Hospital Practices and Research

Understanding Patients’ Meal Experiences through Staff’s Role: Study on Malaysian Public Hospitals

Document Type : Original Article

Authors

Reena Kumari Vijayakumaran 1
Anita Eves 2
Margaret Lumbers 2

1 Nutrition & Dietetics Department, School of Health Sciences, Health Campus, University Sains Malaysia, Kelantan, Malaysia

2 Faculty of Business, Economics and Law, School of Hospitality and Tourism Management, University of Surrey, Guildford, Surrey, UK

https://doi.org/10.15171/hpr.2018.11
Abstract
Background: One way to improve hospital food provision is certainly by understanding the management of hospital foodservices, but there is limited detailed information about staff roles in food provision in many hospitals around the world.
Objective: The hospital meal experience of patients, a part of the services provided by hospitals, is becoming important. Therefore, the role of various hospital staff members was studied through their behavior, attitudes, and practices so as to understand how the foodservice system works to address patients’ food consumption.
Methods: This qualitative research used the convenient sampling method. Data was collected by interviewing twenty hospital employees with different job scopes (nurses, doctors, dietitians, foodservice managers, and directors of hospital foodservices) in 6 public hospitals.
Results: Themes such as providing familiar food, food as the motivational factor for consumption, empathy shown by staff, and influences of the eating environment were identified using content analysis.
Conclusion: The viewpoints and experiences of key stakeholders facilitated the understanding of various factors involved in the provision of hospital food which affect patients’ decisions to accept and consume food.

