1. 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

2. 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

3. 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

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

6. Next steps:
Evaluation
Report
Sharing practice

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

8. 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

9. 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

10. 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

11. 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

12. 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.

13. 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

14. 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

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

16. 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