Foodservice Model Research Articles

Quantifying the locality of the food supply in a large healthcare organisation.

Shocks to the food system (such as extreme weather events, wars, and pandemics) are felt by institutional food systems. For hospitals, these shocks affect the quantity, quality, and variety of foods that can be offered to patients. One strategy to buffer the hospital food supply from external threats is to prioritise ingredients produced locally. Thus, the aim of the current research is to describe the country of origin of all foods purchased by a large, metropolitan healthcare organisation and to identify opportunities for improving the locality of the food supply. This study was of a cross-sectional, observational design. The country of origin for all foods procured over a 1-year period by a large, urban healthcare organisation was determined by proportion of food budget spend. State of origin was identified for fresh fruit, vegetables, and meat. The organisation was in Queensland, Australia and utilised a cook-fresh, room-service foodservice model. Descriptive analysis was used to to determine the number of items and the proportion of budget spend on all foods produced in Australia, and by food category. Similar descriptive statistics were generated to determine the proportion of the budget spend on fresh fruits, vegetables and meats produced in Queensland. Over the 1-year period, 659 individual food items were purchased by the hospital foodservice, and 502 food items were included in the anlaysis. In total, 53% of the food budget was spent on Australian foods (100% Australian ingredients) and almost all fruit (73%) and vegetables (91%) were Australian grown. Procuring fresh fruit (28%), vegetables (35%), and meat (46%) from within the state was less common, and this may reflect the primary states of production across Australia, and seasonal variability of the food supply. Findings offer priority areas for improving the locality of the food supply. Future research to determine if procuring more foods locally has benefits to consistency of the food supply is warranted.

Canteen Crave - Website for College Canteen

This project addresses the outdated canteen website in our college by introducing a modern, user-friendly platform. Focused on enhancing the ordering process and overall dining experience, our research surveys, and iterative design to meet diverse user needs. Through this project, we aim to set a new standard for campus dining, offering insights and best. This research paper investigates the integration of our project ( pre-ordering food systems ) in college canteens as a means to revolutionize traditional food service models. This research paper explores the implementation and impact of our project CANTEEN CRAVE, pre-ordering food systems in college canteens to enhance efficiency and customer satisfaction. With the rising demand for convenient dining experiences, especially within educational institutions, pre-ordering food has emerged as a promising solution to minimize long queues, reduce waiting times, and optimize resource utilization in canteen operations. The study investigates the feasibility, effectiveness, and user perceptions of integrating pre-ordering technology into college canteen services. pr s Keywords — Admin, Backend, Database, Frontend, User.

Identifying solutions to minimize meal tray waste: A mixed-method approach

Background & aimsOver $150,000 are lost annually due to meal tray waste in a large hospital in the United States. This study aims to explore the root causes of meal tray waste within a decentralized foodservice model and strategies to mitigate waste. MethodsA mixed methods sequential explanatory design was used by first identifying hospital units high and low in meal tray waste using recorded food management data from January 2021 through September 2022, then conducting observations, mobile-interviews (n=16), and in-depth interviews with hospital foodservice staff (n=6) and nurses (n=6) in each unit. Lastly, hospital and topic experts (n=10) were engaged in strategizing solutions to reduce meal tray waste. ResultsFindings indicate meal tray waste is increased when patients discharge and when standard trays (i.e., also known as house trays, which include items not requested by patients) are provided. Meal tray waste points to the unpredictability in a hospital that often arises due to patient circumstances, lack of coordination between nursing and foodservice staff, patients' food preferences, and the need for system and workflow improvements in a decentralized foodservice model. ConclusionsFindings highlight considerations that may be applicable across diverse medical institutions seeking to reduce meal tray waste. Hospitals should choose the best foodservice model that suits their institution to manage operations efficiently, focusing on reducing waste, cost optimization, patient satisfaction, and sustainability.

Is meal order timing and flexibility key to improving patient satisfaction with hospital foodservice?

The aim of this study was to retrospectively evaluate and compare patient foodservice (FS) satisfaction using a validated tool and consistent methodology in an acute health service for four different FS models as the organisation transitioned through traditional model (TM), choice at point of service (CaPOS), bedside menu ordering systems (BMOS) and room service (RS) from 2013 to 2016. Patient satisfaction data were collected using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. For the purposes of this study, patients' rating of their overall experience with FS (very good, good, okay, poor or very poor) was compared for each site and model. Satisfaction was significantly higher in the CaPOS and RS models compared with TM. BMOS, although somewhat higher, was not shown to be significantly higher than TM. The RS model was significantly higher than BMOS, but there was no significant difference observed between RS and CaPOS. FS models that support patient flexibility and meal ordering closer to the meal delivery time (as seen with RS and CaPOS) show higher patient satisfaction among hospital patients. It is recommended that sites consistently opt to include patient satisfaction as part of routine auditing. This would enable clear conclusions to be drawn regarding best practice FS models, based on specific and individual hospital requirements.

