Benefits of a Just-In-Time Spoken Patient Menu

Abstract

An opportunity was identified to improve the process of patient meal service. Our current process of 88 menu types required patients to select menu options the day before delivery. Findings suggested that a large percentage of our patients (35%) did not select their menu options. When the menu options were selected, they often did not coincide with the patient's appetite on the day of delivery. In addition, having 88 menu types was labor intensive for our patient tray assembly line. The average length of stay at our institution decreased to 5 days while patient acuity increased. The benefit of a restrictive diet for acutely ill patients with a brief hospital stay is questionable. The use of preprinted diet sheets for patients with diabetes has been discouraged since 1979. In a hospital environment of shortened length of stay, increased patient acuity and emphasis on food service cost control, re-engineering the patient meal service became a necessity. A departmental functional working group was formed. Our goals were to consolidate and liberalize patient menus and to implement a “just-in-time” concept of patient menu ordering. The just-in-time meal delivery system is based on a healthy heart spoken menu. Each regular menu is moderately calorie and sodium restricted; low fat and low cholesterol to meet the NCEP Step 1 guidelines. Diet technicians visit 100 percent of patients to obtain menu requests for the same day. Menu selections now reflect today's appetite, not yesterday's. Patient menu types were streamlined from 88 to 30. Our cycle menu was reduced from two weeks to one week. These changes significantly decreased the number of errors on the patient tray line and saved one full-time equivalent (FTE) in the diet office and one FTE for patient tray assembly at an actual cost savings of $49,000 annually. Our findings suggest that a liberalized spoken menu with day of delivery menu selection optimizes patient nutrient intake, improves patient satisfaction, and significantly reduces labor costs.