daily nutrition intake

In an effort to improve the daily nutrition intake for patients in a healthcare setting, a recent study evaluated the impact of introducing room service to improve nutritional intake for patients.

A well-documented clinical issue is hospital malnutrition, which can be linked to adverse clinical outcomes such as increased mortality and morbidity, longer hospital stays and increased costs. The challenges faced by dieticians in both Australia and the US health care systems are quite similar in regards to treating malnutrition by delivering patients with food services which are high-quality and cost-effective whilst providing them with adequate nutritional intake in a healthcare setting. With increases in resource restrictions in health care, costs for service delivery is under scrutiny and avenues to save money are constantly being investigated. Food services and associated waste costs are often a focus in cost-management of healthcare facilities.

In a bid to improve upon patients’ daily nutrition intake, as well as patient satisfaction and reducing food waste (and thus costs), the Mater Private Hospital Brisbane was the first hospital in Australia to introduce room service in 2013. This foodservice model has since been increasingly implemented across healthcare facilities in Australia. Previous reports have focused on the improvements room service offers in regards to in improving patient satisfaction and associated costs and reduction in food waste. There have been few studies, however, which have investigated whether room service helps improve nutritional intake for patients in comparison to their nutritional requirements.

Recently, a study conducted by McCray and colleagues comprehensively evaluated the differences between room service and a traditional foodservice model in regards to daily nutrition intake, patient satisfaction, plate waste, and meal costs. The results were recently published in the Journal of the Academy of Nutrition and Dietetics.

Participants in the study included adult patients who stayed in the Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia.  A retrospective analysis was conducted of quality assurance data collected between July 2012 and May 2015. In a pre- versus post study design, patient nutritional intake was compared between patients staying in a facility with a traditional foodservice model and those staying in a facility offering room service.  The traditional food service model involved the patients filling out paper menus up to 24 hours in advance and meals delivered at set meal times. The room service model involves patients ordering their food by telephone whenever they wanted.  The meals are prepared fresh and delivered within 45 minutes. Patient satisfaction, plate waste, and patient meal costs were the primary outcomes assessed before and after implementation of the room service model.

Statistically significant increases in nutritional intake were observed for patients receiving room service compared to the traditional food service model, with an increase in both energy and protein intake, along with the percentage of requirements for both. Also, the results indicated patient satisfaction also improved with room service in regards to both the quality of food and flavour of food. Total meal plate waste was decreased from 29% with the traditional food service model to 12% with room service, as was meal costs which was decreased by 15% with room service.

One limitation associated with this study was that the data was gathered over a period of only four days per site. This relatively short time frame resulted in small data sets for each subgroup (medical, surgical, and oncology). Even though the small data sets met the assumptions for statistical analysis, further studies involving a greater number of patients would enable sufficient analysis of these effects in various population groups. Also, as this study only included patients from an adult hospital setting, further investigations exploring these generalised results in a variety of geographical populations including senior living, rehabilitation, and paediatric facilitates are necessary.

Overall, compared to the traditional food service model, the results showed room service not only increased patient daily nutrition intake but also increased patient satisfaction, reduced wastage, and meal costs. Given the paradigm shift towards more personalised patient care and in a budget-constrained healthcare system, the room service model is ideal as it offers a patient-centered food service model which can reduce malnutrition and service costs while increasing patient satisfaction and clinical outcomes associated with nutritional intake.

Written by Lacey Hizartzidis, PhD


McCray S, Maunder K, Krikowa R, MacKenzie-Shalders K. Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost. J Acad Nutr Diet. 2017 Jul 1. pii: S2212-2672(17)30519-1. doi: 10.1016/j.jand.2017.05.014.

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