Dietitians as change agents for promoting healthy and sustainable food systems

Dietitians as change agents for promoting healthy and sustainable food systems

Perceptions of the Impact of COVID-19 Countermeasures on Safe Foodservice Provision at International Sporting Competitions: A Qualitative Study

Over the past 2 years, the SARS-CoV-2 (COVID-19) pandemic has had a pronounced impact on the foodservice sector, including compliance to new food provision guidelines. International sporting events’ over-crowded communal eating areas are considered to be high-risk areas for contracting infectious disease. The purpose of this study was to explore the perceptions, level of preparedness and perceived challenges of key stakeholders when providing food at major athletic competition events during a global pandemic. A qualitative methodology was employed using semi-structure interviews and data was analyzed using interpretive phenomenology. Inductive thematic analysis identified six major themes of COVID-19′s impact on foodservice systems. Adapting foodservice models to pandemic planning is pre-determined and dictated by settings and environments. There were common heightened concerns over sustainability practices, increase in waste management, costs and negative impact on social dining experience, which were all perceived to be impacted by the changes relevant to COVID-19. There was a renewed attention to improving food safety and quality control measures. The outcomes of this study suggest that International organizing committees of major competitions must now be tasked with updated guidelines, including supporting adequate budgets and communication, if stakeholders are to adapt their operations to control the spread of viruses, such as COVID-19, within all foodservice operations at major competitions. Attention should be directed to determine whether food provision changes continue to be recommended and how this will impact foodservice delivery, sustainability and the social dining experience at future sporting events.

The Hospital Food Experience Questionnaire Predicts Adult Patient Food Intake.

Purpose: Describe food/beverage intake among all patients and those with low meal intake and determine if the Hospital Food Experience Questionnaire (HFEQ), or its shorter version (HFEQ-sv), predicts food intake while considering patient (e.g.,gender) and hospital characteristics (e.g.,foodservice model).Methods: Cross-sectional study of 1087 adult patients from 16 hospitals in Ontario, Canada. The valid and reliable HFEQ assessed patients' meal quality perceptions. Visual estimation determined overall meal and food/beverage intake using the Comstock method. Binary logistic regressions tested the association between patient and hospital characteristics and whether HFEQ or HFEQ-sv scores added utility in predicting overall meal intake (≤50% vs. ≥75%).Results: Approximately 29% of patients consumed ≤50% of their meal. Models assessing patient and hospital characteristics and either the HFEQ or the HFEQ-sv were significant (LRT(43) = 72.25, P = 0.003; LRT(43) = 93.46, P < 0.001). Men and higher HFEQ or HFEQ-sv scores demonstrated significantly higher odds of ≥75% meal consumption. Considering HFEQ or HFEQ-sv scores explained greater variance in meal intake and resulted in better model fits.Conclusions: The HFEQ and HFEQ-sv predict patient meal intake when adjusting for covariates and add utility in understanding meal intake. Either version can be confidently used to support menu planning and food delivery to promote food intake.

Impact of room service on nutritional intake, plate and production waste, meal quality and patient satisfaction and meal costs: A single site pre-post evaluation.

Room service is a patient-focused foodservice model gaining interest in Australian hospitals following demonstrated patient and organisational benefits. This study aimed to compare nutritional intake, waste, patient satisfaction, meal costs and meal quality between a bought-in, thaw-retherm foodservice model and a cook-fresh, on-demand room service model at a large tertiary public hospital. A retrospective analysis of quality assurance data compared thaw-retherm to room service. Nutritional intake and plate waste were measured using a visual intake analysis tool; production waste was measured using weighted analysis methodology; patient satisfaction was measured using a validated patient satisfaction survey; meal quality was assessed using a validated meal quality audit tool, and meal costs were obtained from hospital finance reports. Independent sample t-tests or nonparametric equivalent (Mann-Whitney U-test) for continuous variables and Pearson's Chi-square for categorical data were applied for comparative purposes. Average energy and protein intake, as well as percentage requirements met, improved between thaw-retherm and room service (4320 kJ/day vs 7265 kJ/day; 42.4 g/day vs 82.5 g/day; and 46% vs 80.7%; 49.9% vs 98.4%; all P < .001. Reductions in plate waste (40% vs 15%) and production waste (15% vs 5.6%, P < .001) were observed and food costs decreased by 9% with room service. Meal quality audit results improved, and patient satisfaction increased with % respondents satisfied increasing from 75.0% to 89.8% (χ2 9.985[2]; P=.007) for room service. This research demonstrates significant improvements in patient and organisational outcomes with room service compared to a thaw-retherm model in a large public hospital.

