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Hospital meals

#1 User is offline   hukildaspida 

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Posted 04 September 2014 - 05:29 PM

Revealed: Warning over hospital food cutbacks
5:00 AM Saturday Jul 26, 2014

http://www.nzherald....jectid=11299363


Plans to slash costs nationwide by serving cheaper meals spark alarm among nutrition experts that patients could be left malnourished — or dead

From next year, mince will be fattier, the 10g protein count for sandwiches will include bread, and the minimum protein delivered on a daily basis will drop from 90g to 80g. Photos / Sarah Ivey From next year, mince will be fattier, the 10g protein count for sandwiches will include bread, and the minimum protein delivered on a daily basis will drop from 90g to 80g. Photos / Sarah Ivey

Nutrition experts have warned a government cost-cutting team that patients could suffer malnutrition or even death under plans for cheaper hospital food.

Their objections have forced a rethink on plans to reduce the amount of protein fed to patients, cut back on hot food, use plastic plates instead of crockery, remove small and large portion offerings and use lesser-quality ingredients.

Sandwiches were also on the chopping block — hospitals were told to give patients 10g of protein in each sandwich instead of 10g in the filling alone.

Alarm over the changes was sounded by an advisory group set up to give feedback over the plans. They said the cuts would save only 52c per patient a day.

The state-owned cost-cutting agency Health Benefits Ltd (HBL) has now ruled out plastic plates, removal of hot lunches and reducing portion choices.

But from next year, mince will be fattier, the 10g protein count for sandwiches will include bread, and the minimum protein delivered on a daily basis will drop from 90g to 80g.

The options were put forward through HBL by British-based company Compass, which has been selected to buy, prepare and provide food to all district health boards and is negotiating how much it will be paid.

HBL interim chief David Woods has rejected any impact on patients, saying hospital food will be as good as or better than ever and prepared under nationally consistent guidelines.

HBL also says the savings will be higher than the 52c identified by the nutrition experts. It expects to save $3 a day feeding each patient, bringing the cost of meals down to $27 and saving up to $120 million in 15 years.

Health Minister Tony Ryall created HBL to save $700 million in the health system by merging back-office functions and bulk-buying in non-clinical areas. It expects to start bringing in the food-delivery changes next February.

HBL formed the Food Nutrition Advisory Group of hospital dieticians and other health experts to give "robust" feedback on proposals before signing the contract with Compass.

In March, the hospitality operations manager of the Southern District Health Board, Justin Bellass — writing on behalf of the advisory group — said they felt "the focus for the provision of patient meal services appears to be on the benefits which can be achieved by reducing nutritional specifications as opposed to looking at the total picture".

The group said a third of hospital patients were malnourished and "food is cheap medicine" that should be "seen as a cost-saving measure rather than a 'nice to have' that should be cut".

Dieticians in the group warned that not using lean mince would create "fat separation" and "decreased customer satisfaction due to fatty mince mouth-feel and appearance".

They were also concerned removing a hot lunch overlooked the importance hot food had in delivering protein and restricted choices, leaving patients searching out alternative food sources.

"Research shows that DHBs will pay a larger price with malnutrition and poor food intake associated with prolonged hospital stay, frequent admissions and greater-in-hospital mortality".

The way food is prepared is also set to change. Auckland patients will be served packaged hot meals prepared under the Steamplicity system — which has received positive reviews in a British academic study.

Outside Auckland, the practice of cooking meals fresh at the hospital will end. Instead, components for the meals will be delivered to the hospital kitchens for cooking or heating before being put on plates according to patients' orders. Meals-On-Wheels recipients and others will get reheated frozen meals. Mr Wood, a former Treasury executive, said the debate over food was "pretty predictable" but unavoidable.

"If we find any adverse actions on patients, you can be sure we will address them. We have to be very mindful of what DHBs are spending, what they can actually afford."

David Page, who is leading the programme for HBL, said it had worked hard to address the concerns of the hospitals.

He acknowledged there were "strong words" in the advice from dieticians.

"They are a group of very passionate people, and very emotive too. You're going to get crockery and stainless steel. The debate is over."

Mr Page said the sandwiches produced under the new guidelines would be the same as those made now, but the guidelines would more accurately reflect the protein patients received.

