Interprofessional collaboration at mealtimes in hospital: The need for cultural change

Mrs Ella Ottrey1,2,  A/Prof Judi Porter1,2, Dr Catherine E. Huggins1, A/Prof Claire Palermo1

1Monash University, Notting Hill, Australia, 2Eastern Health, Box Hill, Australia

Abstract:

Aim:
Examination of interprofessional collaboration at mealtimes is needed to build a culture where staff work together to prioritise nutrition care. This study explored the relationships, roles and responsibilities of hospital staff involved at mealtimes and the impact on meal provision.

Methods:
This ethnographic study was conducted on two hospital wards in Melbourne. Sixty-seven hours of observation (112 pages of typed fieldnotes) and 75 interviews with 61 staff, volunteers and visitors were used to identify patterns in attitudes and intentions, behaviours and interactions at mealtimes. Data were analysed inductively and thematically, supported by memo writing and reflective journaling.

Results:
Three key themes emerged to describe mealtime culture and reflect the interrelationships of staff involved in the delivery of nutrition care: (1) defining mealtime roles and maintaining boundaries; (2) balancing the need for teamwork and having time and space; and (3) effective communication supports role completion and problem solving. Staff working relationships were degraded by a lack of appreciation of workflow barriers and enablers, and conflict between wanting teamwork and segregation at mealtimes.

Significance of the findings to allied health:
The findings suggest that a culture of interprofessional collaboration is yet to be achieved at mealtimes in hospital. Staff awareness of their and others’ mealtime roles and responsibilities is central to supporting a coordinated approach. Healthcare organisations should reinforce the overall vision for quality patient care and shared goals to improve nutrition care.

Biography:

Ella Ottrey is a clinical dietitian with 10 years of experience across a number of Victorian healthcare services. She is currently undertaking her PhD at Monash University exploring mealtimes in subacute care.