Dining On Call: Outcomes of a hospital patient dining model.

Dining On Call (DOC) is a hospital foodservice model allowing patients to order meals any time throughout the day and is delivered within 45minutes of the order. It is positively correlated with patient satisfaction, improvements in malnutrition, and reducing costs. Pre- and post-DOC data were collected from BC Children's Hospital, BC Women's Hospital, and North York General Hospital (NYGH) using patient satisfaction surveys and tray waste audits to measure outcomes. Patient satisfaction scores increased at all hospitals. BC Children's and Women's hospitals demonstrated reductions in tray waste, food cost/meal/day, and labour cost/meal/day post-DOC. North York General Hospital observed decreases in tray waste; however, food cost/meal/day and labour cost/meal/day increased post-DOC. This research provides convincing evidence into the achievable benefits associated with DOC on mother and paediatric units in hospital settings. DOC may prove to be an effective dining model for hospitals seeking to improve patient outcomes and reduce overall costs.

A Qualitative Study Exploring Hospital Food Waste From the Patient Perspective

ObjectiveTo study the perceptions, beliefs, and expectations of patients related to food waste during their hospital stay. DesignA qualitative study using semistructured interviews and thematic analysis of transcripts. SettingFour hospital wards across 3 hospitals in 1 large health care network in Melbourne, Australia. ParticipantsForty inpatients, 10 each from oncology, maternity, general medicine, and subacute wards. AnalysisA coding framework was developed by researchers; this framework was tested then applied across all interview transcripts. Codes were grouped and summarized to identify and analyze patterns of data. ResultsHistorical experiences influenced participant perspectives on food waste; cost was the primary motivator to limit food waste at home. The following contributors to hospital food waste were identified: patient interest in food/appetite, food quality and quantity, and the foodservice model. Three overarching strategies to address hospital food waste emerged: modify the foodservice system to decrease waste, adopt multimethod food waste management strategies, and reduce and manage nonfood waste. Contamination was identified as a barrier to waste management. Participants reported that the aggregate amount, management, and implications of hospital food waste were invisible to them. Conclusions and ImplicationsThe inclusion of service users in both future studies and the practice of food sustainability is encouraged. Multiple approaches (system modification, multimethod food waste management strategies, and reduction of nonfood waste) could be adopted in practice to reduce hospital-related food waste.

Environmentally sustainable hospital foodservices: Drawing on staff perspectives to guide change

Abstract Foodservice is a key contributor to environmental impacts of the healthcare sector, in particular hospitals. Driving towards sustainable solutions in foodservices can bring financial and social benefits, whilst allowing hospitals to position themselves as leaders towards a sustainable food system and healthcare sector. Such a change depends on those working directly or indirectly with foodservices. Staff possess valuable knowledge, ideas, motivation and responsibility for improving the environmental sustainability of the foodservice system. The aim of this study was to explore the perspectives of staff working across the hospital food supply chain towards: (1) sustainable practices in hospital food provision; (2) existing barriers and enablers; and (3) recommendations for implementing sustainable foodservice practices in the future. Through qualitative inquiry, semi-structured interviews were conducted with individuals at operational and management levels responsible for policy, purchasing, production, onsite plating and delivery and waste disposal at three hospitals in Australia. Framework analysis was used to synthesise transcribed data into practices, barriers and enablers, and recommendations. Interviews (n=46 participants) identified current sustainable practices including those related to recyclable packaging, effective equipment and technology and efficient processes. Unsustainable practices included restrictions on sourcing food, packaging that cannot be separated or recycled, rigid foodservice models and menu, waste production and processes. Enablers to improve sustainability included the power of individuals to influence change, education on recycling, knowledge generation, audits and grants for innovative research, rebates and quality improvement processes. Barriers included competing priorities, poor communication, lack of training opportunities and knowledge, infection control restrictions, lack of policy, funding, and time between meal ordering and delivery. Participants proposed practice changes across the food supply chain and recommended generation and sharing of knowledge, leadership and policy support. Perspectives of individuals within foodservice reveal shared motivation and desire for sustainable foodservices, with support needed from leaders and policy. Future research should use a co-design approach involving staff to create and implement sustainable strategies within hospitals. To see widespread and timely change, action is needed towards effective and meaningful policy.