Labour health spokeswoman Annette King said it was a "penny-pinching" project which would see patients swapping fresh food for chilled and frozen meals.

"Trying to save a few cents will end up costing them dollars in terms of long-term outcomes on patients."

Outsourcing will see the end of bulk food production in hospital kitchens, impacting on the jobs on 1,000 people around the country.

Public Service Association acting general secretary Glenn Barclay said morale had plummeted, with staff unsure of their futures.

He said the dieticians had raised legitimate health concerns.

"Any mistake carries consequences."


'Steamplicity' meals pass the taste test


Food is prepared on the ward in microwaves by HBL's selected national food provider Compass using its "Steamplicity" system. Photo / Sarah Ivey

The future of hospital food is here — and it's tasty. But it's only in Auckland, so if you're outside the Queen City, here's a taste of what you're missing out on.

Lunch was arriving for Trevor Crane, 64, as he was preparing to end an extremely positive visit to North Shore's elective surgery centre.

He is leaving for home after a two-day stay with a new hip and two "flash meals" he can't praise enough.

On Wednesday, Mr Crane came out of surgery hungry and ready for dinner. He found there was no need to wait for scheduled meal times — food was ready when it suited him, not the other way around.

"They rustled up a roast lamb meal for me. I was quite impressed."

Then there was the braised beef, served with "nice fresh vegetables", which was "beautiful".

Food is prepared on the ward in microwaves by HBL's selected national food provider Compass using its "Steamplicity" system.

A valve in the plastic pack containing the meal regulates the temperature, meaning the food is cooked (or heated) using the moisture of the ingredients. The bottom of the pack slides out onto the plate below and is served to the patient.

Studies abroad have recorded high levels of patient satisfaction with the system, which matches Mr Crane's enthusiastic response.

They are backed up by patient satisfaction surveys at the elective surgery centre which are also strongly supportive. One negative comment sits among a mass of positive feedback, reading: "Not into healthy food."

HBL says the elective surgery centre is a model example of how the new system should work.

But outside Auckland, perfection may be a little more distant.

The "Steamplicity" system isn't going into other hospitals when it rolls out in February. The food will be prepared in one central place, and getting it beyond the critical mass of Auckland is difficult.

Everybody else will get meals that will include components prepared somewhere other than in the kitchen of the hospital they are in. The food will then be reheated, and occasionally cooked.

About 80 per cent will be "Cook Chill" — raw, ready-to-cook and cooked products delivered chilled to the hospital for heating or cooking. For those who get Meals-on-Wheels, the future holds frozen dinners.


What's your experience with hospital food? Send descriptions and pictures to [email protected]

- NZ Herald

Read more by David Fisher Email David Fisher
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#2 User is offline   hukildaspida 

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Posted 04 September 2014 - 05:32 PM

Jeremy Hunt tells hospitals they must serve up better and healthier food
More fruit, less salt and choice of meal to be offered, with failure to make changes considered a breach of contracts


Denis Campbell
The Guardian, Friday 29 August 2014
Jump to comments (335)


http://www.theguardi...ls-quality-hunt

The standards will also give patients the right to a choice of meal and to ask to receive food in-between set mealtimes. Photograph: Rui Vieira/PA

Hospitals will be forced to ensure patients receive better quality and healthy food in a crackdown by ministers on what campaigners claim is one of the NHS's longest-running failings.

Under a demanding set of mandatory standards, hospitals will – among other measures – be required to offer fresh fruit around the clock and reduce salt in meals, or risk being fined or losing vital NHS contracts.

Jeremy Hunt, the health secretary,
is aiming to end the inadequacy of much hospital food, after a flurry of government and NHS initiatives since 2001 left the quality of meals still stubbornly poor in many places.

The standards will also give patients the right to a choice of meal and to ask to receive food in between set mealtimes.

The poor quality of much hospital food was set out in a detailed report from a standards panel Hunt set up to investigate the problem, chaired by Dianne Jeffrey, chairwoman of Age UK. "Being in hospital is often a very worrying experience and it can be made even worse when the food is unfamiliar and unappetising and you have no control over what and when you eat and drink," she said. "While hospitals are not five-star restaurants, it's important that food and drink is tasty, nutritious and thoughtfully presented so that people can eat as well as possible."

