- 24 June 2021
I love the topic of this project and it's one that doesn't get a lot of attention. It's not unusual to see QI projects about the impact of patient/resident meals in terms of nutrition or its impact on patient experience. I can see how this information could be the foundation to future changes with PDSA cycles. How will the team approach gaining an understanding of why certain food are wasted? Great work!
- 25 June 2021
Well done Colleen et al! This is an interesting area to explore and as Marie said not something many in healthcare might notice as something that would lend well to improvement activities. I appreciate your team using this to obtain a baseline so you can identify whether or not future interventions work and to what extent. Similar to Marie's question, how might you explore the reasons the underpin the waste from a systems perspective? I think this challenge would lend nicely to a fishbone diagram to visualize the different factors that contribute to waste. Other question, are the snacks perishable or items that are wrapped that can be recycled and reused? I know many main meals you can't re-use but wonder about the packaging and if all items have to be discarded if not eaten.
- 28 June 2021
Thank you both Marie and Allison for your comments on our work. I agree with your comment on it not being unusual to see QI projects about nutrition and patient experience but we found very little about about food waste in particular when we looked at the literature. I suspect this has to do with just how much labour and time is required to accurately measure the scope of food waste in the first place. It was a tremendous amount of work for our students to collect what they did. I've put together a rough fishbone diagram that captures the number of different factors and players involved in contributing to food waste and as we work on food waste reduction we must remind ourselves often that this is complex. Food is more than just nutrition. Snack items are a mix of perishable and non perishable items at our site. Reusing items once labelled and delivered to the a resident is unfortunately not an option due to infection prevention policies. What we found were some items never make it to a resident and do instead end up in a units communal fridge and may be repurposed for another resident. While this could have a positive impact on food waste it does open other challenges such as managing residents with specific dietary needs and ensuring a resident is not given something that is unsafe for them.
- 30 June 2021
Thanks for your response Colleen! There is lots to be learned from this project as well as how QI can play a role in more sustainable healthcare. I do recall a project several years ago aimed at improving patient satisfaction with meals whereby decreased food waste was an unintended positive consequence (balancing measure). That project centred around "just in time" meal and snack selections. One of the contributing factors their root cause analysis efforts revealed was that preferences and choices varied daily depending on how the patient/resident felt and what was going on that day. Not only did patients/residents have a better food experience, there was less food wastage and less inefficiencies associated with replacements, requests and the like. Unfortunately, I don't recall how the waste was measured and whether it was anecdotal. I also recall that there many challenges with infection control with other solutions proposed so I appreciate the constraints on the solutions available. I love how students were involved in this project. Again, great work.