Improving Patient Mealtimes Project

Team Leaders

  • Lucy Leadbetter – Dietitian
  • Keeley Clarkson – Dietitian
Lucy Leadbetter Group Photo

Team Members

  • Joanne Cope – Nutrition Team Dietitian
  • Lucy Leadbetter – Dietitian
  • Keeley Clarkson – Dietitian
  • Maddie Jones – Senior Nurse
  • Sandra Higgins – Catering Manager
  • Isla Jones – Speech and Language Therapist
  • Rachael Mitchell – Speech and Language Therapist
  • Kirsty martin – Dietetic assistant

What was the problem you were trying to address?

A ‘Protected Mealtimes’ Policy has been in place at Aintree for a number of years and was initially designed to encourage an environment that promoted and supported the nutrition of inpatients.  It was well recognised by dietitians, other therapy staff and nurses on the wards that the policy was not adhered to, patients would frequently be un-necessarily interrupted during mealtimes and not always have access to appropriate foods and support during mealtimes. This is not acceptable and has implications for nutritional and clinical status, as well as providing an unfavourable patient experience.

Audit data, including patient and staff opinion strongly supported these concerns and the Nutrition Colloborative was formed on the basis that this was a Trust wide problem, which could best be addressed using skills of a varied mixture of healthcare and catering staff. The aim of the group is to address mealtime related issues, to support working towards a reduction in hospital malnutrition and to improve the overall quality and standard of the mealtime experience at Aintree. 

How did you create your project plan?

Project plan was based audit data – including patient and staff opinion and ward observation, regular collaborative meetings with all MDT stakeholders and patient and staff feedback.

Key Actions

  • Formation of the project group of relevant stakeholders from a variety of MDT roles
  • Gathering and analysis of audit data to understand the current situation.  This included ward mealtime observations, staff questionnaires and patient feedback questionnaires
  • Review of current literature and other successful improving mealtime projects
  • Development of a new Trust wide Improving Mealtimes Policy – with input from dietitians, nursing staff, occupational and speech and language therapists
  • Launch of the above policy
  • Redevelopment of the modified texture diet menus

Main Outcomes

  • 60% of local care homes achieving Food First status
  • Over a 1000 care home staff trained (total)
  • Over 90% of those trained by the team have rated the quality of the training highly and 80% expect the training to have a significant impact on their future work
  • Reduction in reliance on ONS, 63% patients reviewed stopped ONS as it was deemed unnecessary once an individualised care plan had been initiated. This has meant a reduction in the prescribing costs of ONS of 25-50% (depending on locality) providing the PCT’s with savings.
  • Closer working relationship between nutrition and dietetics and social care
  • Raised awareness of the importance of malnutrition at the highest trust levels
  • Winners of trust Effective Team Award and Advancing Healthcare Leadership Award
  • Short listed for Patient Safety awards

How are you going to maintain the improvement?

  • Introduction of new Improving Patient Mealtimes policy
  • Development of subsequent projects around hospital menus, catering systems and specifically modified texture menus

Tips for others planning similar projects

Ensure involvement from a wide variety of MDT staff – in particular those with ward based experiences.

Top Quotes

‘Winners of the Quality and Safety Aintree Excellence Awards and Aintree Team of the Year 2011’