Improving rural and remote hospital foodservices – where to start? A complex needs assessment

Mrs Niccola Currie1, Miss Jessica Kinneally2

1Queensland Health, Weipa, Australia, 2Queensland Health, Brisbane, Australia

Background: Hospital foodservice systems play a vital role in supporting patient oral intake, which if poor, can lead to malnutrition and increase length of stay [1]. A foodservice dietitian oversees foodservice systems and processes [2]. Rurally, dietitians are often sole practitioners with limited foodservice capacity, therefore unable to comprehensively identify and mitigate risks [3].

Aim: To understand, identify and mitigate Torres and Cape Hospital Health Service (TCHHS) foodservice risks through evaluating safety and quality, exploring the sustainability of foodservice management and identifying the capacity for quality improvement.

Method: Four-week visits to Weipa, Cooktown and Thursday Island and a three-day visit to Bamaga Hospital occurred in 2020. Methods included observational analysis: stakeholder consultation, contingency planning, onsite auditing; and reporting compliance against State-wide Key Performance Indicators (KPI) and Queensland Health’s Nutrition Standards for Meals and Menus (QHNSMM). Implementation plans were disseminated to executive and commenced at each site.

Results: Key findings include inadequate: quality cycles, staff knowledge and training, allergen management and manual systems; absence of diet manuals, allergen matrices and clinical leadership; suboptimal compliance to State-wide FS KPI’s and QHNSMM, excess production and non-compliance with International Dysphagia Diet Standardisation Initiative. These findings informed where to start risk mitigation with site-specific action plans. Additional benefits realised included positive change management and raising the profile of foodservices.

Conclusion: A specialist foodservice dietitian successfully identified foodservice risks, collated contextual data to raise the profile of foodservice and created bespoke action plans in the TCHHS. This could provide a framework for other remote multifaceted services.


For the compilation of this presentation Niccola Currie was working in a Torres and Cape Hospital and Health Service Advanced Foodservice Dietitian project role for which she secured funding.  Her substantive position is a Rural Generalist Senior Dietitian based in the remote town of Weipa.  Her role includes inpatient, aged care, foodservices, public health nutrition and outreaches to two Indigenous communities Napranum and Mapoon. She has worked in metropolitan, regional and remote facilities, both privately and publicly, in Australia and United Kingdom. Niccola is a Dietitian, Exercise Physiologist and Diabetes Educator.

Jessica Kinneally is a Senior Dietitian and has worked across a range of clinical areas, across the continuum of care. She has a special interest in systems that support nutrition care including foodservices, delegation and extended scope of practice. Jessica led the needs assessment phase of this project when working as the temporary Advanced Foodservice Dietitian for the Torres and Cape Hospital and Health Service in 2020.  Her current role includes inpatient and outpatient care for rehabilitation and surgical specialities in a new health service, providing further opportunity to develop and implement innovative nutrition systems.

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