaluate an 'On-Demand' snack service in a rehabilitation setting for satisfaction, intake, waste and cost. METHODS In September 2021, a trial of an 'On-Demand' snack service was conducted on two general rehabilitation wards in a purpose-built rehabilitation hospital. A retrospective comparison of pre-implementation, 1-month and 8-month post-implementation audit data was used to evaluate staff and patient satisfaction, nutritional intake, waste and cost (labour and food). Descriptive and inferential statistical analyses were performed for intake quantitative data and content analysis was conducted for qualitative data. RESULTS A total of 26 responses from staff and 34 from patients were received. Staff reported higher overall satisfaction with the 'tea-trolley' service (50% vs. 32%; χ2 6.815 [2]; p < 0.05). Patient satisfaction ratings of the original 'tea-trolley' system were higher than the 'On-Demand' snacks system (96% vs. 59%; χ2 41.60 [2]; p < 0.0001). Median daily intake from snack food and drinks was maintained (938 kJ and 6 g protein vs. 925 kJ and 6 g protein) and waste (23.3% vs. 20.9%; p < 0.05) decreased with the 'On-Demand' service. Cost of ordered food was similar ($778.15 'tea-trolley' vs. $746.1 'On-Demand'), however cost of waste ($179.47 'tea-trolley' vs. $128.7 'On-Demand') and labour ($1650.46 'tea-trolley' vs. $926.44 'On-Demand') reduced by 28% and 44%, respectively, with the 'On-Demand' snack service. CONCLUSION Implementing an 'On-Demand' snack service in the general inpatient rehabilitation setting resulted in reductions in food waste, foodservice staff labour and waste costs, while intake was maintained. Patient and staff satisfaction decreased warranting further investigation into appropriate implementation methods.
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Affiliation(s)
- Jennifer Ellick
- Dietetics and Foodservices, Surgical, Treatment, and Rehabilitation Services, Brisbane, Queensland, Australia
- School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Alice Pashley
- School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Danielle Cave
- School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Queensland, Australia
- School of Health, University of Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Oliver Nelson
- School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Olivia Wright
- School of Human Movement and Nutrition Science, The University of Queensland, Brisbane, Queensland, Australia
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Miyoba N, Ogada I. Diet satisfaction and associated factors among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia; a hospital-based cross-sectional study. BMC Nutr 2020; 5:25. [PMID: 32153938 PMCID: PMC7050853 DOI: 10.1186/s40795-019-0288-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/26/2019] [Indexed: 11/17/2022] Open
Abstract
Background Poor quality of food services in hospital contributes to low diet satisfaction among inpatients in both developed and developing countries. However, there is paucity of literature on diet satisfaction in health care facilities in the sub-Saharan region and in particular Zambia. Therefore, this study sought to assess levels of diet satisfaction among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia. Methods A hospital-based cross-sectional study was conducted over a period of three months. Comprehensive sampling was used to select 98 study participants. A researcher-administered questionnaire adapted from a similar study was used to collect data. The instrument used in this study had 9 aspects of satisfaction. Descriptive statistics such as frequencies, percentages, means and standard deviations were used to analyze the data. Chi-square test was used to test for associations between categorical data. A p-value of less than 0.05 was considered to be statistically significant. Results In this study, 64.3% of surgical orthopaedic inpatients were not satisfied with overall quality of hospital food. In addition, 76.5, 96.9, 65.3 and 71.4% of the patients were not satisfied with type, variety, appearance and taste of hospital food respectively. However, patients who were satisfied with portion size, temperature and time of meal distribution were 67.3, 94.9 and 56.1% respectively. There was no significant association between variables of age, sex, education level, marital status, monthly income, days in hospital and overall satisfaction (p > 0.05). Conclusion Low diet satisfaction is a global problem associated with poor quality of hospital meals. Although the majority of surgical orthopaedic inpatients were not satisfied with more than half of the dimensions of diet satisfaction, they were satisfied with aspects of portion size, temperature and time of meal distribution. Therefore, an assessment of diet satisfaction can inform hospital administrators and policy makers on the deficiencies in hospital diets and thereby help improve quality of meals. Electronic supplementary material The online version of this article (10.1186/s40795-019-0288-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nixon Miyoba