Hunt is introducing five new standards, which he says will be legally-binding on all providers of NHS care, including private operators such as Care UK. They will cover any provider who serves food to patients – acute and specialist hospitals but also mental health units and community service providers.

The standards will also stipulate that every patient entering hospital should be screened for malnutrition and be given a personalised food plan and that any patient who needs help from staff to eat or drink should receive it.

Hospitals that do not implement all the required changes will be in breach of their contracts with the GP-led NHS local clinical commissioning groups (CCGs) which pay them to treat patients.

In addition, from Friday every hospital in England will be ranked, on the NHS Choices website, for seven different aspects of their approach to food. These aspects include the quality and choice of food, choice of breakfast, availability of fresh fruit and ability to eat between meals.

That website will also detail how much each hospital spends in total per day, per patient on food and drink, though that includes the cost of equipment and staff, not just the food itself. The amounts involved currently range from as little as £3.68 to as much as £29.72 per day.

NHS England will include the requirements in the next NHS standard contract, currently being drawn up. The NHS had to "set a clear example in providing healthier food for our patients, visitors and hardworking staff," said Simon Stevens, NHS England's chief executive.

Hunt said that while many hospitals were already offering excellent food, "we want to know that all patients have nourishing and appetising food to help them get well faster and stay healthy".

But Alex Jackson, coordinator of the Campaign for Better Hospital Food, said the new clauses in contracts between hospitals and CCGs would prove "woefully inadequate" and not legally binding. "Jeremy Hunt's announcement that he will introduce 'legally binding' standards for hospital food appears to fulfil what we've always strived for, yet we're left feeling he has pulled the wool over our eyes," said Jackson, who quit Jeffrey's panel in April.

Dr Aseem Malhotra, a cardiologist and obesity campaigner
, endorsed Jackson's view that only primary legislation, like that introduced by Tony Blair's administration in 2006 to improve the quality of school food, would guarantee the "scandal of hospital food" was finally ended.

"The quality of food that continues to be served to most patients in most hospitals is appalling: unpalatable, of poor nutritional quality and often heavily processed, while portion sizes can be too small to be adequate," he said. "Good nutrition is essential to a patient's recovery from illness and an operation, and there's good evidence that poor nutrition in hospitals is a risk factor for the patient having to be readmitted within 30 days of discharge because their dietary needs have been neglected during their initial stay."

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#3 User is offline   hukildaspida 

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Posted 04 September 2014 - 05:33 PM

Robots help deliver meals for patients

By Western Daily Press | Posted: September 03, 2014

Read more: http://www.westernda...l#ixzz3CK2CCluy


http://www.westernda...tail/story.html

This is the incredible fleet of robots helping to provide food for almost 1,000 patients at a new £430 million super hospital.

Southmead Hospital in Bristol has deployed a fleet of 12 automatic guided vehicles to deliver meals to its 950 patients.

The droids, which start work at 10.15 every morning, are capable of opening doors, operating lifts and picking up food without any human assistance.

They transfer chilled dishes to kitchens scattered around the hospital, where they are heated and then served to patients.

After completing their rounds, the machines return to their charging stations until they are called upon again for the next meal.

Catering manager Gary Wilkins said it was as simple as pressing a button and the machines did the rest.

He said: "They (the robots) are very slick and very quick. At first you are a bit worried about whether it is all going to work, but they are amazing."

The automated guided vehicles (AGVs) are also used to transport waste, linen, supplies, sterile instruments, endoscopes and pharmacy items around the building.

They operate in designated areas, which are primarily staff only, and have safety features including the ability to stop if something gets in the way.

They are able to navigate their way along "virtual tracks" using infra-red laser scanners and comparing what they sense with an in-built map. It is hoped the machines, which measure 1,700mm x 610mm x 306mm, will soon be introduced in other parts of the hospital.

The newly built Southmead Hospital was recently criticised for its food, after one patient took pictures of poor portions. But Sharon Fortune, head of facilities for hospitality, defended the food available to patients. She said: "We never run out of food on the wards, people can always ask for extra. It is up to the staff on the ward to judge it.

"We don't know if it is a frail old man we are serving or a large rugby player so it's up to each ward to know their patients and serve food accordingly."

