Hospital Food Research Articles

Perception of Hospital Food Service Workers Regarding Patient Safety Culture and Patient Identification Practice

Implementing the 'Patient Identification' procedure during food distribution will ensure the right diet is served to the right patient. This study explored the perception of patient safety culture and its association with patient identification practices among hospital food service workers. We conducted a mixed method research in a Joint Commission International (JCI)-accredited hospital in Yogyakarta. Food service workers who received patient safety training and were responsible for distributing food in adult inpatient wards (n=76) participated in this study. Perception of patient safety culture was measured using a validated questionnaire and in-depth interview, whereas patient identification practice was observed directly using a checklist. Descriptive statistics and chi-square tests were employed. More than half (55.3%) of the subjects perceived overall patient safety culture well. However, 34.2% of the subjects performed substandard practice verifying the patient's identity (name, address, or medical record number) when delivering food. There was an insignificant association between the perception of patient safety and patient identification practice by food service workers (p0.05), as some considered that patient identification was more appropriate to be performed by other health professions instead of food service workers. Nevertheless, nearly all (98,68%) food service workers perceived their duty to match the patient's name with the label on the food tray as important.

Hospital Food Services Satisfaction Survey among Healthcare Professionals in a Tunisian University Hospital

Background: Periodic monitoring of food quality can help determine the staff’s satisfaction at any institution, such as the hospital. However, the lack of published studies on the evaluation of staff’s satisfaction with hospital food prompted us to conduct the first survey on this topic in Tunisia. The aim was to determine the prevalence of food satisfaction among health professionals and identify factors affecting the satisfaction level. Methods: It was an analytic cross-sectional study conducted among all staff members of Farhat Hached University Hospital in Sousse in November 2020. Data collection took place over a period of 10 days with one service being surveyed per day. Free and informed consent was obtained from all participants. Categorical variables were described in percentages and compared using the Chisquare test. Univariate analyses were performed to examine associations between the level of satisfaction and various factors. Binary logistic regression was used to eliminate confounding factors. Results: A total of 240 professionals participated in the survey. The majority were female (72.5%) with an M/F sex ratio of 0.38, under 40 years old (94.6%), medical doctors (78.8%), and having less than 5 years of professional experience (73.3%). The overall satisfaction rate was 33.3%. The majority of healthcare professionals were not satisfied with the quality of food (75.8%) and with the personal hygiene of staff who presented the food (78.4%). Factors associated with hospital food satisfaction were the taste and variety of food, cleanliness, quality of dishes, and consuming the entire meal. Conclusion: It is the first study to report the meal experience as perceived by hospital staff in Tunisia. The overall satisfaction rate has been found to be 33.3%, which remains low. Efforts should be made to improve the presentation of all meals. Periodic monitoring of food quality can help determine if recommendations and staff expectations are being met.

Hydrothermal pre-treatment of hospital food waste for efficient bio-methane generation

Municipal solid waste management (MWM) in Malaysia has become a challenging task in recent years due to the growth of population, industrialization and an increase in quantity and variation in the types of waste generated. Major solid waste generated in Malaysia is organic waste which includes mainly food waste from households, food processing facilities, markets, food and beverages industry and hospitals. Therefore, it is crucial to identify ways to manage food waste (FW) properly and improve the energy recovery efficiency. This paper is aimed to study the impact of pre-treatment on food waste from Hospital Pakar Sultanah Fatimah (HPSF) as a method to decompose FW faster and to determine the potential of bio-methane generation. A compositional study showed that total solid waste generated was 2,301 kg with 67% waste from lunch followed by 31% from breakfast sessions daily. Hydrothermal pre-treatment was done using a Multipurpose Recycling Machine (MRM) at 1.6MPa for 15 minutes followed by anaerobic digestion with and without the inoculum addition. Un-treated FW with inoculum was used as control in this experiment. It was found out that at a controlled pH of 7, hydrothermal pre-treatment and addition of inoculum i.e. cow manure played an important role in anaerobic digestion process for enhancement of bio-methane production. It significantly reduced the lag phase by 4 days and produced biogas faster compared to nontreated FW and hence, increased the biogas volume up to 638.53 mL compared to 504.08 mL in non-treated FW at the same experimental conditions. Therefore, this study signified that hydrothermal pretreatment is an effective and a beneficial technique added to the waste through the generation of biogas energy.