- 1Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya.,Kitwe Teaching Hospital, Nutrition and Dietetics Unit, P.O. Box 20969, Kitwe, Zambia
| | - Irene Ogada
- 3Saint Francis Xavier University, Antigonish, Canada
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The impact of electronic meal ordering systems on hospital and patient outcomes: A systematic review. Int J Med Inform 2019; 129:275-284. [PMID: 31445267 DOI: 10.1016/j.ijmedinf.2019.06.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 06/24/2019] [Accepted: 06/24/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Malnutrition is a serious clinical issue associated with adverse patient and hospital outcomes. Hospitals need to consider interventions that support the provision of optimal nutritional management and care for patients. Electronic meal ordering (EMO) systems provide an alternative to traditional paper-based meal ordering with the capacity to support appropriate orders, monitor nutritional status, and potentially improve clinical outcomes. METHODS This review aimed to identify the impact of EMO systems on hospital and patient outcomes. We sought quantitative evidence (peer-reviewed and grey literature) from studies evaluating EMO systems in healthcare facilities, published after 1999 and available in the English language. RESULTS We identified 23 studies evaluating one of three distinct EMO system-supported models: spoken menu, room service, and self-service. While limited, the evidence indicated that EMO systems were associated with: improved patient satisfaction; decreased food waste; increased consumption; and, for spoken menus, more time with patients. There was no substantive evidence of impact on clinical outcomes. CONCLUSIONS Whether EMO systems meet their potential to support nutritional monitoring and positively impact clinical outcomes remains unanswered within the evidence. Thus, policy makers and hospital management currently have a poor evidence base upon which to make decisions about the value of implementing EMO. Whether these systems can provide support and guidance to patients during meal ordering, improve order appropriateness and accuracy through compliance checking, identify patients in need of dietary education or those at risk of malnutrition are critical areas of focus for future research.
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Sathiaraj E, Priya K, Chakraborthy S, Rajagopal R. Patient-Centered Foodservice Model Improves Body Weight, Nutritional Intake and Patient Satisfaction in Patients Undergoing Cancer Treatment. Nutr Cancer 2018; 71:418-423. [PMID: 30260687 DOI: 10.1080/01635581.2018.1506490] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Hospital malnutrition is a multi-factorial and complex problem seen in cancer patients receiving treatment, which is associated with poorer outcomes. Appropriate foodservice interventions may be required to improve nutritional status, prevent malnutrition and promote patient satisfaction. We introduced and implemented a patient-centered foodservice model with the aim of improving patient's overall nutritional care and enhancing patient experience. A cross-sectional analysis was done to evaluate outcomes between the traditional foodservice model and the newly implemented patient-centered foodservice model. A meal intake observation tool using a five-point visual scale along with a patient satisfaction survey was used to understand nutritional intake and patient satisfaction, respectively. The findings suggest increased nutritional intake and improved patient satisfaction with the patient-centered foodservice model. Comparison of weight change and nutritional intake between a traditional foodservice model (n = 60) and the patient-centered foodservice model (n = 100) showed a significant weight gain and increase in energy and protein intake (P < 0.01) in the patient-centered foodservice model. Higher patient satisfaction ratings indicated improvement with foodservice across domains in quality and flavor of food, timeliness of delivery, diet education and overall satisfaction. The study concludes that the patient-centered foodservice model can increase the nutritional intake in oncology patients and improve overall patient satisfaction.
