Exploring patient satisfaction with foodservice through focus groups and meal rounds CORILEE A. WATTERS, MSc, RD; JANICE SORENSEN, BSc; ANNA FIALA, RD; WENDY WISMER, PhD ABSTRACT The purpose of this study was to investigate adult patients’ perceptions of hospital foodservice through focus groups with patients postdischarge and with nurses. The focus group themes included an emphasis on health, quality, freshness, and appro- priateness; variety, selection, and choice; inability to provide feedback; menu er- rors; accessibility to food on the units; service; tray layout; and waste. The themes emerging from the focus groups were further explored through meal round inter- views with patients (n=116) to determine areas for improvement. Patients thought food served in the hospital should be a model for a healthy diet. Ongoing education and communication with patients and nurses is important in improving satisfaction with foodservice. J Am Diet Assoc. 2003;103:1347-1349. F oodservice quality can influence pa- tients’ overall hospital stay satisfac- tion (1,2). A 1996 study of patients’ perceptions of hospitalization at the Royal Alexandra Hospital (RAH) indi- cated food contributes to patient recov- ery and well-being (2). Our study further investigates patient foodservice satisfac- tion at the RAH, a tertiary 585-bed teach- ing hospital. The food at the RAH is pre- pared off-site in a cook-chill commissary, and trays are assembled and heated by conduction in rethermalization carts on- site and served through a nonselective, 7-day menu cycle. Diet order entry is computerized, and menus are manually prepared. The first phase of the study included focus groups with patients postdischarge and with nurses to determine patients’ expectations and perceptions of hospital foodservice (3). This qualitative ap- proach was chosen because little is known about patients’ hospital foodser- vice perceptions, and using a more struc- tured approach might not have captured the issues pertinent to patients. Also, so- liciting information from groups adds an important dimension in which percep- tions are partly developed by interaction with others (4). The second phase involved meal rounds with predischarge patients. Meal rounds involve talking to patients during their hospital stay about their foodser- vice experience and satisfaction (5). In- terviewing patients during mealtimes provides an opportunity to obtain de- tailed feedback that can be used to for- mulate applications to improve patient foodservice satisfaction (5). The pur- pose of this study was to determine pa- tients’ perceptions of hospital food- service and what factors influence satis- faction. METHODS Sample Selection Potential participants included adult pa- tients consuming regular-consistency di- ets with a length of stay (LOS) 4 days, and nurses from Internal Medicine, Sur- gery, Cardiac Sciences, and Women’s Health at the RAH. The study was ap- proved by the Capital Health Authority Health Research Ethics Board. Of 250 potential focus group partici- pants identified, 16% (39) agreed and gave informed consent to participate, 31% could not be contacted, and 53% were uninterested or unable to partici- pate. The 39 potential participants were contacted postdischarge, and five pa- tients attended the three patient focus C. A. Watters is a Regional Manager, Education and Development, J. So- rensen is a research assistant, and A. Fiala is a Regional Manager, Patient Service, Regional Nutrition & Food Service, Capital Health, and W. Wismer is an assistant professor, Department of Agricultural, Food and Nutritional Sci- ence, University of Alberta, Edmonton, Alberta, Canada. Supported by a grant from the Royal Alexandra Hospital Foundation. Address correspondence to: Corilee A. Watters, MSc, RD, Regional Nutrition and Food Service, Capital Health, Rm 7443, Aberhart Centre c/o 8440-112 St, Edmonton, Alberta, Canada T6G 2B7. E-mail: cwatters@cha.ab.ca Copyright © 2003 by the American Dietetic Association. 0002-8223/03/10310-0006$30.00/0 doi: 10.1053/S0002-8223(03)01077-0 RESEARCH AND PROFESSIONAL BRIEFS Journal of THE AMERICAN DIETETIC ASSOCIATION / 1347