Patient Experience and Satisfaction with Hospital Food Service

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

2. 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

3. Hospital Food ServiceIntroduction However, food not just about service but encompasses the entire patient experience

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

6. 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

7. Methodology • Focus groups Doctors, nurses, ward hostesses, patients • Interviews Catering manager, facilities manager, dietitians, chief pharmacist

8. Management nutritional care Responsibility without authority Nutrition policy framework Advisory service Fragmented care Recording weight Patient Care PATIENT Monitor patient intake CENTRED Food as treatment Empathy PATIENT CENTRED Aggressive consumer Complaints Food quality Traditional English food Patient Satisfaction Patient satisfaction Branded foods Feedback Protected meal times Meal Time Ambience MEAL Music/crockery TIME Eating in company Fragmentary service Operational tension Hospital food manager Food Service Communication Management Financial constraints Charge for food Staff turnover FOOD FOOD SERVICE Dedicated food service staff Hostess Food Service Customer care/service Staff Welcome pack NUD*IST

9. 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’

10. 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

11. 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

12. 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

13. 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

14. A theoretical model of patient experience and satisfaction with hospital food service Patient Monitoring Simple/rapid (strain gauge) reinforced by multidisciplinary plan of action Nutrient Intake Patient Satisfaction Food Quality Texture Temperature Food Service System Trolley Ward hostess Empathy Wastage Distribution/transportation Minimum delay to prevent nutrient loss and sensory deterioration Meal Place of consumption Peace and quiet Traditional Menu Brand names Interactive Menu Clarity/language Choice Feedback and communication Management Medical staff Caterers Patients Hospital Food Service Manager Hospital Food in Context NHS and the hospital environment i.e. funding, Better Hospital Food and medical condition. Patient expectation and perception of ‘hospitality product’. Hospital Food Service Better Hospital Food Service Incidence of malnutrition reduced Shorter patient stay Improved patient experience Reduction in cost to NHS Primary Health Care team Primary Health Care team

15. Conclusion • Optimal treatment – good nutrition • Patient satisfaction • Quality – texture and temperature