Hospital food service: a comparative analysis of two foodservice systems at a Danish Hospital.

Background
Insufficient dietary intake is common among hospitalised patients and may affect prognosis negatively. Hence hospital meals are central in the treatment, and their efficacy in ensuring adequate intake is crucial. This study aimed to compare patients’ dietary intake from a cook-serve buffet-trolley serving system (BTS) to a new cook-chill pre-plated concept (CCP) allowing patients to choose from a static menu 24/7.
Methods
A quasi-experimental study was conducted at two orthopaedic surgical and a gynaecological surgical ward at a Danish Hospital. 57patients (≥3 days) were served meals from BTS and the dietary intake was measured. After implementation of CCP on the wards, dietary intake was measured on 56 patients. Intake at mealtimes was assessed through a visual portion size assessment method and intake in-between meals was measured using a self-reported dietary record.The number of patients achieving an intake of ≥75 % of energy and protein requirements was compared between groups using a pooled two-proportion z-test. Nutritional risk was assessed according to NRS 2002.
Results
An energy intake ≥75 % of requirements was achieved in 68 % of patients on CCP compared to 56 % on BTS (p=0.199) and protein intake ≥75 % of requirements was achieved on 55 % of the patients on CCP compared to 53 % on BTS (p=0,771).
An energy intake ≥75 % of requirements was achieved in 59% of the patients at nutritional risk on CCP compared to 33 % on BTS (p=0,216) and 59 % reached ≥75% of the protein requirements on CCP compared to 33 % on BTS (p=0,216).
Conclusions
A new foodservice system (CCP) which increases availability and choice of food 24/7 does not show a significant improvement of energy and protein intake in hospitalized patients and patients at nutritional risk. However, further evaluation of CCP is needed.