Hospitalfoodie: an interprofessional case study of the redesign of the nutritional management and monitoring system for vulnerable older hospital patients

Alastair S Macdonald, Gemma Teal, Claire Bamford, Paula J Moynihan

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Abstract

BackgroundTo date, a solution to the problem of hospital malnutrition in older patients in the UK has not been found through previous approaches using isolated interventions. AimsTo identify opportunities for, and to develop and prototype a new food and nutritional management system able to meet individual patients’ daily requirements. MethodUsing an inter-professional team approach, design researchers worked alongside food scientists, dieticians, medical sociologists, ergonomists, computer scientists, technologists, key stakeholders and a ‘food family’ (those concerned with nutrition management, and food supply and delivery in hospital, i.e. food producers, caterers, ward staff, nurses dieticians, physicians, speech and occupational therapists), as well as with older people representatives. Through ethnography and workshop-based methods, major opportunities for service improvement were identified. An iterative design and development process was deployed using mixed methods including ethnography, mapping, personas, storyboarding, role-playing, enactment and narratives. Prototypes of interactive interfaces were developed to test the workability of an electronic nutritional management and monitoring system linked to a nutrition composition database. In parallel, new food products were developed, led by food scientists, and a catering supply and delivery system for ward-based food provision was also developed. The methods used to facilitate inter-professional collaboration, the engagement of the food family, and to develop the food and nutrition service concept are described. Results A demonstration prototype was displayed in exhibition format at a series of conferences to gather further feedback. ConclusionEarly responses to the ‘hospital foodie’ demonstration prototype were favourable and indicate that, with further development, the prototype may offer the means for improving nutritional care standards in hospitals and be adaptable for use across other patient groups.

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