The Spoken Menu

What is the Spoken Menu?

With the current push to improve patient satisfaction in acute care settings, many hospitals are looking to make changes to their patient foodservices. These changes are extending beyond the food itself. Research has suggested that a patient’s satisfaction with hospital meals not only depends on food quality, but also on the way it is presented and delivered². The Spoken Menu is a foodservice model that is increasingly being implemented as a means of improving patient satisfaction. This concept mimics a restaurant-style foodservice system as staff (sometimes titled patient care host/hostess or attendant) visit patients at the bedside, discuss the menu options with them, and take their order. The staff member can assist patients with their meal selection based on their dietary restrictions⁸. Patients usually choose their meal one to two hours in advance of it being delivered, however it can be up to 24 hours in advance, depending on the facility. 

Benefits of the Spoken Menu:

Acute care settings that have implemented the Spoken Menu model have seen many benefits associated with it. Studies have shown that patient food consumption is higher with the Spoken Menu model when compared to the printed menu model. As patients eat more with the Spoken Menu, it is unsurprising that they are more likely to meet their estimated dietary goals and experience improved nutrition status. As up to 20% of a patient’s nutrition status deteriorates in hospital, maintaining and improving nutrition status is an important focus for acute care facilities¹.  

With the Spoken Menu, foodservice staff are available to address patient’s complaints and concerns. The staff can also answer questions that the patient has, provide guidance on meal choices for their specific diet (such as a diabetic diet), and explain menu changes⁷. Furthermore, food quality scores typically increase with the Spoken Menu, even when no changes have been made to the menu. Researchers have suggested that the increased patient-staff interaction may also increase the patient’s perception of the food’s quality^4,6,7.

Some studies have shown that employee job satisfaction increases with implementation of the Spoken Menu⁵. With the Spoken Menu, the nutrition assistant’s duties can change from office-based work to tasks that allow them to use their nutrition knowledge in assisting patients with their meal selections⁵.

Acute care facilities that have implemented the Spoken Menu see an increase in overall patient satisfaction, even when no other aspects of the meal service are changed. It has been suggested that the increased patient-staff interaction which occurs with the Spoken Menu improves patient satisfaction^6,7. 

Challenges Associated with the Spoken Menu: 

The increased cost that comes with changing the foodservice model can be a challenge for many facilities. When transitioning to the Spoken Menu model, at a minimum foodservice and nursing staff must receive education and training. It may be deemed necessary to train other departments as well if they are involved in the meal routine. Training staff can be time-consuming and costly for organizations.

Changes must occur to job routines or workflow to allocate for the increased number of attendants required to take orders^3,8. If labour is unable to be redistributed, the labour budget may need to be increased. Acute care facilities could experience logistical issues with receiving additional funding for labour, as there is a trend towards reducing labour costs.

While several studies have suggested that employee satisfaction increases with the implementation of the Spoken Menu, some acute care facilities have observed an increase in job dissatisfaction. With the Spoken Menu, staff who are taking orders at the bedside must deal with frustrated patients and family members. This can be emotionally taxing, and staff can experience burn out.

Facilities may need to purchase additional equipment to streamline the new foodservice system. Tablets can be an effective way to check patients’ diet and take their order. It is beneficial to use technology over a pen-and-paper method as the order is sent down to the kitchen as soon as the attendant takes the patients order. This allows for the meal to be delivered in a timely manner. However, there is a cost associated with purchasing new equipment and/or software. Furthermore, purchasing expensive equipment may require budget planning several years in advance. 

Key Considerations when Implementing the Spoken Menu in Acute Care Facilities:

Based on the benefits and challenges that are associated with the Spoken Menu, below are several key considerations that should be kept in mind when implementing this foodservice model. 

• Foodservice directors must know the patients’ needs and expectations.
• Adequate time must be allotted for preparation before implementation.
• A business plan should be created and presented to stakeholders.
• Approval must be granted for changes to budget/purchasing new equipment. 
• Staff must be appropriately trained before going live with the Spoken Menu.
• Alternative arrangements must be made for patients who are not appropriate for the Spoken Menu (i.e. for patients who cannot communicate their meal choices).
• Schedules need to be made for staff, and the layout of the hospital should be kept in mind to increase efficiency when taking patients’ orders.
• Scripts should be created for staff to use when speaking with patients.