Meals beyond the bedside: An ethnographic exploration of staffs' perspectives and experiences of communal dining in subacute care

Abstract

Communal dining offers multiple benefits for hospital patients, yet dining rooms may be underutilized in practice. This study aimed to understand and explore staffs' perspectives and experiences of communal dining in subacute care, and the impacts on staff mealtime practice. Using qualitative, ethnographic methodology, 94 hours of fieldwork were conducted across two subacute care wards. Participants were staff involved in nutrition care or present on the ward at mealtimes. Ninety‐one semistructured and ethnographic interviews were conducted with 59 staff, and 54 episodes of observation captured more than 190 staff. Interviews and field notes were thematically analyzed using an inductive approach. Three themes were identified: (i) benefits to patients; (ii) logistical and practical challenges; and (iii) supportive cultural factors. While staff recognized how communal dining benefited patients, logistical and practical challenges impacted their ability to facilitate it in practice. Healthcare organizations seeking to embed communal dining into the mealtime routine should recognize that clear delineation of staff roles and responsibilities, and cultural change involving normalization, setting expectations, and collective advocacy may be needed to optimize benefits for patients.

Indirect Nutrition and Mobility Risks during Hospitalization: An Architectural Perspective on the nutritionDay Study Findings

“…If the room is too far from the patient’s room, it might be difficult for the patient to reach it independently. This creates more workload for the nursing staff to transport patients from their room to the dining room [ 45 ]. In a study in the stroke rehabilitation context, the distance was found to play a role in patients’ mobility—patients were only independently visiting spaces close to their rooms [ 46 ].…”

“…Thus, if communal dining areas for hospitalized patients are implemented, they should be within a distance where most patients can reach them independently. In addition to transporting patients, another challenge of communal eating is keeping careful supervision over all patients during mealtimes, as some patients cannot eat outside their rooms [ 45 ]. This could be alleviated by positioning the dining room centrally on the ward and allowing for easy supervision via a large window close to the nurses’ station [ 45 ].…”

“…In addition to transporting patients, another challenge of communal eating is keeping careful supervision over all patients during mealtimes, as some patients cannot eat outside their rooms [ 45 ]. This could be alleviated by positioning the dining room centrally on the ward and allowing for easy supervision via a large window close to the nurses’ station [ 45 ]. This kind of schematic organization is shown in Figure 6 Type B.…”

“…The location of where main meals are eaten and where snacks are eaten might also not be in the same environment; there could be multiple communal dining options outside of patients’ rooms to allow space to socialize with other patients or to be alone with their visitors. This multiple-space nutritional environment concept needs to be examined from the nurses’ point of view as well, as it would increase the logistical challenges, such as transport and supervision [ 45 ].…”

Foodservice systems and mealtime models in rehabilitation: Scoping review

“…c Two wards reported on, however unable to distinguish systems used in each to report on separately. Three qualitative studies reported over seven papers (Baptiste et al, 2014;Jong et al, 2021;Ottrey et al, 2018Ottrey et al, , 2019Sidenvall, 1999;Sidenvall et al, 1994;Sidenvall et al, 1996) and one mixed-methods study (Mathiesen et al, 2021) discussed outcomes related to the eating environment (n = 8). Attitudes and perspectives, and actions and behaviours were explored in three studies each, and values and beliefs were explored in two studies.…”