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The purpose of this paper is to survey current nutrition/foodservice‐related healthcare professionals to determine their level of knowledge about dysphagia, and their perceptions of dysphagic patients and their needs.

A data collection instrument in the form of a questionnaire was developed to obtain an idea of the perceptions and knowledge‐level of diet/foodservice‐related healthcare workers about dysphagia. Subjects included foodservice workers, including food preparers and food deliverers at a large healthcare facility in the Southwestern United States. A total sample size of n=51 surveys was collected and analyzed.

Given the means from this sample group, healthcare foodservice workers are lacking in some areas of knowledge concerning dysphagia patients, and their dietary needs. Education and training seem indicated, as the number of patients suffering from some degree of dysphagia is only going to increase as the US population ages.

Millions of Americans currently suffer from at least some degree of dysphagia. This number is expected to increase as the Baby Boomer generation reaches retirement age. The USA will be populated by more elderly people than ever before, and will thus host more individuals suffering from swallowing impairment. This paper adds insights to the subject.

This research aims to investigate the sources of food waste generation at two long-term care (LTC) homes located in Canada. Given the distinctive regulatory and operational context LTC's work within there is an opportunity that unique causes of food waste exist.

An initial audit using the Food Delivery System Framework determined the most appropriate method to measure food waste for this study was a quantitative approach supported by field observations.

Results of the study show a significant food waste of over 55% at both facilities. Investigation into the generation of this waste isolated the major cause being government policy ensuring patients at these facilities are offered choices throughout the meal selection process. Plate waste was generated because of additional policies guaranteeing pre-determined nutritional and caloric intakes for each patient.

These findings put into question the operating practices involved with adhering to policies on the choice of food. Ethical questions are raised pitting a patient's “quality of life” versus the environmental impact of the waste generated because of policies. Field observations note a “throw away culture” and an absence of established foodservice management practices that create a lack of awareness and attention to the issue of food waste.

Most studies of food waste in healthcare facilities have looked at caloric and nutritional loss from a patient's point of view. To the best of the authors’ knowledge, this study is one of the first to look at the causes of food waste generation in these operations.

The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food.

Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK.

The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations.

Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals.

The paper identifies opportunities for enhancing hospital food production systems.

The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.

The purpose of this paper is to assess patient perceptions regarding South African hospital foodservice quality.

In total, 419 questionnaires were administered to surgical and medical inpatients consuming a normal diet in six South African provinces. A number of 23 urban and 10 rural hospitals were sampled. Inpatients were surveyed for their opinions on hospital foodservice quality with a view to improving meals and food delivery processes.

Results revealed lower patient satisfaction with aspects relating to foodservice reliability. Among other issues, inpatients were not informed about meal times (overall median=0), had to wait longer than expected for their meals and were not informed about delays (overall median=2). Menu items were not explained to inpatients (overall median=0), and inpatients were not informed about nutritional values (overall median=0). Consequently, patients opined that they were not willing to use the hospital foodservice in future (overall median=2).

To identify South African healthcare issues that need improvement, it is necessary to establish where to act. These findings create awareness among authorities and hospital managers to consider patient perceptions when they review and try to improve public hospital foodservice quality, which could also assist in ensuring improvement in food consumption levels, thereby combating South African hospital malnutrition.

This paper presents an interpretive data analysis from a superordinate study that aimed to determine foodservice satisfaction. The purpose of this paper is to determine inpatient hospital foodservice experiences.

The authors used secondary data obtained from 419 respondents: (225 (53.70 per cent) males, 178 (42.48 per cent) females and 16 (3.82 per cent) undisclosed) participants. A comparative, quantitative and cross-sectional approach was applied to provide insight into hospital foodservice experiences. The Wilcoxon–Mann–Whitney test, interpreted at 0.05 error rate, was used to compare male and female patient experiences.

Male patients had significantly higher rank-sum scores than female patients in almost all items (p<0.0001). The study revealed that hospital personnel, especially foodservice staff, had an unsatisfactory communication approach.

This is the first South African study that compares female and male inpatient foodservice perceptions. Hospital managers and stakeholders may need to consider patient’s gender, as a significant factor that is associated with patient experiences, when embarking on improving foodservice systems.

Most patients in developed countries solely depend on the hospital menu to order their food. The provision of menu choices to patients differs between facilities. The purpose of this paper is to determine which strategies that provide menu choices to patients are effective in improving clinical and non-clinical outcomes in hospital.

Five databases were searched to identify relevant publications. Prospective research published in English with the menu as the primary intervention was included. Study eligibility was determined and risk of bias assessed. Outcome data were combined narratively due to absence of homogeneous study design and outcomes.

Of the 2,201 records screened, six studies met inclusion criteria. Standardised menu formatting and the spoken menu system were found to improve meal tray accuracy. The spoken menu and computerised interactive menu selector system enhanced aspects of patient satisfaction without cost increases. Descriptive menus may increase food consumption. Branding food items was not well supported by patients. One study rated positively for study quality with the remaining five studies receiving neutral quality ratings.

The small number of studies conducted on each intervention and the quality of the evidence made it difficult to establish a solid evidence base around providing menu choices to patients. Further research is needed on menu ordering systems, including spoken and visual menus, to determine their impact on outcomes in hospital.

This review is first to examine the effectiveness of menu interventions in hospital. Hospital foodservice departments should consider these findings when reviewing local systems.

