patient experience and satisfaction with hospital food service h.j. hartwell, j.s.a. edwards and c....

Patient Experience and Satisfaction with Hospital Food ServiceH.J. HARTWELL, J.S.A. EDWARDS and C. SYMONDS, The Worshipful Company of Cooks Research Centre, Bournemouth University

Hospital Food ServiceIntroduction

An essential part of patient care and a fundamental factor in aiding recovery

Increasing concern over high prevalence of malnutrition

Hence a growing interest in the role of food to improve clinical outcomes

Hospital Food ServiceIntroduction

However, food not just about service but encompasses the entire patient experience

Aim

The aim of the research is to critically evaluate patient experience and satisfaction with hospital food service.

Objective

To explore antecedents to satisfaction and experience

Hospital food service does not operate in isolation but requires the co-operation and integration of several disciplines to provide the ultimate patient experience:

medical staff, food service staff, dietitians, hospital managers, pharmaceutical staff, patients and

visitors

Methodology

Focus groups

Doctors, nurses, ward hostesses, patients

Interviews

Catering manager, facilities manager, dietitians, chief pharmacist

Management nutritional careResponsibility without authority Nutrition policy frameworkAdvisory serviceFragmented careRecording weight Patient Care PATIENTMonitor patient intake CENTREDFood as treatmentEmpathy PATIENT

CENTREDAggressive consumerComplaintsFood qualityTraditional English food Patient SatisfactionPatient satisfactionBranded foodsFeedback

Protected meal times Meal Time Ambience MEALMusic/crockery TIMEEating in company

Fragmentary serviceOperational tensionHospital food manager Food ServiceCommunication ManagementFinancial constraintsCharge for foodStaff turnover FOOD FOOD SERVICEDedicated food service staffHostess Food Service Customer care/service StaffWelcome pack

NUD*IST

Results - Patient Care

Nutrition policy – clinical champion‘…an advocate (voice) is required at directorate level’ -

dietitian and nurse

Dietitians – advisory service Not ‘joined up’‘…everybody is looking at things from their own

perspective, coming from different directions and the poor patient is in the middle’ – chief dietitian

Ward communication ‘weigh day’

Results - Patient satisfaction ‘hotel’ service‘…the patients want a restaurant service from non-restaurant

funding’ – facilities manager Best meal experience‘…my best hospital meal experience was where the food

was just like at home, hot, and we ate it sitting around a table’

Worst meal experience‘…hard cold cauliflower and watery mince’ Food quality‘…we can put men on the moon but we can’t get hot food in

hospital’ - patient. Branded foods Trolley system of delivery

Results - Meal Time

Protected meal periods‘…we are all falling over each other in the morning – what

with the blood lady, nurses and consultants’ – hostess

Ambience – music Eating a meal in company Crockery

Results - Food Service Management Fragmentary delivery‘…the whole service needs to be better orchestrated’ -

facilities manager Communication Hospital food manager Budgets – ring fenced Patients to pay? Staff recruitment‘…its difficult to get staff on the amount that we can pay

them – they would rather work in Burger-King’ – catering manager

Results - Food Service Staff

Dedicated food service staff‘sell the product’ ‘reduce wastage’ and ‘tempt jaded palates’

Ward hostess

‘…what we need is basic care, the food that we want, it should be hot, it should be well presented and well cooked. If we don’t eat we will be in hospital for longer and all we want to do is go home’ – patient

HospitalFoodService

Patient Monitoring

Simple/rapid (strain gauge) reinforced by multidisciplinary plan of action

Nutrient Intake

Patient Satisfaction

Food QualityTextureTemperatureFood Service SystemTrolleyWard hostessEmpathyWastageDistribution/transportationMinimum delay to prevent nutrient loss and sensory deteriorationMealPlace of consumptionPeace and quietTraditional MenuBrand namesInteractive MenuClarity/languageChoice

Better HospitalFood Service

Incidence of malnutrition reducedShorter patient stayImproved patient experienceReduction in cost to NHS

Feedback and communication

ManagementMedical staffCaterersPatients

HospitalFood

ServiceManager

Primary Health Care team

Primary Health Care team

Hospital Food in ContextNHS and the hospital environment i.e. funding, Better Hospital Food and medical condition. Patient expectation and perception of ‘hospitality product’.

A theoretical model of patient experience and satisfaction with hospital food service

Conclusion

Optimal treatment – good nutrition

Patient satisfactionQuality – texture and

temperature