Ward culture and staff relationships at hospital mealtimes in Australia: An ethnographic account
Ella Ottrey BNutrDietet, BNut (Hons)
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Department of Dietetics, Eastern Health, Melbourne, Victoria, Australia
Search for more papers by this authorCorresponding Author
Judi Porter BAppSc, MHthSc, PhD
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia
Correspondence
Judi Porter, Department of Nutrition, Dietetics and Food, Monash University, 264 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia.
Email: [email protected]
Search for more papers by this authorCatherine E. Huggins BSc(Hons), PhD
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Search for more papers by this authorClaire Palermo BSc, MNutDiet, MPH, PhD
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Search for more papers by this authorElla Ottrey BNutrDietet, BNut (Hons)
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Department of Dietetics, Eastern Health, Melbourne, Victoria, Australia
Search for more papers by this authorCorresponding Author
Judi Porter BAppSc, MHthSc, PhD
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia
Correspondence
Judi Porter, Department of Nutrition, Dietetics and Food, Monash University, 264 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia.
Email: [email protected]
Search for more papers by this authorCatherine E. Huggins BSc(Hons), PhD
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Search for more papers by this authorClaire Palermo BSc, MNutDiet, MPH, PhD
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
Search for more papers by this authorAbstract
Nutrition care is a fundamental component of quality health care provided to patients in hospital, yet little is known about the staff who deliver this care and their interrelationships, and how this impacts nutrition care. In this ethnographic study on two subacute wards, 67 h of fieldwork was conducted over 3 months to explore the relationships, roles, and responsibilities of those involved at mealtimes, and the influence on meal provision. Data were analyzed inductively and thematically. Three themes describing ward culture and staff relationships emerged: (i) defining mealtime roles and maintaining boundaries; (ii) balancing the need for teamwork and having time and space; and (iii) effective communication supports role completion and problem solving. Lack of appreciation of workflow enablers and barriers degraded working relationships between staff with and without central roles at mealtimes. The present study informs health-care organizations on building a culture that supports interprofessional collaboration in nutrition care in the subacute setting. All staff need to be aware of their and others' mealtime roles and responsibilities to support a coordinated approach.
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