EPS4.10 The principles of the Toyota Production System (TPS) applied to an inpatient food service model can improve nutritional outcomes for children with cystic fibrosis

ePS4.10 The principles of the Toyota Production System (TPS) applied to an inpatient food service model can improve nutritional outcomes for children with cystic fibrosis

Environmental Sustainability of Hospital Foodservices across the Food Supply Chain: A Systematic Review

BackgroundHospitals have a responsibility to support human health, and given the link between human and environmental health, hospitals should consider their environmental impacts. Hospital foodservices can negatively affect the environment at every stage of the food supply chain (production/procurement, distribution, preparation, consumption, and waste management/disposal). ObjectiveTo systematically identify and synthesize the following across the hospital patient food/nutrition supply chain: environmental and associated economic impacts of foodservice; outcomes of strategies that aim to improve the environmental sustainability of foodservice; and perspectives of patients, staff, and stakeholders on environmental impacts of foodservice and strategies that aim to improve the environmental sustainability of foodservice. MethodsEight electronic databases (ie, Cumulative Index to Nursing and Allied Health Literature Plus, Embase via Ovid, Global Health, National Health Service Economic Evaluation Database, Ovid Medline, ProQuest Environmental Science Collection, Scopus, and Web of Science) were searched from database inception to November 2018 for original research conducted across any stage of the hospital food supply chain (from production/procurement to waste management/disposal) that provides food/nutrition to patients, with no restrictions on language or study design. Titles/abstracts then full texts were screened independently by two authors. The Mixed Methods Appraisal Tool was used for quality appraisal for included studies. Data were synthesized narratively. ResultsFrom 29,655 records identified, 80 studies met eligibility criteria. Results were categorized into production/procurement (n=12), distribution (n=0), preparation (n=6), consumption (n=49), waste management/disposal (n=8), and multiple food supply chain aspects (n=5). The environmental impact most widely explored was food waste, with many studies reporting on food waste quantities, and associated economic losses. Strategies focused on reducing food waste by increasing patients’ intake through various foodservice models. Perspectives identified a shared vision for sustainable foodservices, although there are many practical barriers to achieving this. ConclusionThe literature provides examples across the hospital food supply chain that demonstrate how environmental sustainability can be prioritized and evaluated and the opportunities for credentialed nutrition and dietetics practitioners to contribute. Future studies are warranted, particularly those measuring environmental impacts and testing the effects of sustainable strategies in the distribution, preparation, and waste management stages.

Barriers to Oral Food Intake for Children Admitted to Hospital.

Children are at risk for malnutrition in hospital, and a contributing factor may be poor oral intake. Barriers to intake have been studied in adults, but there is a lack of research in children. The purpose of this study was to identify the potential barriers to oral intake for children in hospital. Patients and families (n = 58) admitted to surgery and medicine units at the Stollery Children's Hospital completed a survey on barriers to oral food intake. Barriers were classified into 6 domains and major barriers were those identified by at least 30% of the population. On average each patient was affected by 22% of the barriers. Within each domain, the proportion of patients identifying at least 1 barrier was as follows: organization (74%), hunger (67%), quality (60%), effects of illness (53%), choice (38%), and physical limitations (29%). Having food brought in from home due to hunger, not wanting what was ordered once it arrives, food quality, decreased appetite, sickness, fatigue, and pain were identified as major barriers. Children have unique barriers to oral food intake in hospital which have not been previously identified. Food service models should consider these barriers to better meet the needs of this population.

