Engaging the patient: improving dietary intake and meal experience through bedside terminal meal ordering for oncology patients.

BACKGROUND: The present study aimed to determine changes in patient dietary intake, plate waste and meal experience associated with the implementation of a patient-directed bedside electronic meal ordering system (BMOS) compared to traditional paper menus (PMs).

METHODS: The study evaluated the effect of a BMOS compared to PM at an oncology hospital between 2015 and 2016. Patient dietary intake, plate waste and patient meal experience were the key outcomes measured. Plate waste was determined using a validated seven-point visual wastage scale. The weight eaten estimates were converted into nutrients consumed in each food item to estimate dietary intake. Patient meal experience was measured via written surveys.

RESULTS: There was an increase in patient dietary intake and patient meal experience, with BMOS compared to PM. Comparison between BMOS (n = 105) and PM (n = 96) showed statistically significant increases in ordering sufficient energy (8683 kJ day-1 versus 6773 kJ day-1 , P = 0.004) and protein (97 g day-1 versus 82 g day-1 , P = 0.023), as well as average energy intake (6457 kJ day-1 versus 4805 kJ day-1 , P < 0.001) and protein intake (73 g day-1 versus 58 g day-1 , P < 0.001). Average plate waste remained the same for both cohorts. Patient meal experience showed that 60% of patients accessed the BMOS independently. The BMOS cohort had significant increases in receiving the food that they ordered (P < 0.001) and in choosing food that they liked (P = 0.006).

CONCLUSIONS: The results of the present study demonstrate that a patient-directed electronic meal ordering system improved patient dietary intake and meal experience. These results are most likely a result of empowering patients to make decisions about their meal selections and nutritional care through accessible meal ordering and improved menu communication.