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Disease-related undernutrition is significant in European hospitals but is seldom treated. In 1999, the Council of Europe decided to collect information regarding Nutrition programmes in hospitals and for this purpose a network consisting of national experts from 12 of the Partial Agreement member states was established. The aim was to review the current practice in Europe regarding hospital food provision, to highlight deficiencies and to issue recommendations in improve the nutritional care and support of hospitalised patients. The data collection regarding the nutritional care providers and their practices of nutritional care and support showed that the use of nutritional risk screening and assessment, and of nutritional support and counselling was sparse and inconsistent, and that the responsibilities in these contexts were unclear. Besides, the educational level with regard to nutritional care and support was limited at all levels. All patients have the right to expect that their nutritional needs will be fulfilled during a hospitalisation. Optimal supply of food is a prerequisite for an optimal effect of the specific treatment offered to patients. Hence, the responsibilities of staff categories and the hospital management with respect to procuring nutritional care and support should be clearly assigned. Also, a general improvement in the educational level of all staff groups is needed.

PurposeHospital food has come into focus during the last decade due to reports of under‐nutrition and at the same time food service has undergone significant changes. The aim of this paper is to document and discuss the change in technology and logistics used in the Danish hospital food service during the years 1995‐2003. Further, the aim is to discuss possibilities for integrating food production and patient nutrition at hospitals in order to improve patient nutrition.Design/methodology/approachThe empirical data consist of quantitative serial data on Danish hospital food service collected over a period starting in 1995 and ending in 2003. Data have been collected as part of two large surveys describing the food service systems in Danish hospitals in 1995 and in 2003. Both surveys were carried out by the Food Research Department of the Danish Food Authorities. Answers were compared by means of Chi‐square (χ2) tests with Yates’ correction. Two‐sided p‐values <0.05 were considered significant.FindingsThere have been significant changes in food production systems during the years 1995‐2003. A change in employee profiles in the kitchens has followed this trend.Practical implicationsPlating systems have changed as well with a higher use of buffets and satellite kitchens and less use of central plating during the period 1995‐2003. The educational background of employees has also changed resulting in an increase in number of skilled employees (cooks, catering assistants) and fewer unskilled employees in the kitchens. Increased focus on nutritional status of patients has been observed from ward personnel with no connection to the kitchen. It is suggested that food ambassadors be responsible for the nutritional status of patients.Originality/valueSuccess in explaining technological and logistical changes in Danish hospital food service 1995‐2003 another integration of food production and patient nutrition in hospitals.

Background : Low food intake is a frequent problem in undernourished hospital patients. Objective : To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food, increases the energy and protein intake of the patients. Design : Observational study comparing the food intake before and twice after the implementation of the new system, the first time by specially trained staff and the second time by ordinary staff members, following training. The amount of food served, eaten and wasted was measured, and energy and protein intake calculated. Results : The quartile of patients with the lowest energy intake consumed on average 128 kJ per patient [(95% confidence interval (CI) 79 Á178 kJ] with the old system; with the new system they consumed 560 kJ per patient (95% CI 489 Á631 kJ) on the first occasion, and 1021 kJ per patient (95% CI 939 Á1104 kJ) on the second occasion. With the old system, the wastage was on average 276 g per patient (48% of the total amount produced) compared with 118 g per patient (30%) and 78 g (21%) on the two test occasions with the new system. Conclusions : Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially.

Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support.