Patient experience, nutritional uptake and satisfaction with hospital food services

It has been recognised that hospital food service could be improved, with malnutrition a particular concern. The problem of patients obtaining adequate nutrition in hospital is complex with many constraints at ward level. The hypothesis of this study is that patients able to see and smell the food on offer and with potential for greater server empathy, will achieve better nutritional status and increased meal satisfaction. Data were collected from two wards, Women's Health and Orthopaedic, (n=62) over two, three-day consecutive periods. Firstly, for a pre-ordered, plated meal service and secondly, nine months later, for a trolley service offering choice at the point of consumption. Food was weighed before and after the meal. Questionnaires were administered and interviews conducted with patients (n= 614) to evaluate patient acceptability of both catering systems and other pertinent data. The research methodology also involved collecting observational data during mealtimes. Focus groups were conducted with ward staff, and patients together with their visitors while open ended interviews were conducted with the catering manager, facilities manager, chief dietitian, orthopaedic ward dietitian and chief pharmacist. This was to enhance and validate information already gathered. Results show that nutritional intake was not dependent on the catering system and that possibly in hospital; unlike other `eating out' situations there are barriers to `complete nutrition'1. A theoretical model of patient experience and satisfaction with hospital food service is presented, reflecting data gathered during the case study. Texture and temperature of food were shown to be critical factors impinging on patient satisfaction and the trolley system of delivery is the preferred style of service. Service predisposition demonstrates little significance with patient satisfaction towards the overall meal experience. This research indicates that nutritionally, the method of meal delivery is immaterial but patients do prefer choice at the point of consumption. 1 A term used to define the provision of a healthy nutritionally balanced diet which meets and satisfies both physiological and psychological requirements.