Success Stories

“We Need People to Feed People!” A success story on how Dietitians, Food Services and Volunteers collaborated to address malnutrition among hospital in-patients

Malnutrition in hospitals is a serious and common problem that is often not detected, diagnosed or treated. One in two adults and one in three children are malnourished upon hospital admission and are at risk of further deterioration while in hospital. Malnutrition is associated with an increased risk of infection, delayed recovery and prolonged hospital stays. It is a patient safety issue and a two-billion Canadian health-care problem.

Malnutrition in hospital can occur from not eating enough food - which can happen because of poor appetite, nausea or vomiting and the effects of acute illness and medication. However, for some patients, especially older adults, they simply need help to eat and drink. According to the Canadian Malnutrition Task Force, the top barriers to eating in hospital include poor positioning for eating, difficulty opening food and beverage packaging, and patients unable to reach their food tray.

These barriers existed for patients admitted to a Medicine Unit at the Health Sciences Centre within NL Health Services (St. John's, NL). In a discussion about how to address this issue, a dietetic intern completing a placement on this unit remarked “we need people to feed people.” The journey to creating a Volunteer Meal Assistance Program began!

Over the past several months, registered dietitians, dietetic interns, nursing staff, food services, volunteer resources, professional practice and management have collaborated to develop and implement the Volunteer Meal Assistance Program on the unit. They recruited volunteers, coordinated processes with clinical staff on the unit, and developed and implemented volunteer meal assistance training. This hard work paid off with the successful launch of the program in July 2023.

Meal Assistance Volunteers range from high school and university students to community members and even healthcare managers. Although they aren't actually feeding patients yet, they play an important role, which is to:

• increase patient awareness of mealtimes by letting patients know the meal will soon be arriving;
• promote timely access to food at mealtimes by opening food and beverage packaging;
• clear and adjust the patients bedside table;
• engage in conversation to help improve overall mealtime experience and encourage food and beverage intake; and
• share intake information with a designated member of the care team to help identify patients with consistently low intake.

Besides the logistical side of providing mealtime assistance, volunteers provide a welcoming smile and conversation that patients have been thankful for. A patient shared the following quote which illustrates this beautifully:

“At home, I always ate with others – now that I am not able to do that, it is nice to have someone check-in with me at mealtimes. It really helps make the mealtime experience more meaningful despite being in the hospital.”

Overall, feedback from staff, volunteers and patients indicates the program is a positive initiative and is improving the food intake of patients on the unit. We found people to feed people - and those people are the dedicated volunteers!

By helping patients receive the fuel and strength they need to recover, volunteers are helping to address the challenge of hospital malnutrition, one meal at a time! The passion, collaboration and leadership demonstrated by the professional staff involved with acting on their shared vision of addressing hospital malnutrition, illustrates how a simple idea can evolve into making a big impact!

Written by Vanessa Cooze, Dietetic Intern, NL Health Services Dietetic Internship Program, 2022-23 Cohort and Kara Roberts, Professional Practice Consultant for Dietitians and Director, Dietetic Internship Program, NL Health Services