Pilot Site Reports Mobile Intake is Hospital Food Service Game Changer

Mona Vale Hospital, located on the north side of Sydney, Australia, is the beta site for CBORD's new Mobile Intake® module. The hospital is testing an entirely new way to serve patient meals, and Mobile Intake is being used to correlate the changes with patient intake. It is an extremely ambitious program that has already begun producing interesting, evidence-based results supporting many of the changes they have made.

We spoke with the project leader, Gary Sullivan, Manager of Food Production and Business Support for HealthShare New South Wales. The HealthShare NSW organization provides shared services to support the delivery of patient care within the 150 hospitals in the New South Wales health system. Mona Vale Hospital is one hospital within the system and was chosen to be the pilot for testing changes to the patient meal process. Mona Vale Hospital is a 200-bed site with a wide variety of units including maternity, surgical, rehab, and pediatrics. The pilot program is being tested throughout the hospital.

New Process Increases Patient Intake

The organization's hypothesis is that patients will eat more if meal ordering is moved closer to meal time. To that end, HealthShare NSW implemented a new ordering process using Room Service Choice® from CBORD to support ordering at the bedside. Additionally, small teams work together to take orders, assemble trays, deliver to patients, pick up used trays, and record intake. Orders are taken twice daily—once before lunch and again before dinner (patients order both dinner and breakfast for the next morning). Teams build familiarity with their patients, enhancing the patients' meal experience.

Teams of three serve approximately 60–80 patients daily. They have a goal of 2.5 hours between taking orders and tray delivery for lunch and dinner. Tray tickets print at meal times, and conventional rotating menus are supplemented with prepackaged meals to increase choice. Selections are currently cold plated, warmed, and served using reheating trolleys. Trays are assembled and delivered well within the planned 2.5 hours.

Specially Designed Collection Trolleys Shave Minutes off the Process

Collection trolleys have been designed for tray pickup with speed in mind. Using CBORD's Tray Monitor®, a tray's status is displayed on a large monitor in the kitchen. Tray icons turn yellow after 30 minutes indicating it is time for pick-up. A tablet is mounted on each trolley to support the Tray Monitor process, allowing staff to update in real-time when trays have been collected. At the same time, they can easily complete an intake survey. The collection trolleys allow staff to sort waste and organize the used trays. This process significantly reduces the time spent on wash-up, and allows more time with the patients taking orders.

Mobile Intake Provides Actionable Information

Completing the intake survey on average only adds 10 to 15 seconds to the tray collection process, Sullivan stated. He also noted an interesting observation: When patients were familiar with their servers, and servers were focused on the patient's intake, patients consumed their entire meal more often. Sullivan also commented on employee acceptance. He originally was worried employees might not easily accept the new tablet technology. He reports this has not been an issue; employees learned to use the tablets very quickly and had no problem adapting to the change.

"Mobile Intake has performed just as we had hoped. It provides us with real data not just on what people order, but also what they consume. It is going to change food service operations in hospitals forever. We can make changes and really know if our changes are improving patient food intake," Sullivan commented.

When given a choice, some patients will order the same thing many days during the week. Some prefer a variety. Knowing this, HealthShare NSW has made changes to the menu, making more à la carte items available every day. They also found patients don't eat as much when what is delivered doesn't match expectations. By naming each dish correctly and including pictures of all the menu items, the staff has been better able to meet patients' expectations. Moving ordering close to delivery and setting accurate expectations have both worked to increase patient intake.

Turning Information into Cost Savings

HealthShare NSW spends approximately $70 million a year on patient food. Research over time shows hospitals will waste between 25% and 40% of the food they prepare, for a variety of reasons. Sullivan believes with new processes and accurate measurement they can increase intake and dramatically lower waste below 20%. "The data we are collecting will challenge the acceptable level of waste and ultimately drive hospitals to waste less food. If we can lower our food waste by 10%, we can save $7 million a year. I can also see how this will be a game changer when it comes to caring for patients suffering from malnutrition, and reporting on and finding ways to increase nutritional intake," he noted.

HealthShare NSW is now planning the next phase of the pilot, which is to learn if prepackaged food can be served in the packaging. Sullivan's team is testing what kind of dishware and packaging is most acceptable, and how patients react to prepackaging. Using Mobile Intake, HealthShare NSW will have accurate data telling the team what was consumed and what was left on the tray. With this kind of feedback, HealthShare NSW is confident it will be able to lower food costs, improve patient intake, and drive up patient satisfaction. At CBORD, we are proud to provide a solution for measuring patient intake.

We are excited to see how Mobile Intake will support a research environment where meal options and process are being tested. Mobile Intake was designed with two objectives: (1) to measure meal acceptance and intake, and (2) to help identify and treat malnutrition.

To learn more, check out our webinar, Improve Malnutrition with Mobile Intake.