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Ensuring nutritionally adequate food intake in institutions is a complex and important challenge for dietitians. To tackle this problem, we argue that dietitians need to adopt a systematic, integrative, and patient-centered approach to identify and manage more effectively organizational determinants of the quality of food intake under their control. In this study, we introduce such an approach, the blueprint-based case study, that we applied in the context of a midterm care facility for elderly patients. Data gathered through interviews and field observations were used to develop, from the perspective of key patient encounters, detailed representations of the food, nutrition, and nursing activities necessary to ensure adequate food intake. These service 'blueprints' were developed to illustrate all activities that might potentially impact on the nutritional, sensory, functional, and social quality of patients' meals. They were also used as roadmaps to develop a case study analysis in which critical areas were identified and opportunities for improvement put forth, while considering services' resources and priorities. By providing a precise, objective, yet comprehensive mapping of the service operations and management, the blueprint-based case study approach represents a valuable tool to determine the optimal allocation of resources to insure nutritionally adequate food intake to patients., Ensuring nutritionally adequate food intake to elderly clientele in midterm and long-term healthcare facilities is critical to the quality of care (1). Indeed, patients stay in institutions long enough for [...]

Objectives To investigate the basic dimensions of patient emotional experience of hospitalization; to identify the moderators of emotional experience in terms of individual characteristics and contextual factors; and to investigate the contribution of the dimensions of the patient emotional experience to satisfaction with foodservices. Design Survey questionnaire. Subjects/selling One hundred two hospitalized patients of a specialized, acute-care, urban hospital in Canada who required one or more overnight stays. Patients with notable physical, cognitive, or emotional limitations were excluded from the study. Patients admitted to the obstetrics department were also excluded because of the unique nature of their emotional experience of hospitalization. Statistical analyses performed Factor analysis followed by orthogonal rotation (varimax), analyses of variance, and multiple regression analyses. Results Five dimensions represented the emotional experience of hospitalization: positive emotions, arousal emotions, and three negative dimensions structured on the basis of their possible causes (situation-, other-, or self-attributed negative emotions). Individual characteristics (gender, age, marital status, perceived health status) and contextual factors (perceived control over the situation, complexity of medical diagnosis, and admission procedures) significantly influenced patient emotions. Satisfaction with foodservices was structured in technical and interpersonal dimensions; the largest part of the common variance was accounted for by interpersonal aspects. The relationship between emotions and satisfaction was direct for positive emotions and, surprisingly, for situation-attributed negative emotions and self-attributed negative emotions. Other-attributed negative emotions and arousal emotions were negatively associated with satisfaction with foodservices. Applications Results suggest that dietitians' interventions should be adapted for subgroups of patients who experience different emotions. Results also provide insights on individual and contextual factors that can be used to identify or better understand the specific characteristics of these subgroups. The pattern of relationships between emotions and satisfaction demonstrates that the fine-tuning of dietitians' interventions as a function of patients' emotional states may be conducive to increased patient satisfaction with foodservices., For dietitians involved in health care, managing patient satisfaction with foodservices and nutrition counseling has become a necessity. Researchers have attempted to identify the dimensions along which patients perceive and [...]

Practice-based research has often suggested that nutrition counseling may not be as effective as it could be, even when the diet is the cornerstone of therapy (1). As a result, [...]

To survive in the competitive jungle of the health care industry of the 1990s, administrative dietitians have been forced to focus their concern on patient satisfaction. During the past decade, [...]