title: Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.
abstract: BACKGROUND
  Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care.
  
  
  METHODS
  Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically.
  
  
  RESULTS
  Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care.
  
  
  CONCLUSIONS
  The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed.
authors.affiliation: University of Waterloo, Waterloo, ON, Canada.
authors.forename: H H
authors.initials: HH
authors.lastname: Keller
authors.forename: E
authors.initials: E
authors.lastname: Vesnaver
authors.forename: B
authors.initials: B
authors.lastname: Davidson
authors.forename: J
authors.initials: J
authors.lastname: Allard
authors.forename: M
authors.initials: M
authors.lastname: Laporte
authors.forename: P
authors.initials: P
authors.lastname: Bernier
authors.forename: H
authors.initials: H
authors.lastname: Payette
authors.forename: K
authors.initials: K
authors.lastname: Jeejeebhoy
authors.forename: D
authors.initials: D
authors.lastname: Duerksen
authors.forename: L
authors.initials: L
authors.lastname: Gramlich
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D004032:Diet; D004046:Dietetics; D005521:Food Service, Hospital; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D009752:Nutritional Status; D011787:Quality of Health Care
keywords: food service; hospital; nutrition; organisation; quality