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Affiliation(s)
- Esther Sathiaraj
- a Department of Onco-Nutrition , Cytecare Hospitals , Bengaluru , India
| | - Krishna Priya
- a Department of Onco-Nutrition , Cytecare Hospitals , Bengaluru , India
| | | | - Revathi Rajagopal
- b Department of Psycho-Oncology Services , Cytecare Hospitals , Bengaluru , India
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McCray S, Maunder K, Norris R, Moir J, MacKenzie-Shalders K. Bedside Menu Ordering System increases energy and protein intake while decreasing plate waste and food costs in hospital patients. Clin Nutr ESPEN 2018; 26:66-71. [DOI: 10.1016/j.clnesp.2018.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/15/2018] [Accepted: 04/18/2018] [Indexed: 10/16/2022]
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Barrington V, Maunder K, Kelaart A. Engaging the patient: improving dietary intake and meal experience through bedside terminal meal ordering for oncology patients. J Hum Nutr Diet 2018; 31:803-809. [DOI: 10.1111/jhn.12573] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V. Barrington
- Department Dietetics and Human Nutrition; College of Science, Health and Engineering; Latrobe University; Melbourne VIC Australia
| | - K. Maunder
- The CBORD Group Inc.; Chatswood NSW Australia
| | - A. Kelaart
- Cancer Council Victoria; Melbourne VIC Australia
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Greig S, Hekmat S, Garcia AC. Current Practices and Priority Issues Regarding Nutritional Assessment and Patient Satisfaction with Hospital Menus. CAN J DIET PRACT RES 2018; 79:48-54. [DOI: 10.3148/cjdpr-2018-002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: Patient satisfaction with hospital food enhances consumption and adequate intake of nutrients required for recovery from illness/injury and maintenance of health; accordingly, the nutrient content of the menu must balance patient preferences. This study of Ontario hospital foodservice departments collected data on current practices of analyzing the nutritional adequacy and assessing patient satisfaction with menus, and it explored perceptions of priority issues. Methods: Foodservice managers/directors from 57 of 140 (41%) hospitals responded to cross-sectional in-depth telephone interviews. Deductive analysis of responses to open-ended questions supplemented quantitative data from closed-ended questions. Results: The hospitals without long-term care facilities (LTCFs) assessed regular (58%), therapeutic (53%), and texture-modified (47%) menus for nutritional adequacy. This differed from hospitals governing LTCFs where there was a higher frequency of assessment of regular (75%), therapeutic (75%), and textured-modified (66%) menus. Most departments (86%–94%) obtained patient satisfaction feedback at the departmental/corporate levels. Many identified budget and labour issues as priorities rather than assessing menus for nutritional adequacy and patient satisfaction. Conclusions: Hospital menus were not consistently assessed for nutritional adequacy and patient satisfaction; common assessment methodologies and standards were absent. Compliance standards seem to increase the frequency of menu assessment as demonstrated by hospitals governing LTCFs.
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Affiliation(s)
- Susan Greig
- School of Food and Nutritional Sciences, Brescia University College, London, ON
| | - Sharareh Hekmat
- School of Food and Nutritional Sciences, Brescia University College, London, ON
| | - Alicia C. Garcia
- School of Food and Nutritional Sciences, Brescia University College, London, ON
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10
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McCray S, Maunder K, Krikowa R, MacKenzie-Shalders K. Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost. J Acad Nutr Diet 2018; 118:284-293. [DOI: 10.1016/j.jand.2017.05.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 05/12/2017] [Indexed: 11/26/2022]
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Russell-Bennett R, Glavas C, Previte J, Härtel C, Smith G. Designing a medicalized wellness service: balancing hospitality and hospital features. SERVICE INDUSTRIES JOURNAL 2017. [DOI: 10.1080/02642069.2017.1354988] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Charmaine Glavas
- QUT Business School, Queensland University of Technology, Brisbane, Australia
| | - Josephine Previte
- UQ Business School, University of Queensland, Brisbane, St Lucia, Australia
| | | | - Geoff Smith
- QUT Business School, Queensland University of Technology, Brisbane, Australia
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12