Análise comparativa da percepção de pessoas idosas e adultos hospitalizados sobre a qualidade da dieta hospitalar

Abstract Objective To analyze and compare the perception of hospital diet quality between older adults and hospitalized adults. Method Quali-quantitative research conducted at a public hospital in the state of São Paulo, Brazil, involving older adults (n=185) and adults (n=185) who have been hospitalized for at least three days, receiving a general/soft oral diet, and classified according to the prescribed diet type: unrestricted diet (GSR), for glycemic control (GDM), or low-sodium (GHSS). The data were collected through individual interviews, utilizing a validated questionnaire. Diet quality was assessed using a Likert scale, considering the categories of taste, temperature, quantity, appearance, meal timing, hygiene, and availability for food substitution. The qualitative data were subjected to thematic content analysis, while the quantitative data underwent descriptive and statistical analysis using Kruskal-Wallis tests (for quantitative variables) and chi-square tests (for qualitative variables). Results Regardless of the prescribed diet (p≥0.05), both older adults and hospitalized adults considered the quality of hospital food satisfactory (Good/Excellent) across the assessed satisfaction categories, except for taste, which showed a significant association with the prescribed diet for older adults (p=0.05). Three thematic categories emerged from the reports, indicating that both older adults and adults understand the importance of hospital diet for health recovery, yet a negative expectation regarding the offered meal is still prevalent. Hospital diets with restrictions influence taste perception in older adults. Understanding this particularity can assist in the creation of strategies for adaptation and better acceptance of hospital diets for this age group.

A review on hospital food waste quantification, management and assessment strategies in the eastern Mediterranean region

BackgroundHospital food wastage has been identified as a significant issue within the foodservice sector. Numerous studies have shed the light on the amount of food waste in hospitals, along with its financial and environmental implications. Consequently, reducing food waste in hospitals has become a priority for the foodservice management sector in the Eastern Mediterranean Region (EMR). AimsThis review aims to examine studies on food waste in the hospitals of the EMR countries, and highlight research gaps in quantification, management, and assessment strategies in this region. MethodsPubMed and Google Scholar databases were searched between January 6 and September 1, 2023, to identify relevant articles published up to 2023 in the EMR. ResultsSix studies were included in this review. Among EMR countries, only Iran, Saudi Arabia, and Qatar have assessed food waste at hospitals. The average food waste in the EMR represents 25.4 % of total food served. Factors contributing to food waste include clinical issues, food preferences, meal timing, and ward sections. Patient's plate waste reduce dietary intake, affects patient's nutritional status and predispose to malnutrition. While some strategies to reduce plate waste have been proposed in many countries, there is a notable lack of food and food-related waste management policies and programs in hospitals food services in the EMR. ConclusionThis review summarizes the hospital's food-related waste assessment, quantifications, and management used by hospitals in the EMR. This review is a benchmark for the EMR's hospitals to work on adopting proactive measures as a general strategy to move toward food and food-related waste reduction.

Hospital food management: a multi-objective approach to reduce waste and costs

Food waste contributes significantly to greenhouse emissions and represents a substantial portion of overall waste within hospital facilities. Furthermore, uneaten food leads to a diminished nutritional intake for patients, that typically are vulnerable and ill. Therefore, this study developed mathematical models for constructing patient meals in a 1000-bed hospital located in Florida. The objective is to minimize food waste and meal-building costs while ensuring that the prepared meals meet the required nutrients and caloric content for patients. To accomplish these objectives, four mixed-integer programming models were employed, incorporating binary and continuous variables. The first model establishes a baseline for how the system currently works. This model generates the meals without minimizing waste or cost. The second model minimizes food waste, reducing waste up to 22.53 % compared to the baseline. The third model focuses on minimizing meal-building costs and achieves a substantial reduction of 37 %. Finally, a multi-objective optimization model was employed to simultaneously reduce both food waste and cost, resulting in reductions of 19.70 % in food waste and 32.66 % in meal-building costs. The results demonstrate the effectiveness of multi-objective optimization in reducing waste and costs within large-scale food service operations.