The purpose of this study was to survey current culinary, hospitality and nutrition students to determine their level of knowledge about dysphagia, or swallowing impairment, and the dysphagia diet. In addition, the study provided a means by which to gauge current students’ awareness of health-care foodservice as a career option.

A pilot study conducted in 2009 indicated that health-care foodservice workers were unaware of many of the risks associated with the dysphagia diet. A second study was conducted in 2012 to obtain an idea of the perceptions and knowledge levels of culinary, hospitality and nutrition students about dysphagia. Subjects included students across the three disciplines at two large universities in the Midwestern USA, and a private culinary school on the east coast of the USA. The instrument consisted of a traditional paper survey containing 18 questions. A total sample size of n = 139 surveys was collected and analyzed.

Results of the survey suggests that current university students are lacking in some areas of knowledge concerning dysphagia patients and their dietary needs. Education and training are indicated, as the number of patients suffering from some degree of dysphagia is only going to increase as the US population ages. Findings also indicate that many introductory-level students are unaware of health-care foodservice as a viable career choice in industry.

The primary limitations to this research were the relatively small sample size, and the fact that most students surveyed were not interested or aware of health-care foodservice as a viable industry career choice. This study would be greatly enhanced by contacting professors/instructors at several universities representing the Northeast, Midwest, and east and west coasts of the USA. Educating future foodservice professionals at the introductory level would allow industry leaders to make students aware of this large and necessary sector of the foodservice industry. Likewise, there is no doubt that food preparers, food deliverers and foodservice managers in health care will come in contact with a patient with some level of dysphagia as our population ages. More research to strengthen this body of data is indicated, as are similar studies across broader ranges of the population.

The occurrence of dysphagia is growing as the US population ages. That fairly little research has been done is somewhat alarming. There is a need for standardization of recipe formulas, benchmarking viscosities of dietary liquids and solids and training of food preparers. The symptom is found in very large populations in the USA, as well as in Europe. Also, the fact that dysphagia has so many potential causes makes the symptom that much more of a health issue. More research is certainly called for to better prepare potential institutional foodservice employees for the next 20 years.

Millions of Americans currently suffer from at least some degree of dysphagia. This number is expected to increase as the Baby Boomer generation reaches retirement age. The USA will be populated by more elderly people than ever before, and will thus host more individuals suffering from swallowing impairment. Health-care foodservice, including hospital and long-term care foodservice will certainly become a viable career choice for current students of culinary arts, nutrition and hospitality.

This paper aims to reflect on the sources of the technical inefficiency of health care foodservice operations, using a sample of Australian and American hospitals.

The paper applies the stochastic frontier model to reflect on the technical inefficiency and its sources. The advantage of the model is that it allows the simultaneous parameters estimation of technical efficiency as well as the factors that explain variations in technical efficiency. A set of hypotheses are tested to ensure the applicability and suitability of the suggested model. Then the model parameters are estimated, discussed and checked against the theoretical requirements and the literature.

Results show that all the variable coefficients are correctly signed and that the average technical efficiency is around 83 percent for Australia and 80 percent for the USA.

The technical efficiency results, according to the introduced model, suggest that health care foodservice operations in both countries are not operating at a full efficient level. The results also reveal that factors such as manager's education, manager's experience, and size have a direct impact on reducing the level of technical inefficiency of these operations.

This paper overcomes the limitations of the existing efficiency techniques in the area of health care foodservice and also provides policy implications by emphasizing on the sources of technical inefficiency of health care foodservice operations for Australia and USA.

The major aim of this paper is to model, estimate and compare the technical efficiency and technology gap ratios of health care foodservice operations that operate in different Australian regions.

This paper uses a metafrontier model to analyse the difference in health care food efficiency across the various Australian regions. The interesting feature of this model is that it allows for the estimation of firms' efficiency in of various groups that might differ in technology and other production environments. In testing the model, cross‐sectional input/output data were used reflecting on the operational characteristics of health care foodservice operations.

The estimation process was initially supported by a hypothesis test which confirmed the validity of the metafrontier model in comparing the efficiency of the different outlined groups. Results showed that operations in the states of NSW and Victoria are producing on average 85.6 per cent of their potential output with respect to the metafrontier technology. The ratio is lower in other states with an average of 73.4 per cent. The average technical efficiency for operations in NSW and Victoria is also higher both in terms of local (87.8 per cent) and metafrontier technologies (66.6 per cent).

The paper is the first to introduce the metafrontier model to the health care foodservice area, especially for Australian regions.

The purpose of this paper is to confirm the inter-relationship between healthy cafeteria attributes, perceived value, eating behaviour, satisfaction and post-purchase behaviour in the hospital setting.

A conceptual model proposed comprises of five latent variables representing healthy cafeteria attributes, perceived value, eating behaviour, satisfaction and post-purchase behaviour. A total of 570 completed questionnaires were collected, and the hypotheses were tested using structural equation modelling.

This study found that eating behaviour and satisfaction significantly mediates the relationship between healthy cafeteria attributes and customers’ post-purchase behaviour. Meanwhile, customers’ perceived value weakly moderates the relationship between healthy cafeteria and eating behaviour.

This paper is among the first few which attempt to holistically measure the attributes that influence people to visit healthy cafeterias and the subsequent effect they have towards their post-purchase behaviour. The novelty of this study is portrayed through the inclusion of eating behaviour and the perceived value dimension in healthy foodservice study, which is still minimal compared to commercial foodservice.