Read more at http://www.westernda...WeV1kEcSV32f.99
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#4 User is offline   hukildaspida 

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Posted 04 September 2014 - 05:38 PM

In our opinion all patients should have there Body Mass Index (BMI)taken when in hospital care to ensure any pre-existing eating disorders may be assisted.

It is unbelievable to see that such poor quality meals are readily available when we have a worldwide issue of rising obesity.

Why have hospitals not moved with the times and ensured healthy & freshly made fruit & vegetable juices are given to patients?

Why is it also that hospital vending machines tend to have sugar laden foods & drinks instead of healthy fruits?

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#5 User is offline   netcoachnz 

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Posted 05 September 2014 - 06:16 PM

View Posthukildaspida, on 04 September 2014 - 05:38 PM, said:

In our opinion all patients should have there Body Mass Index (BMI)taken when in hospital care to ensure any pre-existing eating disorders may be assisted.

It is unbelievable to see that such poor quality meals are readily available when we have a worldwide issue of rising obesity.

Why have hospitals not moved with the times and ensured healthy & freshly made fruit & vegetable juices are given to patients?

Why is it also that hospital vending machines tend to have sugar laden foods & drinks instead of healthy fruits?



Interesting information in this topic, thanks for bringing this matter to our forum community.

Having spent 23 days in hospital this year, we are well versed in the quality and quantity of hospital meals. Most hospitals have dieticians who monitor each patient - we have had our menu choice changed as it was not suitable. The hospital meals at our DHD were in the main shipped in from another centre 2 hours away. Our DHB also supplies meals to 2 old folks homes.
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#6 User is offline   Campy 

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Posted 05 September 2014 - 06:28 PM

View Posthukildaspida, on 04 September 2014 - 05:38 PM, said:

In our opinion all patients should have there Body Mass Index (BMI)taken when in hospital care to ensure any pre-existing eating disorders may be assisted.

It is unbelievable to see that such poor quality meals are readily available when we have a worldwide issue of rising obesity.

Why have hospitals not moved with the times and ensured healthy & freshly made fruit & vegetable juices are given to patients?

Why is it also that hospital vending machines tend to have sugar laden foods & drinks instead of healthy fruits?



YOU'RE IN THE WRONG DHB... Or are you generalising again?
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#7 User is offline   greg 

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Posted 05 September 2014 - 06:38 PM

I did not choose to be in hospital but then last year I was offered
good food and I won't complain . I was well feed and looked after.
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#8 User is offline   hukildaspida 

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Posted 12 December 2014 - 11:36 AM

Broccoli from China for patients?
WILMA MCKAY
Last updated 17:36, December 11 2014

http://www.stuff.co....na-for-patients


The Southern DHB envisages almost $900,000 in annual savings if it joins a national food services contract but hospital food workers say expect broccoli from China and catfish from Vietnam on menus.


The DHB announced today it had decided to pursue a Health Benefits Ltd (HBL) business case for national provision of hospital food services.

First it would consult with staff, board chairman Joe Butterfield said.

The business case, if approved, was expected to save the DHB $870,000 in its first full year, he said. That posed significant savings for the DHB, he said, adding the numbers used are conservative and savings could be significantly higher.

Developed by HBL, along with DHBs, the business case helped reduce costs and improve standards for DHBs.

Southern DHB members
agreed to canvas views from hospital food workers who sent a delegation to the board's monthly meeting today.

The staff, who were also members of the Service and Food Workers Union, were asked to come back to the board for a closed meeting early in the afternoon.

Butterfield released the board's decision not long after that.

Service and Food Workers Union national spokeswoman for public and community services Jill Ovens said the Southern DHB decision was hugely disappointing.

The concerns weren't just about workers' jobs, Ovens said.


This was an issue for the whole southern community and the community as a whole should be consulted on the decision.


Ovens said current southern hospital food systems provided for freshly cooked meals using local suppliers.


Under the HBL contract foods would no longer necessarily be sourced from local suppliers. Patient meals and local Meals on Wheels would be pre-packaged and reheated at hospitals, she said.

Ovens said to expect menus that could include broccoli from China, catfish from Vietnam, and to forget about "our nice South Island" potatoes.

One hospital catering company operating in Christchurch was using potatoes from the Netherlands, she said.

Auckland DHB was timed to release its decision as to whether it was buying into the HBL deal coming Monday.

