A look into how room service dining can improve patient satisfaction and increase efficiency and satisfaction for workers as well.

1. HOSPITAL ROOM SERVICE DINING:
A PARADIGM SHIFT WITH HIGH ORGANIZATIONAL IMPACT
HELEN M. NICHOLS, MSW, HEALTHCARE RESEARCH ANALYST, SODEXO

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The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2016
In 2014, U.S. hospitals admitted more than 35 million patients and generated expenses in excess of $890 billion.1
As
the demand for healthcare services continues to grow, hospitals are under mounting pressure to remain competitive in
an industry that is increasingly focused on the cost-effective delivery of personalized, high-quality and comprehensive
patient-centered care.2,3,4,5
Foodservice providers in hospitals have also shifted their focus toward the provision of
patient-centered care.6,7,8
This shift has led to the adoption of room service-style food delivery programs within hospitals
– a trend that shows no signs of slowing down9
with proven benefits for patients, workers and organizations.
In the not-so-recent past, food service in hospitals was limited to unimaginative and standardized procedures and
options. Menu options were typically on rotation and served only at predetermined times each day. Patients who missed
meals would receive a boxed meal in its place. Assembly lines and production prepared food well in advance of meal
times, with little variation or attention to individual preferences of patients. This system led to common complaints of
cold meals, poor timing and unappetizing choices. Today, many hospitals have turned to room service dining in an effort
to improve patient satisfaction and realize a number of other benefits for patients, workers and hospitals alike.
Key Components of Room Service Dining in Hospitals10,11
Patients decide when
they eat – meals are
prepared at their
request.
• Meals are ordered by patients using their
bedside telephone or a tablet computer.
• Orders are routed through a central
call/order system.
• Patients can order any menu item at
any time that the kitchen is open for
business.
• Meals are delivered within 30-45
minutes of ordering.
• Each patient has access to a bedside
menu with numerous food options from
which to choose.
• Items available for each patient are
limited to those that meet their
physician-prescribed diet order.
Food is delivered
when patients want –
meal ordering times
are flexible.
Patients choose the
food items –
foodservice menus
have a variety of
choices.

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As such, they cannot be reproduced or utilized without permission. ©2016
Room Service Benefits for Patients,
Workers and Hospitals
»» Increased Patient Satisfaction
Room service in hospitals has been associated with
increased flexibility of meal delivery and variety of
food choice, along with improved taste, temperature
and quality of foods; all resulting in improved
patient satisfaction and dietary intake.12,13,14
Hospital
foodservice quality is a key component of overall patient
satisfaction,15
and the addition of room service programs
can increase patient satisfaction with meals up to 9%.16
»» Improved Patient Nutrition
The routine diet designed for hospital inpatients is
largely unrestricted; as a result, nutritional requirements
are often not met,17
which is a contributing factor to
undesirable clinical outcomes.18
In fact, nutrition intake
is especially important for the healing patient,19
as
insufficient nutrition has been linked to increased rates
of infection, complication and mortality.20,21
Delivering
high-quality meals in a more flexible manner, with
greater variety and improved taste, has the potential
to improve patient nutrition by increasing food
intake. Indeed, multiple studies have shown that food
consumption after the introduction of room service
increased more than 40% 22,23
and caloric and protein
intake improved by 18%.24
»» Greater Efficiency and Job Satisfaction for Workers
The implementation of room service-style food delivery
also has benefits for nurses and foodservice workers.
Nurses benefit from such a program because it allows
them to spend more time performing other clinical
duties. With respect to hospital foodservice workers,
in one study, they reported feeling more motivated
and satisfied with their jobs due to the positive patient
feedback that resulted from room service dining.25
Job satisfaction among frontline healthcare workers,
such as hospital foodservice staff, is especially
important for organizational success. Job satisfaction
is the necessary precursor to establishing a patient-
centered organization26
– a primary goal for hospitals.
Additionally, job satisfaction is linked to patient
satisfaction; patients develop perceptions of their
hospital experience based on the workers with whom
they have frequent direct contact, which are usually the
frontline workers.27