Keywords

Dietary Services
Health Personnel
Health Care Quality
Hospitalization
In-Patient
  1. Andersson AC, Elg M, Perseius KI, Idvall E. Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare. BMC Health Serv Res. 2013;13:48. doi:10.1186/1472-6963-13-48.
  2. Russell NC, Wallace LM, Ketley D. Evaluation and measurement for improvement in service-level quality improvement initiatives. Health Serv Manage Res. 2011;24(4):182-189. doi:10.1258/hsmr.2011.011010.
  3. Almdal T, Viggers L, Beck AM, Jensen K. Food production and wastage in relation to nutritional intake in a general district hospital--wastage is not reduced by training the staff. Clin Nutr. 2003;22(1):47-51. doi:10.1054/clnu.2002.0590.
  4. Barton AD, Beigg CL, Macdonald IA, Allison SP. High food wastage and low nutritional intakes in hospital patients. Clin Nutr. 2000;19(6):445-449. doi:10.1054/clnu.2000.0150.
  5. Edwards JS, Nash AH. The nutritional implications of food wastage in hospital food service management. Nutr Food Sci. 1999;99(2):89-98. doi:10.1108/00346659910254394.
  6. Ofei KT, Holst M, Rasmussen HH, Mikkelsen BE. How practice contributes to trolley food waste. A qualitative study among staff involved in serving meals to hospital patients. Appetite. 2014;83:49-56. doi:10.1016/j.appet.2014.08.001.
  7. Jessri M, Mirmiran P, Jessri M, et al. A qualitative difference. Patients’ views of hospital food service in Iran. Appetite. 2011;57(2):530-533. doi:10.1016/j.appet.2011.06.012.
  8. Naithani S, Whelan K, Thomas J, Gulliford MC, Morgan M. Hospital inpatients’ experiences of access to food: a qualitative interview and observational study. Health Expect. 2008;11(3):294-303. doi:10.1111/j.1369-7625.2008.00495.x.
  9. Hwang JL, Desombre T, Eves A, Kipps M. An analysis of catering options within NHS acute hospitals. Int J Health Care Qual Assur Inc Leadersh Health Serv. 1999;12(6-7):293-308. doi:10.1108/09526869910287567.
  10. Belanger MC, Dube L. The emotional experience of hospitalization: its moderators and its role in patient satisfaction with foodservices. J Am Diet Assoc. 1996;96(4):354-360. doi:10.1016/S0002-8223(96)00098-3.
  11. Banks M, Hannan-Jones M, Ross L, Buckley A, Ellick J, Young A. Measuring the quality of Hospital Food Services: Development and reliability of a Meal Quality Audit Tool. Nutr Diet. 2017;74(2):147-157. doi:10.1111/1747-0080.12341.
  12. Wright OR, Connelly LB, Capra S. Consumer evaluation of hospital foodservice quality: an empirical investigation. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006;19(2- 3):181-194. doi:10.1108/09526860610651708.
  13. Dall’Oglio I, Nicolo R, Di Ciommo V, et al. A systematic review of hospital foodservice patient satisfaction studies. J Acad Nutr Diet. 2015;115(4):567-584. doi:10.1016/j.jand.2014.11.013.
  14. Keller H, Allard J, Vesnaver E, et al. Barriers to food intake in acute care hospitals: a report of the Canadian Malnutrition Task Force. J Hum Nutr Diet. 2015;28(6):546-557. doi:10.1111/jhn.12314.
  15. Sheehan-Smith L. Key facilitators and best practices of hotel-style room service in hospitals. J Am Diet Assoc. 2006;106(4):581- 586. doi:10.1016/j.jada.2006.01.002.
  16. Huang JS, Chun S, Cheung C, Poon L, Terrones L. The nutritional value of food service meals ordered by hospitalized children. Clin Nutr ESPEN. 2016;15:122-125. doi:10.1016/j.clnesp.2016.06.008.
  17. Schenker S. Undernutrition in the UK. Nutr Bull. 2003;28(1):87- 120. doi:10.1046/j.1467-3010.2003.00303.x.
  18. Stratton RJ, Elia M. Deprivation linked to malnutrition risk and mortality in hospital. Br J Nutr. 2006;96(5):870-876. doi:10.1017/BJN20061852.
  19. Hartwell HJ, Shepherd PA, Edwards JS. Effects of a hospital ward eating environment on patients’ mealtime experience: A pilot study. Nutr Diet. 2013;70(4):332-338. doi:10.1111/1747-0080.12042.
  20. Walton K, Williams P, Tapsell L, et al. Observations of mealtimes in hospital aged care rehabilitation wards. Appetite. 2013;67:16- 21. doi:10.1016/j.appet.2013.03.006.
  21. Cumming A. Report to Scottish Executive Health Department on the Implementation of the Clinical Standards for Food. In: Fluid Nutritional Care in Hospital. London: 2004.
  22. Hwang LJ, Eves A, Desombre T. Gap analysis of patient meal service perceptions. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2003;16(2-3):143-153. doi:10.1108/09526860310470874.
  23. Kowanko I, Simon S, Wood J. Nutritional care of the patient: nurses’ knowledge and attitudes in an acute care setting. J Clin Nurs. 1999;8(2):217-224. doi:10.1046/j.1365-2702.1999.00251.x.
