Sally McCray Director Nutrition & Dietetics, Mater Group Brisbane

 

When you’re a patient in hospital, so much is dictated to you – including when your meals are served, and the choices available to you each day for meals. Now, imagine being able to order from a menu, room service-style, across extended hours, while you’re an inpatient. While your food choices remain in line with your individual health and nutrition needs, you suddenly have access to a scrumptious array of offerings that (usually) transcend broth and jelly.

From a dietitian’s point of view, a room service-style program’s benefits extend beyond just patient choice: food waste is reduced; dietitians are better able to manage nutritional needs of their patients; and overall food quality is heightened. It’s a revolution in food service. And Sally McCray, APD, Director Nutrition and Dietetics, Mater Group Brisbane, was a leader in this revolution. Mater’s “Room Service” concept was initially implemented in 2013. This was followed by comprehensive analysis of key outcomes including nutritional intake, waste, food costs and patient satisfaction. Today, Mater’s Room Service model delivers over 2,000 patient meals a day out of 3 kitchens across 2 campuses.

We recently spoke with Sally to learn more about this innovative model — and its stellar results to date. Read part one of our interview now, and stay tuned for our next issue, when we continue with Sally to learn more about Room Service.

 

Infuse: Mater’s room service program is Australia’s first hotel-style hospital room service. What was the impetus behind the development of this innovative program?

Sally McCray: Room Service was initially driven by a desire to create a better service for patients, through a strong collaboration between Nutrition and Dietetics and Food Services. Like many hospitals in Australia, prior to implementing Room Service, there was a very traditional, manual model in place whereby patients completed their menu choice on a paper menu. This was undertaken well in advance of the mealtime, and often with little interaction with staff. Then patients were served meals at set times often not suited to them.

As a result, there were many late and extra meal deliveries; patients often didn’t get a meal of their choice; and there was significant waste associated with this. Patient satisfaction with food was rated poorly during feedback surveys, and their nutritional intake was suboptimal.

By focusing on all of these key drivers together – consumer engagement, customer satisfaction plus improved clinical and organisational outcomes – the room service model was implemented.

 

Infuse: What are some of the key outcomes thus far, in terms of positive changes to patients’ nutritional intake?

SM: We have consistently measured four key outcomes in a balanced scorecard-type framework when making any change to our foodservice models at Mater. These are nutritional intake, plate waste, food costs and patient satisfaction.

In terms of nutritional intake, we have seen both an increase in total energy (kilojoule) and protein intake, as well as an increase in energy and protein as a percentage of patient’s requirements. This innovative model demonstrates the importance of patients being able to order flexibility, both in terms of the type of food items that patients feel like eating, as well as ordering food at a time of day that they feel like eating. This improvement in intake can assist to decrease the risk of malnutrition, which is well documented in the acute-care setting globally at approximately 30% of hospitalised patients. Malnourished patients have a longer length of hospital stay, greater risk of complications and poorer in-hospital clinical outcomes, which can also significantly add to costs of the organisation.

Also, from recent Australian research we know that over half of malnourished patients eat less than or equal to 50% of food offered to them in a typical acute-care setting, so anything we can do to improve this can help address malnutrition and assist patients’ clinical outcomes and recovery.

 

Infuse: How does the system ensure that the room service options available to patients are in line with their individual dietary needs?

SM: We use a sophisticated electronic menu management system (CBORD TM) that allows meal order staff to see all menu items that are compliant to a patient’s particular diet or combination of diet restrictions. When setting up the system, every menu item, ingredient and recipe is coded into the database by a dietitian as either compliant or non-compliant to each diet type. The system interfaces with our patient information system where the patient’s diet is recorded, so that when a patient phones the call centre to place their order, the system shows the meal order staff which items are compliant (in black text) that the patient can order and those that are noncompliant (in red text) that the patient cannot order. This functionality also allows meal order staff to be able to have a conversation with patients around alternative items and assist them to meet their nutritional goals.

 

Please join us in the next edition of Infuse for part 2 of our Interview with Sally!

 

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