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My Food Choice: Transforming Patient Food Services

HealthShare NSW
Project Added:
23 September 2016
Last updated:
10 October 2016

My Food Choice: Transforming Patient Food Services

Summary

This project reimagined the way hospital food is delivered to patients in public hospitals, using new workflow processes, menus, staff training and technology, while remaining inside the current budget footprint.

Aims

  1. To reduce the time between ordering and receiving meals to four hours or less, while improving the choice, quality and nutrition of food choices.  
  2. To improve business processes, empower staff and support clinicians with new technology and systems.

Benefits

  • Reduces the time between ordering and receiving meals, so patients on full and simple diets can match their choices to their immediate levels of wellness and hunger.
  • Uses new technology to support just-in-time ordering, better business practices and better management of diet orders.
  • Improves the level of service provided to patients.
  • Supports nutrition and promotes eating by increasing the choice and quality of food available.
  • Provides clinicians with data on what patients have eaten, to support nutrition management.
  • Provides managers with data that improves ordering, receiving and business practices.
  • Eliminates the need for spare and default meals, reducing costly food waste.
  • Empowers staff by building a greater sense of ownership, quality and responsibility.
  • Enhances hospital kitchens with cost-effective investments.

Background

The current method of preparing and serving patient meals in hospital is outdated, having changed little in the past 30 years. It does not reflect changes in technology and modern food service systems, or support a modern hospital system with shorter lengths of stay, advanced technology and a greater need for responsive and personalised patient care.

Prior to the project, it was common for a delay of 30 hours between the time the patient ordered and received their meal. This was not sustainable and resulted in high levels of waste and non-choice default meals, which contributed to patient dissatisfaction. The paper-based ordering system was inefficient, while the production line model of preparing meals in the kitchen meant that staff were isolated from patients and their needs.

To address these challenges, My Food Choice was developed as a new, improved and personalised way of preparing and serving patient meals.

Implementation

  • Small teams of staff take orders from small groups of patients using a tablet device. The order is immediately sent to the kitchen via Wi-Fi.
  • Patients can choose from up to 18 hot meals at every service, as well as a range of fresh sandwiches and salads. The menu features images of the meals to help the patient make an informed choice. 
  • HealthShare NSW has worked with local producers to ensure each meal is easy to open, reflects a variety of foods, supports Australian businesses and meets NSW Health’s mandatory nutrition standards.
  • Kitchen staff use touchscreens to efficiently manage their workload, which features streamlined reporting for managers.
  • Hospital kitchens have been redesigned to replace tray assembly lines with agile stations, where staff fill the orders they have personally taken. They deliver the meals and return to collect trays from the same patients.
  • Staff are trained in customer service, to ensure their interaction with patients is always positive.
  • As staff collect meal trays, they record what the patient has eaten on their tablet device. This can be sent directly to the patient’s clinician, to support nutrition care planning.
  • New equipment, including custom-designed collection trolleys and high-performance dishwashers, were purchased to improve Work Health and Safety standards and efficiency.

Project status

  • Implementation - the initiative is ready for implementation or is currently being implemented, piloted or tested.

Key dates

  • Pilot project: January 2015 – December 2015
  • Rollout to all NSW public hospitals: January 2016 – December 2019

Implementation sites

  • Mona Vale Hospital, Northern Sydney Local Health District
  • Blacktown Hospital, Western Sydney Local Health District
  • Mount Druitt Hospital, Western Sydney Local Health District

The model will be implemented in an additional three hospitals in the coming months and rolled out to all NSW public hospitals by December 2019.

Partnerships

  • KPMG
  • Improformance
  • Strategic Access
  • CBORD
  • Kuisine Company
  • Snapfresh
  • Simplot
  • Northern Sydney Local Health District 
  • Western Sydney Local Health District 
  • Polytec
  • ErgoAnalyst
  • NSW Ministry of Health

Evaluation

The pilot project at Mona Vale Hospital was evaluated in November 2014 to provide baseline data for the project. Post-implementation results were measured between July and October 2015, using a combination of qualitative and quantitative data to evaluate the operational impact of My Food Choice on patient food services.

Results

  • Nearly all patients who were able to exercise a meal choice, did so.
  • Ordering patterns changed when patients ordered closer to meal time, with more patients choosing sandwiches over hot meals.
  • Default meals dropped from 29% at baseline to less than 1% in all subsequent pilot phases.
  • Patient meal intake increased from an average of 67% at baseline to a high of 85%, despite the fact that the amount of food served remained largely unchanged.
  • Patient food waste decreased from 48.7% of all food purchased at baseline, to a low of 24.5%.
  • Spare meals were effectively eliminated, from 10% of all meals at baseline to less than 1%.
  • Removing spare meals, changing workflows and team structures, and the introduction of new equipment and infrastructure allowed staff to focus on patient-facing activities. Staff were rostered to spend between 40% and 44% of their time on patient-facing activities, compared to a NSW average of 14% to 25%.
  • The project also enabled staff to respond to peaks in demand with a static workforce. A static workforce of 16.8 full-time equivalent (FTE) staff were able to respond to between 2,316 and 2,703 total meals prepared.
  • The purchase of a new dishwasher and increased use of pre-packaged meals reduced wash-related activity. The total time to complete the wash process reduced by 42%, from 245 minutes per day in Phase 1, to 142 minutes per day in Phase 3 of the pilot project.

Lessons learnt

  • Facilities must be provided with appropriate and effective processes, workflows, equipment and infrastructure.
  • Wi-Fi capability must be adequate throughout the hospital.
  • Staff and management must have capability, capacity and cultural readiness to implement the project.
  • Hospital management and clinical stakeholders must be engaged in planning, preparation and implementation.
  • Protocols should be developed so that My Food Choice data is provided to clinicians, to support operational and clinical decision-making.
  • Patient satisfaction should be measured on a regular basis.

Additional resources

My Food Choice Video

Contacts

Carmen Rechbauer
Director, Food & Patient Support Services
HealthShare NSW
Phone: 02 8644 2024
Carmen.Rechbauer@health.nsw.gov.au

Gary Sullivan
Program Manager, My Food Choice
HealthShare NSW
Phone: 02 8838 1338
gary.sullivan@health.nsw.gov.au

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