Investigating the patient food experience: Understanding hospital staffs' perspectives on what leads to quality food provision in Ontario hospitals

Abstract

Background: Food quality influences patient food satisfaction, which may subsequently affect food intake and recovery, influencing hospital costs. The present qualitative study aimed to gain an understanding of hospital staff/ volunteers experiences of serving food in Ontario hospitals, perceptions of food quality and challenges to quality food provision. Methods: Sixteen Ontario hospitals participated. Semi-structured interviews (n = 64 participants) and focus groups (n = 24; 150 participants) were conducted. Transcripts were analysed using inductive thematic analysis. Results: Four themes emerged: (1) Providing Good Quality Food (e.g., attributes that comprise the construct of meal quality, patients' expectations and desires from meals); (2) Individualising the Food and Mealtime Experience (e.g., processes to identify and cater to patients' needs and preferences); (3) Acknowledging Organisational Constraints (e.g., staffing, budget, etc.); and (4) Innovating Beyond Constraints (e.g., identifying innovation within potential modifiable and unmodifiable organisational constraints). Conclusions: Serving meals in hospital is complex because of organisational and patient factors; however, current efforts to serve quality food despite these complexities were uncovered in our investigation. Discussions highlighted current practices that promote food quality and strategies for improvement. Improving food quality and the hospital meal experience can support food intake and patient outcomes, as well as reduce waste and hospital associated costs. The findings can be used to support quality improvement measures aiming to serve high quality food that meets patients' expectations and nutritional needs.clinical nutrition, food service, food service and management, meals, food and drink, qualitative, study design and analysis, research Key points • Staff described quality hospital food as having favourable sensory attributes (e.g., flavour) in addition to food-related attributes such as freshness and variety. • Various organisational constraints such as foodservice budget, staffing and foodservice processes influence the capacity to serve high-quality hospital food. • Despite constraints, current practices such as facilitating opportunities for patients to choose their meals support quality food provision in hospital.

Hospital Food Waste: Contributing Factors of Waste Generation and Strategy for Waste Minimization

“…The meal quality ratings are more significant when dietary employees are responsible for the delivery (Hartwell & Edwards, 2003). In contrast, patients may negatively perceive the food given in hospitals due to inadequate staff behaviors, perhaps reinforcing unfavorable perceptions and leading to decreased food intake and satisfaction (Trinca et al, 2022). In addition, the delivery by nursing staff is associated with higher scores in terms of care and concern (Hartwell & Edwards, 2003).…”

“…Providing clean and comfortable rooms devoid of any unpleasant odors and staff-related disturbances can enhance patients' dining experience. According to a study conducted in the Netherlands, which examined the associations between plate waste and various patient and environmental factors, it was determined that other than appetite, the movement of individuals entering and exiting rooms for patients was the most substantial indicator of heightened plate waste (Trinca et al, 2022;Williams & Walton, 2011). Diana et al (2022) also mentioned a significant correlation between environmental factors and hospital services, specifically inpatient classes, and the amount of plate waste generated within certain hospitals in Indonesia.…”

“…The food selection allows patients to exert a certain degree of influence over their healthcare experience, albeit limited, such as having the option to choose their dessert. This may enhance their satisfaction levels and views on food quality (Trinca et al, 2022). A further pilot study was conducted to investigate if a chosen menu might raise food intake and reduce plate waste by hospitalized children with orthopedic conditions.…”

“…Moreover, this approach effectively handles several concerns by using strategies such as enhancing staff-patient interactions and granting patients autonomy in meal selection, in contrast to the conventional food service approach (Manimaran et al, 2023;McCray et al, 2018). Although implementing bedside ordering and room service models may incur high costs, it is essential to consider the potential cost savings achieved through enhanced intake, reduced food waste, and decreased hospital-associated expenses (Trinca et al, 2022). The decrease in excessive meal orders for patients who could not select their preferred meals or had their dietary needs altered after submitting their initial menu choices significantly reduced waste, consequently leading to cost savings (McCray et al, 2018).…”

“…It has been extensively established to have negative consequences such as higher rates of death, morbidity, prolonged hospital stays, and increased healthcare expenses (Neaves et al, 2022). Furthermore, Inadequate nutritional intake and aggravation of malnutrition are connected to rising hospital expenses due to readmission and resource usage (Trinca et al, 2022). Hence, it is imperative to understand the factors contributing to waste generation and implement measures to enhance the quality of food services inside hospital settings, with the dual objective of mitigating malnutrition and minimizing food wastage.…”