A preliminary assessment of two hospital food service systems using parameters of food safety and consumer opinion

Packaged hospital food appears safe and feasible to reuse

AIM

To determine the safety, operational feasibility and environmental impact of collecting unopened non-perishable packaged hospital food items for reuse.

METHODS

This pilot study tested packaged foods from an Australian hospital for bacterial species, and compared this to acceptable safe limits. A waste management strategy was trialled (n = 10 days) where non-perishable packaged foods returning to the hospital kitchen were collected off trays, and the time taken to do this and the number and weight of packaged foods collected was measured. Data were extrapolated to estimate the greenhouse gasses produced if they were disposed of in a landfill.

RESULTS

Microbiological testing (n = 66 samples) found bacteria (total colony forming units and five common species) on packaging appeared to be within acceptable limits. It took an average of 5.1 ± 10.1 sec/tray to remove packaged food items from trays returning to the kitchen, and an average of 1768 ± 19 packaged food items were per collected per day, equating to 6613 ± 78 kg/year of waste which would produce 19 tonnes/year of greenhouse gasses in landfill.

CONCLUSIONS

A substantial volume of food items can be collected from trays without significantly disrupting current processes. Collecting and reusing or donating non-perishable packaged food items that are served but not used within hospitals is a potential strategy to divert food waste from landfill. This pilot study provides initial data addressing infection control and feasibility concerns. While food packages in this hospital appear safe, further research with larger samples and testing additional microbial species is recommended.

Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review

This review aims to identify hospital food service strategies to improve food consumption among hospitalized patients. A systematic search that met the inclusion and exclusion criteria was manually conducted through Web of Science and Scopus by an author, and the ambiguities were clarified by two senior authors. The quality assessment was separately conducted by two authors, and the ambiguities were clarified with all the involved authors. Qualitative synthesis was used to analyze and summarized the findings. A total of 2432 articles were identified by searching the databases, and 36 studies were included. The majority of the studies applied menu modifications and meal composition interventions (n = 12, 33.3%), or included the implementation of the new food service system (n = 8, 22.2%), protected mealtimes, mealtime assistance and environmental intervention (n = 7, 19.4%), and attractive meal presentation (n = 3, 8.3%). Previous studies that used multidisciplinary approaches reported a significant improvement in food intake, nutritional status, patient satisfaction and quality of life (n = 6, 16.7%). In conclusion, it is suggested that healthcare institutions consider applying one or more of the listed intervention strategies to enhance their foodservice operation in the future.

Food production and service in UK hospitals

PURPOSE

The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food.

DESIGN/METHODOLOGY/APPROACH

Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK.

FINDINGS

The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations.

RESEARCH LIMITATIONS/IMPLICATIONS

Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals.

PRACTICAL IMPLICATIONS

The paper identifies opportunities for enhancing hospital food production systems.

ORIGINALITY/VALUE

The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.

A systematic review of hospital foodservice patient satisfaction studies

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.

Knowledge, Attitudes, and Practices of Food Service Staff Regarding Food Hygiene in Shiraz, Iran

Background:

The practice of safety measures by the food service staff in hospitals is necessary for the prevention of food-borne outbreaks. Hospitalized patients are more vulnerable to potential hazards, and neglecting these principles can lead to increased morbidity and mortality.

Methods:

We assessed the knowledge, attitudes, and practices of food service staff regarding food hygiene in government and private hospitals in Shiraz, Iran. Two questionnaires were designed, one for food service staff and the ofher for supervisors. Thirty-one hospitals were approached, and the response rate was 99.5%. Four models were developed regarding knowledge, attitudes, and practices, and a multiple logistic regression analysis was performed. Comparison among the government and private hospitals was done.

Results:

This study showed that personnel had little knowledge regarding the pathogens that cause food-borne diseases and the correct temperature for the storage of hot or cold ready-to-eat foods. Older personnel had better attitudes and practices. Females practiced safety measures less often than did males. Personnel working in hospitals with fewer than 300 beds also had better practices. Most of the personnel had positive attitudes, but disparity between attitude and practice was noted.

Conclusion:

There is a dire need for education and increased awareness among food service staff regarding safe food handling practices.

Patients' satisfaction with the bulk trolley system in a government hospital in Malaysia

Purpose

The purpose of this paper is to determine patients' satisfaction with the bulk trolley food service system and the effect of the system on energy and protein intakes.

Design/methodology/approach

An interview‐based questionnaire was used to measure patients' satisfaction (n=70) with the hospital food services. Dietary intake of hospital food was determined through one‐day weighed food intake survey and a food record for non‐hospital food.

Findings

The majority of the patients (98.6 per cent) were satisfied and 1.4 per cent was very satisfied with the food service. Energy (kcal) and protein (g) intakes from hospital food were higher than that of outside food (p<0.05). However, most patients did not obtain their full energy and protein requirements from the hospital food provided. Four food service dimensions were found to be significantly correlated with patients' overall satisfaction (p<0.05).

Research limitations/implications

The questionnaire was adapted from the study by Capra et al. and modified to suit the local food service system, thus the application may be context‐specific. The instrument did not measure factors that influence hospital food consumption, nor did it differentiate between the acceptability of different kinds of food. Also a comparison of patients' acceptance between the plated and bulk trolley system was not conducted in this study.

Practical implications

The results of the study can be used as a basis for decision making and for future planning of the food service system. The findings prompt analytical comparison, between the bulk trolley, and plated systems, in determining patients' preference, and to increase food intake.

Originality/value

Patient satisfaction surveys are regularly conducted in the country but none had ever studied the effectiveness of the bulk trolley system in relation to patients' satisfaction. The findings are noteworthy and, compared with the past literature review, the difference in the way the system is carried out in the country may be the contributing factor regarding patients' satisfaction system.