Consultation had been limited to two weeks, Ovens said. She had doubts whether the Southern DHB consultation would be any different.

Butterfield said the Southern DHB had a mixed model of distribution. Some of the food for Southland Hospital and all food for Wakari Hospital was prepared in Dunedin.

"We recognise the impact implementation of this decision may have on affected staff and local suppliers and Southern DHB will not enter into a contract until we are completely satisfied with its benefits," Butterfield said.

"Under the business case there would be opportunities for all existing staff to transfer to the new employer on the same terms and conditions.

"We will now consult with staff on the proposal," Butterfield said.

- The Southland Times

Don’t Eat The Broccoli In China is well worth a read

Don’t Eat The Broccoli In China

June 13, 2012

Read more at http://www.redorbit....LyzQTcuoSKQA.99

Michael Crumbliss for redOrbit.com

China has the worst pollution problems in the world. And it is getting worse as the utterly unchecked rush to industrialization continues. Much of this is pollution is linked to coal mining and power generation, but the sources of toxins are myriad.

While air and water pollution are highly visible and overwhelming on an everyday basis, the worst long-term toxic buildup may be lurking quietly underfoot in the soil. Nowhere is the global push to restore degraded land likely to be more important, complex and expensive than in China, where vast swaths of the soil are contaminated by arsenic and heavy metals from mines and factories.

There are dire consequences for food production and human health. On top of having the highest cancer rate in the world China has the highest rate of birth defects. No one disputes that this is the result of pollution. It could be argued that the country is fast on the way to killing itself as it grows.

Literally at the root of this epidemic of poisoning is tainted soil that sends toxins and carcinogens to the dinner table, where people unknowingly eat them. Where does this lead? Will parents tell their children not to eat vegetables? It seems that perhaps they should.

Zhou Jianmin, director of the China Soil Association,
estimated that one-tenth of China’s farmland was affected. “The country, the government and the public should realize how serious the soil pollution is,” he said. “More areas are being affected, the degree of contamination is intensifying and the range of toxins is increasing.”

Other estimates of soil pollution range as high as 40%, but an official risk assessment is unlikely to be made public for several years.

Mining is largely to blame, though lead and heavy metals from factories and overuse of pesticides and fertilizers by farmers are also a factor.


Chen Tongbin of the Chinese Academy of Sciences said the worst contamination was in Yunnan, Sichuan, Hunan, Anhui and Guizhou, but there were also parts of Beijing where the soil is tainted.


Unlike in Europe where persistent organic pollutants are the main concern, Chen said China’s worst soil contamination is from arsenic, which is released during the mining of copper, gold and other minerals. Roughly 70% of the world’s arsenic is found in China — and it is increasingly coming to the surface with horrendous consequences.

“When pollution spills cause massive die-offs of fish, the media usually blames cadmium, but that’s wrong. Arsenic is responsible. This is the most dangerous chemical,” he said. The country’s 280,000 mines are most responsible, according to Chen.

Chen estimated that “no more than 20% of China’s soil is seriously polluted”, but he warned that the problem was likely to grow because 80% of the pollutants in the air and water ended up in the earth.

“The biggest environmental challenge that China faces today is water pollution, but there are efforts underway to control that. In the future, the focus must be on soil pollution because that is much harder to deal with. Soil remediation is an immense and growing challenge.”

Read more at http://www.redorbit....LyzQTcuoSKQA.99
http://www.redorbit....ccoli-in-china/
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#9 User is offline   hukildaspida 

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Posted 12 December 2014 - 11:39 AM

Why are these DHB's etc not been reprimanded for there intent to further increase "carbon emissions" instead of reducing them?

Farmers would be hammered if they set out to do something similar & indeed they already get slammed for cattle doing basic necessities of toileting yet our DHB's, may be going to import harmful toxins into NZ & feed them to there unsuspecting patients.

Guess it's one way of ensuring the population doesn't increase.

Disgraceful.