  24. Hartwell HJ, Edwards JSA, Symonds C. Foodservice in hospital: development of a theoretical model for patient experience and satisfaction using one hospital in the UK National Health Service as a case study. Journal of Foodservice. 2006;17(5‐6):226-238. doi:10.1111/j.1745-4506.2006.00040.x.
  25. Council of Europe. Food and Nutritional Care in Hospitals: How to Prevent Undernutrition : Report and Recommendations of the Committee of Experts on Nutrition, Food Safety and Consumer Protection. Strasbourg: Council of Europe Publishing; 2002.
  26. Ministry of Health. National Healthcare Establishments and Workforce Statistics (Hospital) 2008-2009. Kuala Lumpur, Malaysia: Ministry of Health; 2009.
  27. Vijayakumaran RK, Eves A, Lumbers M. Patients Emotions during Meal Experience: Understanding through Critical Incident Technique. Int J Hosp Res. 2016;5(4):113-121. doi:10.15171/ijhr.2016.21.
  28. Neuendorf KA. The Content Analysis Guidebook. Canada: SAGE: Thousand Oaks; 2002.
  29. Fitzgerald DM. 194 Hospital Food – An Evaluation Of Patient Satisfaction With Lunchtime Meal And Audit Of Compliance With Standards. Age Ageing. 2016;45(suppl_2):ii13-ii56. doi:10.1093/ageing/afw159.176.
  30. Johns N, Edwards JS, Hartwell HJ. Hungry in hospital, well-fed in prison? A comparative analysis of food service systems. Appetite. 2013;68:45-50. doi:10.1016/j.appet.2013.04.006.
  31. Beck AM, Balknas UN, Furst P, et al. Food and nutritional care in hospitals: how to prevent undernutrition--report and guidelines from the Council of Europe. Clin Nutr. 2001;20(5):455-460. doi:10.1054/clnu.2001.0494.
  32. DeLuco D, Cremer M. Consumers’ perceptions of hospital food and dietary services. J Am Diet Assoc. 1990;90(12):1711-1715.
  33. Gregoire MB. Quality of patient meal service in hospitals: delivery of meals by dietary employees vs delivery by nursing employees. J Am Diet Assoc. 1994;94(10):1129-1134. doi:10.1016/0002-8223(94)91132-0.
  34. Mahoney S, Zulli A, Walton K. Patient satisfaction and energy intakes are enhanced by point of service meal provision. Nutr Diet. 2009;66(4):212-220. doi:10.1111/j.1747-0080.2009.01373.x.
  35. Chang CC, Lin LC. Effects of a feeding skills training programme on nursing assistants and dementia patients. J Clin Nurs. 2005;14(10):1185-1192. doi:10.1111/j.1365-2702.2005.01240.x.
  36. Walton K, Williams P, Tapsell L. What do stakeholders consider the key issues affecting the quality of foodservice provision for long‐stay patients? Journal of Foodservice. 2006;17(5‐6):212- 225. doi:10.1111/j.1745-4506.2006.00039.x.
  37. Ellins J, Glasby J. “You don’t know what you are saying ‘Yes’ and what you are saying ‘No’ to”: hospital experiences of older people from minority ethnic communities. Ageing Soc. 2016;36(1):42-63. doi:10.1017/S0144686X14000919.
  38. Harrison R, Walton M, Healy J, Smith-Merry J, Hobbs C. Patient complaints about hospital services: applying a complaint taxonomy to analyse and respond to complaints. Int J Qual Health Care. 2016;28(2):240-245. doi:10.1093/intqhc/mzw003.
  39. Westergren A, Lindholm C, Axelsson C, Ulander K. Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations. J Nutr Health Aging. 2008;12(1):39-43. doi:10.1007/BF02982162.
  40. Hope K, Ferguson M, Reidlinger DP, Agarwal E. “I don’t eat when I’m sick”: Older people’s food and mealtime experiences in hospital. Maturitas. 2017;97:6-13. doi:10.1016/j.maturitas.2016.12.001.
  41. Xia C, McCutcheon H. Mealtimes in hospital--who does what? J Clin Nurs. 2006;15(10):1221-1227. doi:10.1111/j.1365-2702.2006.01425.x.
  42. Macht M, Meininger J, Roth J. The Pleasures of Eating: A Qualitative Analysis. J Happiness Stud. 2005;6(2):137-160. doi:10.1007/s10902-005-0287-x.
  43. Edwards D, Carrier J, Hopkinson J. Mealtime assistance for older adults in hospital settings and rehabilitation units from the perspective of patients, families and healthcare professionals: a mixed methods systematic review. JBI Database System Rev Implement Rep. 2016;14(9):261-357. doi:10.11124/JBISRIR-2016-003100.
  44. Johns N, Hartwell H, Morgan M. Improving the provision of meals in hospital. The patients’ viewpoint. Appetite. 2010;54(1):181- 185. doi:10.1016/j.appet.2009.10.005.
  45. Kowanko I. Energy and nutrient intake of patients in acute care. J Clin Nurs. 2001;10(1):51-57. doi:10.1046/j.1365-2702.2001.00436.x.
  46. Wright ORL. Foodservice management returns: The need to rejuvenate the superhero contribution of dietetics. Nutr Diet. 2017;74(2):113-115. doi:10.1111/1747-0080.12349.
  47. Hartwell H, Johns N, Edwards JSA. E-menus—Managing choice options in hospital foodservice. Int J Hosp Manag. 2016;53:12- 16. doi:10.1016/j.ijhm.2015.11.007.

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us