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Ottrey E, Porter J. Hospital menu interventions: a systematic review of research. Int J Health Care Qual Assur 2017; 29:62-74. [PMID: 26771061 DOI: 10.1108/ijhcqa-04-2015-0051] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Most patients in developed countries solely depend on the hospital menu to order their food. The provision of menu choices to patients differs between facilities. The purpose of this paper is to determine which strategies that provide menu choices to patients are effective in improving clinical and non-clinical outcomes in hospital. DESIGN/METHODOLOGY/APPROACH Five databases were searched to identify relevant publications. Prospective research published in English with the menu as the primary intervention was included. Study eligibility was determined and risk of bias assessed. Outcome data were combined narratively due to absence of homogeneous study design and outcomes. FINDINGS Of the 2,201 records screened, six studies met inclusion criteria. Standardised menu formatting and the spoken menu system were found to improve meal tray accuracy. The spoken menu and computerised interactive menu selector system enhanced aspects of patient satisfaction without cost increases. Descriptive menus may increase food consumption. Branding food items was not well supported by patients. One study rated positively for study quality with the remaining five studies receiving neutral quality ratings. RESEARCH LIMITATIONS/IMPLICATIONS The small number of studies conducted on each intervention and the quality of the evidence made it difficult to establish a solid evidence base around providing menu choices to patients. Further research is needed on menu ordering systems, including spoken and visual menus, to determine their impact on outcomes in hospital. ORIGINALITY/VALUE This review is first to examine the effectiveness of menu interventions in hospital. Hospital foodservice departments should consider these findings when reviewing local systems.
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Affiliation(s)
- Ella Ottrey
- Department of Nutrition and Dietetics, Monash University, Notting Hill, Victoria, Australia
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Dall'Oglio I, Nicolò R, Di Ciommo V, Bianchi N, Ciliento G, Gawronski O, Pomponi M, Roberti M, Tiozzo E, Raponi M. A systematic review of hospital foodservice patient satisfaction studies. J Acad Nutr Diet 2015; 115:567-84. [PMID: 25634093 DOI: 10.1016/j.jand.2014.11.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 11/12/2014] [Indexed: 10/24/2022]
Abstract
The quality of hospital foodservice is one of the most relevant items of health care quality perceived by patients and by their families. Patient satisfaction is considered a way of measuring the quality of services provided. The purpose of this study was to retrieve and review the literature describing patient satisfaction with hospital foodservices. The systematic review was conducted on three electronic archives, PubMed, Excerpta Medica Database, and the Cumulative Index to Nursing and Allied Health Literature (1988 through 2012), to search for any articles reporting patient satisfaction with hospital foodservices. A total of 319 studies were identified. After removing duplicates, 149 abstracts were reviewed, particular attention being given to the presence of a description of the tool used. Thirty-one articles were selected and the full texts were reviewed. Half the studies (n=15) were performed in North America. Patient satisfaction scores were generally high, with some variation among hospitals and different modes of food delivery that was investigated through intervention studies. Qualitative studies were also reported (ethnographic-anthropologic methods with interviews and focus groups). Quantitative tools were represented by questionnaires, some of which relied on previous literature and only a few were validated with factorial analysis and/or Cronbach's α for internal consistency. Most analyses were conducted assuming a parametric distribution of results, an issue not primarily tested. More studies on the quality of hospital foodservice have been carried out in North America than in Europe. Also, a variety of tools, most of which have not been validated, have been used by the different investigating facilities.
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Cheung G, Pizzola L, Keller H. Dietary, food service, and mealtime interventions to promote food intake in acute care adult patients. J Nutr Gerontol Geriatr 2013; 32:175-212. [PMID: 23924254 DOI: 10.1080/21551197.2013.809673] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common intervention with demonstrated effectiveness. "Food first" approaches have also been developed and evaluated. This scoping review identified and summarized 35 studies (41 citations) that described and/or evaluated dietary, foodservice, or mealtime interventions with a food first focus. There were few randomized control trials. Individualized dietary treatment leads to improved food intake and other positive outcomes. Foodservices that promote point-of-care food selection are promising, but further research with food intake and nutritional outcomes is needed. Protected mealtimes have had insufficient implementation, leading to mixed results, while mealtime assistance, particularly provided by volunteers or dietary staff, appears to promote food intake. A few innovative strategies were identified but further research to develop and evaluate food first approaches is needed.