Oral diet in a hospital environment: factors that make it difficult for elderly patients to eat

Introduction: Changes in nutritional status in the elderly are related to the cause of many clinical complications. Inadequate acceptance of the diet can lead to a significant worsening of nutritional status during hospitalization. Objective: to analyze the dietary factors that make it difficult for elderly hospitalized patients to accept the oral diet. Methods: The study was quantitative, exploratory-descriptive and cross-sectional, with patients aged 60 years or over using the exclusive oral route for at least 3 days, both sexes, from June to September 2023. The medical records were analyzed for information for nutritional anamnesis. Data on food acceptance were obtained and the Dietary Assessment Scale for the Hospitalized Elderly was applied. Results: The sample consisted of 13 elderly people with predominantly low weight nutritional status. It was identified that dietary factors are not those that make oral feeding most difficult for those evaluated, but that those who mentioned it, pointed out the temperature as decisive for eating. Conclusion: There is a need to evaluate the processes involved in preparing these meals and develop strategies to stimulate patients' food intake, based not only on nutritional functions, but also on the hedonic and social functions of hospital food.

Individualised nutritional treatment increases the positive effects of a novel á la carte hospital food service concept: Results of a quasi-experimental study

One-third of hospitalised patients are at nutritional risk, and limited choice regarding meals and meal times, and inadequate nutritional support may contribute to inadequate nutritional intake during hospitalisation. The aim was to test the effect of a novel á la carte hospital food service concept as a stand-alone intervention and combined with individualised nutritional treatment. Medical inpatients at nutritional risk were recruited for this three-arm quasi-experimental study. The control group received meals from the traditional bulk trolley food service system. Intervention group 1 (IG1) received meals from a novel á la carte food service concept with an electronic ordering system, whereas intervention group 2 (IG2) in addition to this received individualised nutritional treatment by a clinical dietitian. Nutritional intake and length of stay was measured, and patient satisfaction was assessed with purpose-designed questionnaires. 206 patients were included: 67 in the control group, 68 in IG1, and 71 in IG2. The proportion of participants reaching ≥75% of both their energy and protein requirement was higher in IG1 compared to the control group (34% vs. 12%, p=0.002) and higher in IG2 compared to IG1 (53% vs. 34%, p=0.035). Length of stay was shorter in IG2 compared to the control group (6.0 vs. 8.7 days, p=0.005). It was important to participants to be able to choose when and what to eat, and this preference was met to a larger extent in the intervention groups. The novel á la carte concept increases energy and protein intake in hospitalised patients, and the positive effects are increased, when the concept is used in combination with individualised nutritional treatment.

Do food delivery apps influence food waste generation? A stimulus-organism-behavior-consequence (SOBC) exploration

PurposeFood waste in the hospitality sector has emerged as a global concern. Various technology-driven online food services such as the food delivery apps (FDA) contribute to hospitality food waste. FDA users might behave irresponsibly by ordering more foods than required which may lead to food waste generation. To date, limited studies have been attempted to understand how consumers’ over-ordering behavior through FDA result in hospitality food waste.Design/methodology/approachThe authors used partial least squares structural equation modeling (PLS-SEM) to analyze survey data from 248 FDA users.FindingsThe results indicated that perceived convenience and trust positively influence consumers' attitude toward FDA, which in turn promotes over-ordering behavior. Interestingly, the anticipated positive relationship between price advantage and attitude toward FDA was not supported by the data. Furthermore, the authors confirmed that over-ordering behavior contributes to food waste, an outcome that has crucial implications for both the hospitality sector and sustainability efforts.Originality/valueThe current study employs the stimulus-organism-behavior-consequence (SOBC) theory to investigate the catalysts and consequences of over-ordering behavior via FDA. This study thus highlights the importance of the SOBC model in understanding consumer behavior.

