Improving Meal Time Processes Making Meals Matter: Improving Meal Time Processes Claire Blackwood, Nutrition Champion, NHS Ayrshire and Arran Elaine Gordon, Nutrition Champion, NHS Greater Glasgow & Clyde Joy Farquharson, Nutrition Champion, The State Hospital

Volunteers at mealtimes - background National sub-group Volunteer Development Scotland (VDS) VDS recommendations re patient contact Awareness of continuous improvements for nutritional care Improved social aspects of care for patients Better Together findings

Volunteers at Mealtimes: Aims of the project To enrich in-patient experience and promote nutritional intake To provide support and encouragement at mealtimes for patients who require it To enable greater partnership working between volunteers/carers and healthcare professionals To further develop the scope of volunteering activities available within the organisation

Volunteers recruitment Recruitment process: Disclosure /PVG check Confidentiality agreement Health declaration Corporate Induction process Training/education Ward selection and induction Pre/post experience evaluation

Next steps: Evaluation Report Sharing practice

hungry to be heard – part 1 and 2 Lighthearted video with powerful messages

The sub group journey so far………. Embedding good practice from Phase 1 Key work areas Protected mealtimes Safe and Effective Nutritional Care Volunteers at mealtimes OUTPUTS Developing making meals matter resources Observation tools Patient experience questionnaire Staff Questionnaire Volunteers at mealtimes report TESTING AND GATHERING DATA Test sites identified Prototypes developed; Testing Collecting data; learning from data Identifying resources SPREAD Testing in different areas to promote spread

NPSA Protected Mealtimes Poster 2007 Feedback from the champions indicated that although raised awareness of PMT further support was required to embed effective proccesses for PMT NPSA Protected Mealtimes Poster 2007 Phase 1- Nationally endorsed NHS Scotland Poster

Insert Protected Mealtimes timings poster EG to send Door Poster Phase 2, embedding good practice, needed to further raise awareness and understanding of PMT amongst all staff group, patients and relative/carer Needed something that was catchy and that focused attention back on the mealtime, generic and transferable We have nutritional analysed menus, red trays, etc but if the patient isn’t eating the meal then none of the other stuff is important. We needed to put the focus back on the food. Subgroup came up with the acronym Making MEALS Matter (appropriate and direct) and this poster demonstrates the focal points of an effective mealtime which is easily understood by all particularly patients and carers Insert Protected Mealtimes timings poster EG to send Door Poster Focus attention on the Meal Easy to understand poster that can be displayed in all care settings

Insert Protected Mealtimes timings poster EG to send Door Poster Varying definitions and meanings of protected mealtimes, did a scoping exercise picked the 3 closest definitions and asked all nutrition champions to vote on which definition most closely matched OK to have definition but in order to ensure there was effective mealtime processes the subgroup developed the principles of protected mealtimes Insert Protected Mealtimes timings poster EG to send Door Poster National operational definition of PMT Principles of Protected Mealtimes developed

Although the subgroup focused on mealtimes they thought it was an ideal opportunity to build on the good work of Phase 1 by developing key principles of safe and effective nutritional care from admission to discharge.

Improving Nutritional Care Event June 11 Launch of resources Making Meals Matter Parallel session Identified request for a monitoring tool to provide evidence against implementation of Making Meals Matter resources 2 monitoring tools are being developed focusing at present on PMT, will discuss later Hand over to claire

Aim 95% of pilot areas can demonstrate improvement in their priority area of mealtime processes by November 2011 Primary drivers Staff understanding Individuals requiring support are identified and supported as appropriate Minimising interruptions to meals Secondary drivers Monitoring Tool Staff questionnaire Patient experience questionnai

Tools Observation of Mealtimes tool Patient experience of mealtimes questionnaire Staff awareness questionnaire Crib Sheet

NEXT STEPS Identify the pilot wards Carry out baseline observation of mealtimes and carry out patient and staff questionnaires Identify areas for improvements Raise awareness within care setting of MMM resources e.g handover Clearly display resources in care setting Carry our first observation since launch Analyse results, has displaying resources made improvements on baseline? Identify further improvements from results