Assessing plate waste in public hospital foodservice management - Theory and Practice in Hospitality and Tourism Research - page 362

According to Angelopoulou, Kangis, and Babis
(1998), patients in public hospital are more focused
on medical and technical nature and do not con-
cern about contextual or environment features of
a hospital. Thus the patients in public hospital did
not demand on features including food served by
the institution. Their concerns are more on the
medical services.

There are several ways to measure plate waste.
Comstock, Symington, Chmielinski, and McGuire
(1979) in their research had listed out seven ways of
data collection method to measure plate waste which
are (i) aggregate nonselective plate waste; (ii) gar-
bage analysis; (iii) food preference questionnaires;
(iv) self-estimation; (v) individual plate waste; (vi)
aggregate selective plate waste and (vii) visual esti-
mation. According to Williams and Walton (2011),
plate waste usually measured by weighing food or by
visual estimation of the amount of food remaining
on the plate. Therefore, this research will use visual
estimation method where visual estimation scales
were based on portion of the original serving which
remained as waste (Comstock et al., 1979).

2.2 Hospital foodservice
However, Lau and Gregoire (1998) stated in their
study that health care is a type of service industry
and patients are becoming more discriminating
about service quality. Since 30 years ago, with lots
of demand from consumers, advances in technol-
ogy and economic pressure, health care foodservice
industry has changed (Assaf, Matawie & Black-
man, 2008). In the past, the provision of food to
patients was the responsibility of each individual
hospital, which had its own kitchen facilities. Food
was cooked, plated and served hot to patients. But
this system required large number of staff to han-
dle, and it was always a challenge to be working
within tight schedules and at the same time staff
must achieve high standard of quality (Assaf et al.,
2008).
Besides, Engelund, Lassen, and Mikkelsen
(2007), found that there are significant changes
in food production systems in Danish hospitals
since year 1995 to 2003. A change in employees'
profile in kitchens also followed the trends. The
educational background of employees resulted to
an increase number of skilled employees. Plating
system changed as well, with higher use of buffets
and satellite kitchens and less use of central plat-
ing during the period. They also found out that
increased used of cook-chill technology may pos-
sibly resulted in focusing more on the nutritional
status of patients by offering more menus and
buffet-style distribution.

2.4 Food preferences
Some researchers found that presentation and
varieties of food are the primary factor that influ-
enced patient satisfaction towards meal services in
hospital (Hartwell & Edwards, 2009; Hwang, Eves
& Desombre, 2003). Patients satisfaction towards
food served to them will lead to zero plate waste.
Previous studies by DeLuco and Cremer (1990);
Dubé, Trudeau, and Bélanger (1994); Gregoire
(1994); Lau and Gregoire (1998) indicated that
several items that are related to food preferences
and quality such as meal taste, variety of foods,
flavor and temperature of hot food and texture of
meat and vegetables have the most influential over-
all foodservice satisfaction.
Monitoring client (patient) satisfaction with the
items that related to food quality appears to be desir-
able since foodservice aspects is the most influential
towards patients satisfaction (Wright, Connelly &
Capra, 2006). Additionally, Dhingra, Sazawal,
Menon, Dhingra, and Black (2007), Zakiah et al.
(2005), Hartwell, Edwards, and Beavis (2007) stated
that the reasons for high levels of plate waste can
relate to the clinical condition of patients, food and
menu issues such as poor food quality, inappropri-
ate portion sizes, and limited menu choice), service
issues including difficulty accessing food and com-
plex ordering systems, and environmental factors
such as inappropriate meal hour, interruptions, and
unpleasant ward surroundings.

2.3 Plate waste
Goonan, Mirosa, and Spence (2014) had stated
that foodservice organization especially hospital
were the largest producers of food waste. Wil-
liams and Walton (2011) referred to plate waste in
hospitals as the served food that remains uneaten
by patients. The implication of high level of plate
waste will become an indicator to the level of mal-
nutrition among patients and will affect financial
problem to the management (Williams and Wal-
ton, 2011). In their study at 32 hospitals, the results
for median plate waste in hospitals are 30 percent
higher than other foodservice establishment. They
also concluded that, hospitals that used bulk food
delivery system have lower level of plate waste as
compare to plated meal delivery.

3 METHODOLOGY

As stated in research objectives, this study intent
to assess the percentage of plate waste produced
by using visual estimation method and to find
the primary reason of wastage that could occur,
therefore this study will apply a mixed methods
study approach. Goerres and Prinzen (2012) stated
that when the usage of qualitative approach and