Selection of suppliers using FBWM-FGRA hybrid approach in hospital food supply chain

In the current study, a new approach to assess and select food suppliers in hospitals is presented using integrated group evaluation method of fuzzy best- worst method (FBWM) and fuzzy gray relational analysis (FGRA). Evaluation criteria are selected by experts and weighed by the fuzzy best-worst method. After that, suppliers are rated using FGRA method. The proposed approach was implemented with seven criteria in one of the Iranian hospitals, and the results showed that quality, delivery time and trust criteria had the highest and skilled manpower and lack of surplus production criteria had the lowest score. Using FGRA, existing suppliers were ranked and the appropriate supplier was identified. In order to evaluate the reliability of the results, sensitivity analysis was performed on the criteria changes. The results showed that the supplier’s selection is greatly influenced by the criteria estimation values by the experts.

Exploring knowledge, perception, and expectation about hospital food among pediatric cancer patients at Dr. Sardjito Hospital, Indonesia

Exploring knowledge, perception, and expectation about hospital food among pediatric cancer patients at Dr. Sardjito Hospital, Indonesia

Hospital food service in piedmont region: State of the art and trends

Hospital food service in piedmont region: State of the art and trends

Individualised nutritional treatment increases the positive effects of a novel á la carte hospital food service concept: Results of a Quasi-experimental study

Individualised nutritional treatment increases the positive effects of a novel á la carte hospital food service concept: Results of a Quasi-experimental study

DETERMINANTS OF INPATIENT SATISFACTION IN FOOD SERVING AND FOOD SERVICE AT MELATI HOSPITAL TANGERANG

Hospital is one of the health service industries that has an important role in providing health services to the community. One of the services at the hospital is hospital nutrition service activities which consist of outpatient nutrition care, inpatient nutrition care, food administration, and research and development. Many parties often pay attention to the organization of food in hospitals, in this case, inpatient food services because it is related to patient satisfaction. This study aims to determine the determinants associated with inpatient satisfaction in serving and serving food. The research method used is the chi-square correlation. The sample in this study were inpatients at Melati Hospital Tangerang, totaling 193 patients. The sampling technique used purposive sampling and was taken using a questionnaire. The significance values of the variables age, gender and education were 0.035, 0.048 and 0.018 less than ? (0.05) while the significance values of the variables of work and type of diet were 0.637 and 0.642 more than ? (0.05). This study obtained the results that there was a significant relationship between age, gender and education with service satisfaction and food serving, while work and type of diet did not have a significant relationship with food serving and service.
 Keywords: Food Service, Food Serving, Patient Satisfaction, Chi-square

HOSPITAL FOOD SERVICE QUALITY IMPROVEMENT QUESTIONNAIRE (HFSQIQ): DEVELOPMENT, TRANSLATION AND VALIDATION OF A QUESTIONNAIRE

The hospital food service department provides meals to staff, patients, and their caregivers while adhering to dietary therapy guidelines and promoting nutritional wellness. High-quality food service plays a pivotal role in offering inpatients nourishing meals that promote physical and mental well-being, aiding their recovery and overall health during their hospitalisation. This study aimed to develop and validate a tool for measuring and evaluating hospital food operations using the Total Quality Management approach. A literature review, in-depth interviews with food service employees, and a peer-review process were conducted to identify the domains and items for the questionnaire. A “Hospital Food Service Quality Improvement Questionnaire” (HFSQIQ) with 61 items in six domains was developed and the content validation was performed by seven experts. The questionnaire was translated into Malay, and the internal consistency of the HFSQIQ was examined using Cronbach’s alpha. Resultantly, the HFSQIQ depicted high validity and reliability, with a high I-CVI and Kappa index rating for most items and a Cronbach alpha value of 0.97 and 0.98 for the importance and performance scales, respectively. In conclusion, the HFSQIQ is a useful tool for evaluating and improving the quality of hospital food service operations.