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#10 User is offline   fuckstain 

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Posted 12 December 2014 - 11:44 AM

There is No money in fixing us however farming us can make a fortune, so feeding us not that important .....
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#11 User is offline   hukildaspida 

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Posted 12 December 2014 - 11:47 AM

Related topic "What's really in our food?"

http://accforum.org/...987#entry195987
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#12 User is offline   hukildaspida 

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Posted 12 December 2014 - 01:38 PM

Menu planning guidelines for Aged Care Homes – Missing in action
smitha
on August 12, 2014 at 8:00 am

http://www.hospitalh...missing-action/

Aged Care Accreditation Standards are demanding increasing levels of excellence and facilities are coming under ever increasing scrutiny around the provision of nutrition and hydration. Food Service Managers are struggling with tighter budgets and needing to do more with less. Anne Schneyder asks where are the Nutrition and Menu Planning Standards for aged care facilities?

FEATURED- Food services Many older people have multiple medical problems, poor appetites, increased nutrient requirements and special dietary needs, meaning that it can be difficult to achieve an adequate nutritional intake. Studies have reported the rate of malnutrition among residents in residential care homes can be as high as 70%1,2,3,4,5. ‘Malnutrition is both a cause and a consequence of ill-health. It interferes with an individual’s ability to benefit from health treatments and affects every domain of their well-being’1, it impacts on quality of life and increases the cost of care7. Weight loss in the elderly population generally results in loss of skeletal muscle mass and strength (sarcopenia)6. Sarcopenia has huge personal and financial costs and remains largely unrecognised.

There are multiple factors that may contribute to weight loss and malnutrition. These may include:

financial problems
social difficulties
multiple medical problems
respiratory difficulties (for example dyspnoea)
dysphagia
poor dentition
adverse effects of drugs
polypharmacy
depression, bereavement
dementia
reduced taste and smell
poor appetite.

The above factors are ‘individual specific’, but there are numerous ‘system specific’ causes of malnutrition:

“Access to adequate food and nutrition in a form that is enjoyable and without imposition of unnecessary or arbitrary restrictions is a fundamental right for all residents in our aged care homes.”

ANNE SCHNEYDER

The food supply

Does the menu provide adequate nutrients even if the resident’s appetite is good? How do we know?
Do the serves sizes meet guidelines? What guidelines are used?
Are there enough opportunities to eat during the day? How many hours are there between breakfast and the evening meal?
Are residents placed on unnecessary special diet restrictions? e.g. low cholesterol, low salt, weight reduction, low fat diets)
How is the food cooked?
Is the food cooked fresh or are there a large number of commercial processed options?
Are the textures correct? Are there lumps or skins in the puree foods leading to fear of eating?
Are necessary special diets adhered to correctly? (e.g. allergies, gluten free diets)
Are staff available to feed the residents? Do they have sufficient time?
Where and with whom do they share a meal?

Communication issues

Do the residents always receive the correct meal?
Where are the details documented?
Is documentation referred to when plating the meals?
Do the residents enjoy their meals? How do we know?
Do they have a real choice?
What is provided when an item is disliked?

We must identify and treat malnutrition on an individual basis1, but a ‘food first’ approach to adequate nutrition and nutrition support plays an integral role in ensuring residents have sufficient nutrition and energy to meet their needs without the need for expensive supplements or interventions. Good menu planning is an essential component of good nutrition care9.

So, where are the food service and menu planning guidelines we can turn to that are specific to aged care?

The newly revised Australian Dietary Guidelines9 include guidelines regarding the dietary needs of individuals over 70 years of age but specifically exclude the frail elderly and are not intended to be a guide for food service.

Aged Care Accreditation Standards include nutrition and hydration standards11, however these are very general and outcome based; standards addressing actual menu planning are limited or non-existent.

The Best Practice Food and Nutrition Manual for Aged Care Facilities by Bartl and Bunney10 is an excellent Australian manual describing the various nutrition issues in aged care homes. It provides practical advice and examples for care facilities. It is now ten years old, with a new version having been developed in early 2012 but not yet released by the Department of Health. It addresses a variety of nutrition, hydration and catering issues but is not intended to be a catering guide and does not address menu planning in depth.

Most Australian states have developed a set of Nutrition Standards for food service in hospitals12,13,14,15. Some were designed as specifications for recipes for catering organisations to ensure that dishes have a minimum nutrient profile. The Queensland and Victorian documents discuss aged care facilities and catering but are not specifically focussed on the needs of the frail aged population. In practice the frail elderly often do not eat the quantity of foods recommended (personal observation).