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Affiliation(s)
- Grace Cheung
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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16
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Gibson F, Shipway L, Barry A, Taylor RM. What’s It Like When You Find Eating Difficult. Cancer Nurs 2012; 35:265-77. [DOI: 10.1097/ncc.0b013e31822cbd40] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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"Learning" from other industries: lessons and challenges for health care organizations. Health Care Manag (Frederick) 2012; 31:65-74. [PMID: 22282000 DOI: 10.1097/hcm.0b013e318242d399] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although it is true that health care has several distinguishing characteristics that set it apart, analysts both within and outside the industry point to several similarities with other fields and suggest opportunities for health care to learn from other industries. Applications from other industries have been described in the literature, but the transfer of learning at health care industry level has not been examined. This article investigates health care learning from other industries in the recent decade, focusing on aviation, high-reliability organizations, car manufacturing, telecommunication, car racing, entertainment, and retail; evidence suggests that most innovative practices originate with these fields. The diffusion of innovations from other industries appears to start with a few early adopter organizations (hospitals and health systems) and influential other organizations (The Joint Commission, Institute of Medicine, Agency for Healthcare Research and Quality, or Institute for Healthcare Improvement) pushing for the innovations. Once the trend becomes accepted, consultants and copying behavior seem to contribute to its spread across the industry. An important question to explore is whether the applications in the early adopter organizations are different (in terms of their effectiveness) from those in the rest of the industry. Another intriguing issue is to examine whether other industries learn from health care organizations.
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Kim K, Kim M, Lee KE. Assessment of foodservice quality and identification of improvement strategies using hospital foodservice quality model. Nutr Res Pract 2010; 4:163-72. [PMID: 20461206 PMCID: PMC2867228 DOI: 10.4162/nrp.2010.4.2.163] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 03/30/2010] [Accepted: 03/30/2010] [Indexed: 11/22/2022] Open
Abstract
The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.
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Affiliation(s)
- Kyungjoo Kim
- Department of Food and Nutrition, Seoul Women's University, 623 Hwarangro, Nowon-gu, Seoul 139-774, Korea
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Kuperberg K, Mager D, Dello S. Transformation to Room Service Food Delivery In a Pediatric Health Care Facility. CAN J DIET PRACT RES 2009; 70:200-3. [DOI: 10.3148/70.4.2009.200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Patient food service is an important component in the nutritional management of hospitalized children. The previous meal delivery system at The Hospital for Sick Children in Toronto was a cold-plating re-thermalized system. Issues related to this model included order lead time, the reheating process, menu selection, and service style. Research into other systems led us toward room service, an innovative and flexible mode of meal delivery. Transformation to room service occurred over one year, and included implementation of a new computer system, kitchen renovation, redesign of menus and a new meal delivery system called Meal Train, and changes to human resource allocations. Throughout the transformation, consultations were held with key stakeholders, including the children’s council, the family advisory, the nursing council, and a multidisciplinary committee involving nursing staff, dietitians, patient service aides, infection control personnel, occupational health employees, patient representatives, and food services staff. Now, Meal Train is running smoothly, and meal days and food costs have been reduced. Others considering a project like this must know their clients’ needs and be willing to think outside the box. They should familiarize themselves with current information on systems and equipment, consult with key stakeholders within their organization, and then create the system that will work for them.
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Affiliation(s)
- Karen Kuperberg
- Department of Nutrition and Food Services and Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, ON
| | - Diana Mager
- Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, ON, and Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB
| | - Susan Dello
- Department of Nutrition and Food Services, The Hospital for Sick Children, Toronto, ON
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Kuperberg K, Caruso A, Dello S, Mager D. How will a room service delivery system affect dietary intake, food costs, food waste and patient satisfaction in a paediatric hospital? A pilot study. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1748-0159.2008.00103.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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