Predicting Patient Satisfaction Levels Using Artificial Intelligence Technology for Food Service at ERI Soedewo RSPAD Gatot Soebroto

Satisfaction is one aspect that assesses the quality of health services, namely in serving food in hospitals. The purpose of this study was to describe the level of patient satisfaction with food at the Eri Soedewo Pavilion, Gatot Soebroto Army Hospital. The results of a study of 47 patients in the Eri Soedewo Pavilion in June 2021 showed that the remaining food of patients who consumed 20%, 35 patients were categorized as good, while 12 patients had the remaining food consumed 20%, which was classified as not good. Therefore, researchers are interested in conducting this research. Methods: The type of research used is observational with a cross-sectional design. Samples were taken using purposive sampling with inclusion criteria: male and female inpatients aged18 years admitted for at least two days, patients who received oral food from the hospital, were not illiterate and could communicate, had signed the PSP form and were willing as research samples. The model in this study was 47 patients taken in June 2021. Results: Based on the sample size calculation, 47 people were determined. The results of the level of patient satisfaction at the Eri Soedewo Pavilion, Gatot Soebroto Army Hospital, found that the performance of food serving has not met the minimum standard set, namely 90%. With a higher percentage of reality, namely with an average of 82.0%, the average expectation percentage is 76.7%. However, suppose the real results are compared with patient expectations. In that case, the result is that the patient is satisfied with the services provided. Artificial intelligence can assess medical data, food preferences, and patient feedback to improve food serving performance.

Investigation of Parasites in Food Handlers in Turkey.

Increasing world population parallelly also brings an increase in food production and consumption. As food consumption increases, so do foodborne infections. In cases where adequate food safety and hygiene is not provided in places such as restaurants, dormitories, prisons, hospitals where mass feeding is made outside the home, many parasitic agents can be transmitted to people through food. People working in the food processing and distribution sector and who are in the position of porters play an important role in the spread of parasites, as they can transmit parasitic agents to food through fingernails and hands. Parasites such as Enterobius vermicularis, Entamoeba histolytica, and Giardia intestinalis can be transmitted to food and then to patients through nails and hands. This study was planned to investigate the presence of parasites in hospital food production and distribution workers, such as cooks and waiters, using various methods. Stool and serum samples were taken from 100 food production and distribution workers. Stool samples were examined by native-Lugol, concentration, trichrome, acid-fast staining, and cellophane tape methods. E. histolytica antigen in stool and Toxoplasma and Taenia antibodies in serum were searched by enzyme-linked immunosorbent assay. Parasites were detected in 59% people, and 41 were evaluated as negative. This positivity was 71.9% (23/32) in the 45-61 age range. Blastocystis sp. (27%), Toxoplasma (25%), E. histolytica (10%), Taenia spp. (7%), E. vermicularis (7%), Entamoeba coli (7%), G. intestinalis (5%), Chilomastix mesnili (1%), and I. butschlii (1%) were detected in food handlers. High Toxoplasma antibody positivity (25%) suggests the possibility of transmission to kitchen workers through ways, such as infected raw meat. However, the detection of E. histolytica, Taenia spp., E. vermicularis, G. intestinalis parasites in workers at significant levels poses a significant risk for society consuming these foods. As a result, it is important to investigate the presence of parasites in the employee dealing with food production and distribution to protect patients from parasitic infections especially in hospitals where the people are immunocompromised and more susceptible, and where mass meals are eaten.

Changes in serum albumin concentrations over 7 days in medical inpatients with and without nutritional support. A secondary post-hoc analysis of a randomized clinical trial.