In October 2011, Dr Peter Williams was contracted by the Dietitians Association of Australia to conduct a scoping project to review literature and documentation relevant to nutrition and menu planning standards in Australia and New Zealand20. Dr Williams reviewed all known Australian and New Zealand nutrition or menu standards, guidelines or checklists for their applicability for use in the aged care sector. He also compared key standards from the USA and UK.

Key recommendations from Dr Williams’ report included:

there is strong support for the development of aged care specific menu planning guidelines
guidelines should not be mandatory but should provide a ‘best practice’ approach
guidelines should be simply and clearly written, practical and understandable by non-dietitians
development of guidelines should involve not only dietitians in Australia and New Zealand, but also representatives of the Institute of Hospitality in Health Care, major companies providing food services to RACFs, the Aged Care Standards and Accreditation Agency, and peak bodies such as the Aged Care Associations of Australia and New Zealand.

To date there has been no action or follow-up from this report. There are excellent documents from the US, UK and Europe8,17,18,19 that can be referred to but there are no up-to-date Australian standards.

The Accreditation Agency calls for menus to be reviewed on a regular basis. Aged care homes may contract a dietitian to review their menu.

But what standards should be used to audit against?

Dietitians will most commonly refer to The Best Practice Food and Nutrition Manual for Aged Care Facilities10 despite the fact that it is now ten years old and out of date, and the New Zealand Menu Audit Tool for Aged Care Facilities developed by Dietitians New Zealand16. In practice dietitians, food service managers, and care staff use a combination of the available guidelines and their own experience, together with input from a variety of sources (including the resident and their families) to plan and assess menus for aged care homes.

The quality of a menu review can vary greatly, from a review of food groups in the written menu only, to a comprehensive assessment of nutrition care within a facility. It is not sufficient to fax the menu off for a quick tick. An assessment needs to be made on how the menu integrates into care. Audits of serve sizes, documentation, malnutrition assessments and pathways of care should be assessed. The food should be viewed and tasted: without a site visit the menu review does not provide a complete picture of what really happens in a facility! A comprehensive assessment is far more than a review of paperwork.

Access to adequate food and nutrition in a form that is enjoyable and without imposition of unnecessary or arbitrary restrictions is a fundamental right for all residents in our aged care homes. Menu Planning Guidelines that are specific to aged care are required to ensure that all residents receive quality nutrition care. A minimum standard for menu reviews is needed so that the review has meaning and so that the advice is consistent.

“Organisations have to deal with so many competing priorities and may ask: ‘Why should we prioritise nutrition and hydration care?’ The answer is simple. Without food and water, people will die.”

Janine Roberts, Programme Director, Malnutrition Taskforce, UK

NPA-13-Anne-SchneyderAnne Schneyder is a director of Nutrition Professionals Australia

Anne Schneyder is a director of Nutrition Professionals Australia. She has over 30 years experience in a variety of clinical settings. Anne has been involved in the private sector for most of her professional life, conducting a successful private practice and consultancy service. Anne, together with Julie Dundon established Nutrition Professionals Australia in 2001, and the business has now grown to be one of the largest providers of nutrition and dietetic services in Australia. Anne has been awarded Advanced Accredited Practising Dietitian status by the Dietitians Association of Australia.

References:

1. Dietitians Association of Australia. Evidence-based guidelines for the nutritional management of malnutrition in adult patients across the continuum of care. Nutr Diet 2009;66 Suppl 3:51.

2. Australian and New Zealand Society for Geriatric Medicine. Under-Nutrition and the Older Person. Position Statement No 6 2007 www.anzsgm.org/documents/PositionStatementNo6Under-NutritionintheElderly.pdf

3. Marilyn Banks et al. Prevalence of malnutrition in adults in Queensland public hospitals and resdential aged care facilities. Nutrition and Dietetics 2007.

4. Gaskill D, Black L, Isenring E, Hassall S, Sanders F, and Bauer J. Malnutrition prevalence and nutrition issues in residential aged care facilities. Austral J Ageing 2008; 127: 189-194.

5. Woods J, Walker K, S I-B, and Strauss B. Malnutrition on the menu: nutritional status of institutionalised elderly Australians in low-level care. J Nutr Health Aging 2009; 13: 693-698.

6. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412-23.

