Veteran-Centered Care

New cart delivery system improves patient satisfaction scores.

JACKSON, Miss.—Patient meal service at the GV Montgomery VA Medical Center was changed last spring to increase patient satisfaction. Instead of a traditional trayline delivery system, a new veteran-centered care program brings meals to the floor on carts, allowing patients to select from three daily entrée options.

Tricia Mathias, R.D., chief of nutrition and food services, says the new cart program allows veterans greater control and flexibility with their meals.

“We’re trying to create a culture of veteran-centered care by allowing veterans to select foods and try to get them to directly participate in their healthcare,” Mathias says. “When you’re in a hospital you don’t have very much control. Doctors and nurses decide what’s going on. This is an effort to give them more control and to offer them choices.”

Meals now are delivered using hostess carts, and residents now have a selection of options. There are two entrée choices, as well as a sandwich at lunch and dinner. There are also options for beverages, vegetables, salads and desserts.

“The carts allow us to bring the food up to the wards, so the patients can smell the food,” Mathias says. “It’s fresh and hot and the meals can be individualized. Our foodservice workers go into the room right at mealtime and ask the veterans what choice they want. It’s good because then the foodservice worker can interact with the veteran. We have all the condiments and extra things on the cart. So if the veteran wants two milks or three sugars then we can provide it right there. We stay on the ward a longer time than before. Before we were just delivering the tray and going. If there is something else that they need or they don’t like what they got, we’re still up on the ward. We’re available to the nursing staff. It gives us more time to interact with the veteran and provide better customer service.”

Mathias says that some of the residents’ choices were surprising. “We were usually serving milk and tea. Then almost everyone wanted lemonade,” she says. “The desserts were another one. I thought everyone would want cakes and pies, but ice cream was what everybody wanted. I also thought a lot of veterans would want soup and a sandwich, but they didn’t want that at all. They want the hot meal.”

One of the big selling points of the new cart program was it did not increase FTEs.

“Before we had a trayline and we had to have a certain number of employees on a trayline and then additional staff to deliver the trays. This way it’s the same number of staff, but they just stay on the unit rather than having to stay in the kitchen. A lot of the employees who really weren’t getting that much time with the veterans are able to.”

Mathias says the reaction to the program has been positive. Veterans love the interaction with the foodservice workers, she says, and satisfaction scores have improved. “Another positive asset, something the dietitians like to see, is the consumption of food has improved. I think it’s mainly because veterans are getting things that they want and so they are eating more of the food that they are being given.”