Patient-Centered Foodservice Model Improves Body Weight, Nutritional Intake and Patient Satisfaction in Patients Undergoing Cancer Treatment

Hospital malnutrition is a multi-factorial and complex problem seen in cancer patients receiving treatment, which is associated with poorer outcomes. Appropriate foodservice interventions may be required to improve nutritional status, prevent malnutrition and promote patient satisfaction. We introduced and implemented a patient-centered foodservice model with the aim of improving patient’s overall nutritional care and enhancing patient experience. A cross-sectional analysis was done to evaluate outcomes between the traditional foodservice model and the newly implemented patient-centered foodservice model. A meal intake observation tool using a five-point visual scale along with a patient satisfaction survey was used to understand nutritional intake and patient satisfaction, respectively. The findings suggest increased nutritional intake and improved patient satisfaction with the patient-centered foodservice model. Comparison of weight change and nutritional intake between a traditional foodservice model (n = 60) and the patient-centered foodservice model (n = 100) showed a significant weight gain and increase in energy and protein intake (P < 0.01) in the patient-centered foodservice model. Higher patient satisfaction ratings indicated improvement with foodservice across domains in quality and flavor of food, timeliness of delivery, diet education and overall satisfaction. The study concludes that the patient-centered foodservice model can increase the nutritional intake in oncology patients and improve overall patient satisfaction.

Room service in a public hospital improves nutritional intake and increases patient satisfaction while decreasing food waste and cost.

Room service (RS) is a hospital foodservice model that is traditionally unique to the private sector. It allows patients to order meals compliant to their nutritional requirements from a single integrated menu at a time that suits them. Meals are prepared and delivered within 45 min of order. Following implementation in a private adult facility in 2013, Mater Group implemented the first RS in a public adult facility in Australia in 2016. In a pre-post study comparing RS with a traditional foodservice model (TM), key outcomes were measured and analysed. A retrospective analysis of quality assurance data audits in a pre-post study design was undertaken to assess patient nutritional intake, plate waste, satisfaction and meal costs before and after RS implementation. Comparison of nutritional intake between TM (n = 84) and RS (n = 103) showed statistically significant increases with RS in both energy (5513 kJ day-1 versus 6379 kJ day-1 , P = 0.020) and protein (53 g day-1 versus 74 g day-1 , P < 0.001) intake, as well as energy and protein intake as a percentage of requirements (64% versus 78%, P = 0.002 and 70% versus 99%, P < 0.001, respectively). Total average plate waste decreased from 30% to 17% (P < 0.001). Patient satisfaction indicated an improvement with RS, with 98% of patients scoring the service good to very good, compared to 75% for TM (P < 0.04). Patient food costs decreased by 28% per annum with RS. This research provides insight into the benefits achievable with RS in the public hospital setting, confirming that a patient-centred food service model can cost-effectively improve clinical outcomes.

Glycemic Control with Different Foodservice Models: On Demand Room Service and Batch Set-time Models in an Urban Academic Medical Center

Glycemic Control with Different Foodservice Models: On Demand Room Service and Batch Set-time Models in an Urban Academic Medical Center

Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost

BackgroundRoom service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. ObjectiveThe aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. DesignA retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre−post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. ParticipantsAudit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. Main outcome measuresThe primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Statistical analyses performedIndependent samples t-tests and χ2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ2 used for the plate waste analysis. Significance was assessed at P<0.05. ResultsThis study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0.005) and protein (52 g/day vs 66 g/day, P=0.003) intake, as well as energy and protein intake as a percentage of requirements (63% vs 75%; P=0.024 and 65% vs 85%; P=0.011, respectively). Total mean plate waste decreased from 29% (traditional foodservice model) to 12% (room service) (P<0.001). Patient satisfaction ratings indicated improvement with room service across all Press Ganey meal scores: 68th to 86th percentile overall; 64th to 95th percentile for “quality of food”; and 60th to 99th percentile for “flavor of food.” Evaluated during comparable times of the year, patient meal costs decreased by 15% with room service. ConclusionsA patient-centered foodservice model, such as room service, can improve patient nutritional intake and enhance patient satisfaction in a budget constrained health care environment.

LOD기반의 문화콘텐츠 정보서비스 확장에 관한 연구: K-Food 분야를 중심으로

In the Korean wave 3.0 age, it is needed to prepare how to globalize and hold Korean culture through development of various Korean wave culture contents from existing contents focused on media. The goal of this study is to establish the foundation for developing the various Korean wave culture contents as linking information about other culture contents as well as food culture by extending Korean culture contents service based on LOD. For this purpose, this study established and assorted the concept of food culture through the literature review and case study and analyzed the applicability of the services of food culture contents based on LOD. Futhermore, this study provides the basis on extension of Korean wave culture service and suggests the process of implementation of food culture LOD and service model.

Findings from Wave 1 of the Models of SNAP Education and Evaluation Study

To determine whether the 4 demonstration projects included in wave 1 of the United States Department of Agriculture Food and Nutrition Service Models of SNAP-Ed and Evaluation study can serve as good examples of effective nutrition education.