Serum albumin concentrations are frequently used to monitor nutritional therapy in the hospital setting but supporting studies are largely lacking. Within this secondary analysis of a randomized nutritional trial (EFFORT), we assessed whether nutritional support affects short-term changes in serum albumin concentrations and whether an increase in albumin concentration has prognostic implications regarding clinical outcome and response to treatment. We analyzed patients with available serum albumin concentrations at baseline and day 7 included in EFFORT, a Swiss-wide multicenter randomized clinical trial that compared individualized nutritional therapy with usual hospital food (control group). Albumin concentrations increased in 320 of 763 (41.9%) included patients (mean age 73.3 years (SD ± 12.9), 53.6% males) with no difference between patients receiving nutritional support and controls. Compared with patients that showed a decrease in albumin concentrations over 7 days, those with an increase had a lower 180-day mortality [74/320 (23.1%) vs. 158/443 (35.7%); adjusted odds ratio 0.63, 95% CI 0.44 to 0.90; p = 0.012] and a shorter length of hospital stay [11.2 ± 7.3 vs. 8.8 ± 5.6 days, adjusted difference -2.2 days (95%CI -3.1 to -1.2)]. Patients with and without a decrease over 7 days had a similar response to nutritional support. Results from this secondary analysis indicate that nutritional support did not increase short-term concentrations of albumin over 7 days, and changes in albumin did not correlate with response to nutritional interventions. However, an increase in albumin concentrations possibly mirroring resolution of inflammation was associated with better clinical outcomes. Repeated in-hospital albumin measurements in the short-term is, thus, not indicated for monitoring of patients receiving nutritional support but provides prognostic information. ClinicalTrials.gov Identifier: NCT02517476.

Sustainable Food Waste Management Practices: Perspectives from Five-Star Hotels in Thailand

Although food waste management has been significant for all stakeholders from all industries globally, research in hospitality food waste management and practices still needs to be further studied, especially in five-star hotels in developing countries. Using the Food Waste Hierarchy, this study proposes to contribute to the knowledge of sustainable food waste management and practices in five medium and large five-star hotels to promote the United Nations Sustainable Development Goals (SDGs). Findings of in-depth structured questions from purposive and snowballing samplings show different aspects of sustainable food waste management and practices at these hotels supported by policies and implemented by practices at all levels, from top management to operations levels. The thematical analysis shows four emerging themes: food waste management policies; food service planning, procurement, and storage; food waste handling and operations in the kitchens, staff canteen and restaurants; and food waste management through reusing, recycling, donations, and disposal. The findings highlight these hotels’ challenges and suggestions for sustainable food waste management and practices. By providing the current situation of sustainable food waste management and practices, this study embellishes the guidance and recommendations for the hotels’ restaurants. It augments the industry practitioners with actual practices and solutions in implementing sustainable food waste management and practices in hotels’ restaurants.

1791-PUB: Implementation of a Food Pharmacy into a Pediatric Diabetes Clinic

Introduction: Social Determinants of Health (SDOH) is an essential focus in providing equitable diabetes care. Food and nutrition are integral parts of T1D and T2D management. Food insecurity (FI) increases the risk for T2D and is associated with higher A1C levels and hospitalization in those with diabetes. Children’s National Hospital and Capital Area Food Bank (CAFB) collaborated to create a Food Pharmacy within the diabetes clinic. Methods: The Food Pharmacy Program was implemented October 2021. Groceries, including grains, vegetables, fruit, dairy, and protein, are provided by the CAFB and stored in clinic. Each set of bags weighs about 50 lbs and serves a family of 4 for 3 days. A FI questionnaire is provided to diabetes patient families during their clinic visit. If positive, families qualify to receive supplemental groceries from the clinic, which are provided to families before they leave. Menus change on a quarterly basis based on feedback from patients and the dietetic team. Results: To date, 62% screened positive for FI. Approximately 20% of our diabetes patient population (496 families) have received groceries (46% male; mean age 14.4±3.9 years; 46% T1D; 51% prediabetes or T2D; mean diabetes duration 3.4 years; Ethnicity: 32% Hispanic; Race: 55% Black; 5% Caucasian). Over the initial 6 months of the program, an average of 49 families per month were receiving groceries. Since then, an average of 117 families per month are receiving groceries. A total of 24,800 pounds of food have been provided through the Food Pharmacy. Conclusions: A Food Pharmacy was successfully implemented within a diabetes clinic, showing the benefits of a partnership between a hospital and local food bank focusing on SDOH to improve patient care. A research project is being developed to study diabetes, psychosocial, cost analysis, and health utilization outcomes with a more intensive food intervention in youth with prediabetes or T2D. Disclosure E. Frymark: None. A.M. Richardson: None. H. Kessenich: None. S.L. Holly: None. O. Odimayomi: None. S. Topping: None. J. Leon: None. S. Majidi: None.