7. Karen Freijer et al. The economic costs of disease related malnutrition. Clinical Nutrition 32 (2013) 136-141

8. Pioneer Network Food and Dining Clinical Standards Task Force: New Dining Practice Standards 2011. http://www.pioneerne...ceStandards.pdf

9. National Health and Medical Research Council. Australian Dietary Guidelines. 2013 www.eatforhealth.gov.au/

10. Bartl R and Bunney C. Best practice food and nutrition manual for aged care facilities: addressing nutrition, hydration and catering issues. Gosford: Central Coast Health, 2004.

11. Aged Care Accreditation and Standards Agency Accreditation Standards. http://www.accredita...ENGLISHV1_3.pdf

12. Nutrition Standards for adult inpatients in NSW hospitals (NSW Agency for Clinical Nutrition) http://www.aci.healt...trition_web.pdf

13. Nutrition Standards for Menu Items in Victorian Hospitals and Residential Aged Care Facilities (Department of Human Services (Victoria) http://www.health.vic.gov.au/ archive/archive2011/patientfood/nutrition_standards.pdf

14. Nutrition Standards for Meals and Menus (Queensland Health) http://www.health.ql...utritionstd.pdf

15. WA Health. Nutrition Standards for Adult Inpatients in WA Hospitals http://www.health.wa...chments/811.pdf

16. Dietitians New Zealand. Menu audit tool for aged care facilities. Wellington, 2010. http://bit.ly/1nn2IcS

17. National Association of Care Catering Malnutrition Taskforce. Malnutrition in Later Life: Prevention and Early Intervention- Best Practice Principles & Implementation Guide. 2013. http://www.malnutrit...fe_Hospital.pdf

18. Council of Europe Committee of Experts on Nutrition, Food and Consumer Health. Nutrition in care homes and home care Report and recommendations: from recommendations to action

19. The Caroline Walker Trust. Eating Well Resources http://www.cwt.org.u...al-Resource.pdf

20. Williams, P. Scoping Project: Development of Nutrition and Menu Planning Standards for Residential Aged Care Facilities in Australia and New Zealand- Literature Review and Final report. http://daa.asn.au/fo...s/nutritionand- menu-planning-standards-in-residential-aged-care-facilities-in-australia-andnew- zealand/
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Posted 15 December 2014 - 02:56 PM

Auckland Hospital workers walk over outsource call
SHABNAM DASTGHEIB
Last updated 13:12 15/12/2014

http://www.stuff.co....-outsource-call

Food workers at Auckland Hospital have walked off the job today after a district health board decision to outsource the supply of hospital food.

It was a bad decision for workers and it would be a bad decision for patients, spokeswoman for the Service and Food Workers Union Jill Ovens said.

"The workers are devastated and patients and their families will be very disappointed when they experience the reality of outsourced food."

In a statement Auckland District Health Board said the three boards in the region had decided to proceed with a proposal to have Compass Group responsible for procurement, preparation and delivery of food.

Under the agreement, Compass Group would be responsible for patient meals, meals-on-wheels, cafeteria supplies, food to wards and departments and function catering.

Staff were told of the decision today after a consultation process which ran for three weeks.

The agreement would improve food quality and manage costs in the face of a rising population, DHB chief executive Ailsa Claire said.

"I regret the uncertainty the proposal has caused. We will do our best to work with Compass to ensure that our people can have certainty about the future."

Ovens said token commitments around locally supplied food and better employee relations did not make the decisions more palatable.

She said the timing of the announcement just before Christmas had been devastating for the workers.

She said the DHB had said that one in five food service jobs would go across Auckland.

But Claire said there would be no kitchen closures and all staff would be offered the opportunity to transfer to Compass on the same terms and conditions.

Meals will continue to be prepared in kitchens at all sites using a mixture of fresh, ready-to-cook, pre-cooked and frozen ingredients as is the case today.

The DHB believes that over the 15-year contract, based on today's dollars, the Auckland Metro DHBs could save approximately $80-90 million for redirection into clinical services.


Ovens said the Government's intention was to roll this out food outsourcing across the whole country in 2015, affecting over 1500 kitchen workers and every patient requiring hospital food. The union had no planned strike action but she was calling on the health boards to reconsider the decision.

The remaining 17 DHBs around the country are considering the business case of the proposal, Auckland DHB confirmed.


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