The poor state of food served in hospitals is often the most critiqued of the hospital experiences and can be a sore point for patients. In an effort to improve quality and streamline services, NSW Health is harnessing technology as the special ingredient in improving food delivered to patient bedsides.

Since its pilot program in 2014, the state’s My Food Choice has overturned 30 years of practice and streamlined meal production processes, changing the stereotype about hospital food along the way. 

“Traditionally hospital food is ordered up to 36 hours ahead of the time the meal is delivered to the patient. Under My Food Choice we have reduced this timeframe to two to four hours. This means patients can order food more appropriate to how they are feeling,” Chief Executive of HealthShare NSW Carmen Rechbauer said.

“We have also partnered with manufacturers to develop a range of meals that meet our statewide nutritional standards. This means we can offer a greater variety and up to 15 choices at lunch and dinner.”

Food service staff use iPads to take patients’ meal choices and the information is immediately transferred to the kitchen.

“The time between ordering and receiving a meal is reduced because we are using technology in real time. The key advantage is that patients are able to order according to their appetite,” Ms Rechbauer said.

“This means that if a patient isn’t feeling well they might order something lighter or if they are feeling better they may order more food. They are not receiving meals according to their appetite 24 hours previously.”

The project, which has achieved gastronomic gains in 40 of the state’s public hospitals so far, will be rolled out throughout all of NSW’s public hospitals by December 2019. 

The system is creating much needed change in an area of hospital care that can be under-prioritised but has a proven impact on patient outcomes.

In a four-year study in the UK, researchers compared food production in prisons with hospitals, analysing menus, interviewing catering staff and hearing from meal recipients.

In hospitals, priority was given to diagnostic tests and medical treatments, and delivering food from kitchens to patients could be a fragmented and badly coordinated process. Meanwhile, a prison governor said problems with meal delivery in jail could cause a riot. 

But while the risk isn’t quite so violent, the stakes are high in hospitals where food can play an important role in improving patient recovery, with inadequate nutrition found to lengthen patients’ hospital stays by 50 per cent and triple mortality rates. 

The UK researchers said prisoners consumed about three times more calories than patients and their diet more closely adhered to UK Government nutritional guidelines. Malnourishment was rife among patients, however, despite their risk of weakened immune systems, muscle wasting and delays in wound healing.

Through the implementation of My Food Choice in NSW, delivery of quality food that patients want to eat has dramatically improved. It has also provided insights into their health. 

“When the meal tray is collected from the patient, the staff record what has and has not been eaten. This provides our clinical dietitians with valuable information about the eating habits of patients and allows for earlier intervention if required,” Ms Rechbauer said.

“For example if a patient is not eating, dietitians have the capability to meet with the patient to find out why and put solutions in place to assist with better eating.”

Prior to the implementation of My Food Choice, the then paper-based ordering system was inefficient, leading to high levels of food waste and patient dissatisfaction. The production line model of preparing meals in the kitchen also meant staff were isolated from patients and their needs. But now, NSW Health has seen vastly improved processes and patient focused cultural change – and staff are more engaged in healthcare.

“My Food Choice connects Food Service staff with the patients. Under the previous model the delivery of food services had become very process focused. My Food Choice is a much more patient focused model,” Ms Rechbauer said.

“Feedback from staff has been very positive. They enjoy the interaction. They work in small teams so the person who takes the order is also part of the process of putting the meal together and delivering it. This means our staff need to learn new skills.”

In addition to learning how to use the technology and adjust to updated work processes, staff have been trained in customer service to ensure positive interactions with patients.

Hospital kitchens have been redesigned to replace tray assembly lines with stations where staff fill the orders they have taken. They deliver the meals and return to collect trays from the same patients.

Staff also use touchscreens to manage their workloads and reporting for managers as part of the food production overhaul.

Carmen Rechbauer, Chief Executive of HealthShare NSW, will be delivering the keynote address ‘Food services of the future – Using technology to improve service efficiency and patient experience’ to the Corporate Services stream at Australian Healthcare Week on 27 March 2019.