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The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2016
»» Reduced Food Costs for the Organization
The increased patient autonomy in meal decisions, driven by room service dining, has been proven to reduce the level
of food waste – and subsequently food cost – to the organization.28,29,30
A study among pediatric patients demonstrated
that implementing a room service-style food delivery system successfully reduced meal cost and food waste by
reducing individual food and beverage item orders by 21% and overall meals by 23%.31
Another study that looked at
various inpatient units found that the adoption of room service resulted in an average decrease of 27% in food waste per
meal.32
»» Faster Patient Recovery and Decreased Length of Stay Lowers Hospital Costs
The improved food quality and patient consumption resulting from the implementation of room service dining can
also lower healthcare costs for hospitals. The promotion of optimal patient nutrition and foodservice quality through
room service can help patients recover faster and reduce their length of stay in the hospital, in turn lowering hospital
expenditures.33,34
»» Improved Patient Perception Contributes to Overall Financial Success for Hospitals
Hospitals face new financial challenges resulting from the passage of the Affordable Care Act (ACA) and the concurrent
authorization of the Value-Based Purchasing (VBP) program.35
This new reimbursement system provides monetary
incentives and penalties aimed at ensuring that hospitals emphasize quality of care and patient perception. The
incentive or bonus payments determined by VBP equate to 1-2% of inpatient Medicare billable services, a significant
amount, considering hospitals
reported an average operating
margin of 7.2% in 2012.36
The
financial impact that patient
perception now wields is not
insignificant, given that hospitals
who regularly report high scores in
patient satisfaction are also among
the most financially successful,37
and foodservice is an important
component of overall patient
satisfaction.38,39
»» Positive Impact on Overall
Public Health
The improved nutrition that can
result from room service dining
also provides hospitals with
an important opportunity – to
reinforce public health messaging
for a healthy lifestyle through a
healthy diet. Research has shown
that patients are responsive to
making dietary changes post-
discharge40,41,42
and hospitals can
successfully promote healthy
eating habits by serving nutritious
meals that align with national
recommendations.
SOCIETY
PATIENTS WORKERS
HOSPITALS
• Increased satisfaction
• Better nutritional intake
• Improved public health
through the promotion
of healthy dietary choices
• Increased job
satisfaction
• Increased efficiency
• Decreased food costs
• Decreased healthcare costs
Benefits of Hospital Room Service Dining

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The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2016
Implementation of Room Service Dining in Hospitals
Best Practices
1. A multidisciplinary approach is ideal. All foodservice staff should be involved, including those who prepare the
meals, those who deliver meals to patients, and staff who take meal orders. Nursing staff should also be familiar
with room service, and hospital management support is critical for operational success.
2. Sufficient time should be allowed for development and implementation. Each hospital foodservice department
will need to customize room service dining to its specific needs. This does not end after initial implementation –
continual adaptation is vital to ongoing success.
3. Foodservice workers should receive thorough training in customer service.
4. Patients should drive overall decisions regarding program design and menus. Feedback from patients should be
routinely solicited and incorporated into menu changes and additions.
5. Food and menu choices should be tailored by geographic area. Tailored menus allow for food options that not only
reflect local preference, but are also healthy and taste good.
6. Automated technology should be utilized for diet changes, menu ordering and meal tracking. This is also
important for patient safety – to ensure that meals meet physician orders and take allergies and other potential
adverse reactions into account.
Potential Benefits Outweigh the Costs
Costs are incurred when implementing any new service delivery system – while room service dining in hospitals is not
an exception to this rule, the benefits and cost savings are likely to outweigh the associated costs. For instance, room
service requires hospitals to make an initial investment in new equipment, computer software and training of staff.43,44
However, room service has been shown to reduce direct costs by eliminating late meals, reducing floor inventory
requirements and preventing costly over-production.45
There are also the indirect cost savings generated by improved
job satisfaction among workers and increased patient satisfaction with the overall hospital stay. Lastly, room service
systems are sometimes associated with greater labor costs, but many hospitals report that these costs are only higher
during implementation and subsequently drop back to normal.46
Conclusion
When people are staying in the hospital,
they care about the food they are
served – meal choice, delivery timing,
presentation and overall satisfaction
with foodservice are all important to
patients.47
Foodservice providers in
hospitals face numerous challenges
in meeting patient expectations, with
the most common patient complaints
including cold meals, meals served at
odd times, lack of appetite and poor
quality.48,49
To address these issues,
hospitals are increasingly turning to
room service-style food delivery. Room
service dining benefits not only patients,
but also healthcare workers and a
hospital’s bottom line.

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The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2016
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The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2016
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suppl 2), A62.
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