Project Summary

MAPP-Mal is a three year NDA multidisciplinary research project that will exploit new technologies to rethink and test new ways that food can be produced and delivered to older patients using a ‘a joined-up’ approach that considers all stages of the food journey, from production to consumption (i.e. products, people, places and procedures). The amenability of this new systems prototype to become embedded in current UK practice in hospitals and other care settings will also be investigated by engaging end users and key stakeholders throughout the development.

Investigator(s)

• Paula Moynihan, Newcastle University

Team

• Alastair Macdonald, Glasgow School of Art
• Lisa Methven, University of Reading
• Martin Maguire, University of Loughborough
• Patrick Olivier, Newcastle University
• Margot Gosney, University of Reading
• Carl May, Newcastle University

Contact details

Paula Moynihan

Background

• It is estimated that 60% of older people are at risk of malnutrition whilst in hospital, increasing complications and reducing quality of life.
• The cost of malnutrition to healthcare is estimated to exceed 7.3 billion pounds per year, half of which is expended on those aged 65 years and above.
• Despite helpful guidelines to prevent malnutrition and tools to identify those at risk, a broad strategy to address malnutrition in older people that considers all stages of the food journey, from production to consumption and that makes use of novel technologies has not previously been considered.

Aims/objectives

The aim of this project is to address the problem on malnutrition in older patients by exploiting new and existing technologies to rethink and test new ways that food can be produced and delivered to older patients using a ‘a joined-up’ approach that considers all stages of the food journey, from production to consumption (i.e. products, people, places and procedures). The overall research question is therefore ‘Can new products, partnerships, service models and enhanced eating experiences and environments from food production to patient consumption prevent malnutrition in older patients?’

Design

Firstly, current practice with respect to products, people, places and procedures, in the hospital setting for older patients will be studied in order to identify opportunities for change.

Next, a prototype for a proposed new food system will be devised which will consider 4 key areas:

• The sensorial quality of the food product provided
• The food journey from where it is produced to the point of consumption
• The environment in which the older patient eats and drinks
• Monitoring of food and nutrient intake

Key end users (The ‘Food Family’) within the project include: food providers, caterers, dieticians, nurses, doctors, occupational therapists, speech therapists, carers, older patients/relatives) and other stakeholders (e.g. NHS, key professional bodies, charities such as Age Concern). They will be engaged in all stages of development of the new prototype. This will achieved by conducting workshops, focus groups and interviews to inform on the feasibility and acceptability of the new system, its workability and potential integration in real life.

The work will be conducted in five Work Packages (WP):

WP1 Defining current systems

Observations of current NHS hospital systems and interviews with the Food Family and Stakeholders will be conducted to identify areas for change.

WP2 End user engagement

Feedback on the new prototype (from WP 3 and 4) will be obtained from the Food Family and Stakeholders throughout the project, to assess its practicality and to refine it.

WP3 Developing new food products for older patients

Using state of the art technology, food with improved sensory quality will be developed, including new foods for those with swallowing difficulties. The potential use of releasing food aromas at ward level to stimulate patient appetite will be tested.

WP4 Utilising innovative design and technology to optimise the Food Journey and the older patient’s Eating Environment

A new prototype for the ‘food journey’ from production to patient and the environment in which the patient eats will be developed. Sketches, physical mock-ups and virtual 3D modelling of ward/patient environments will be used to develop scenarios of the new service in operation. A fast and accurate technology-based prototype to monitor food intake of patients will also be developed.

WP5 Potential application to other settings

Interviews and focus groups with the Food Family and Stakeholders will collect feedback on the potential application of the new concepts to other settings (e.g. care homes).

Policy implications

The outcomes of this research, a proof of concept food design, preparation and delivery prototype, will be of interest to a broad range of policy makers, professional bodies and charities that are working towards reducing the crisis of malnutrition in older people in hospitals.

Policy, practice and product implications relate to reducing malnutrition in older people in hospitals through the development of a new systems prototype for food provision. The prototype aims to optimise food intake through fresh innovative approaches to food production, delivery and the eating environment in hospitals and other care settings.

The project will produce general principles that will inform policy for the future development and updating of catering facilities in hospitals. We also hope that it may form part of the future vision of hospital care and patient right. It will produce specific guidelines that can be taken up by professionals such as dieticians, speech therapists and nurses. Guidelines for product and equipment design in relation to food production and delivery to the patient will also be produced.

This will include recommendations for:

• new food products specifically designed to meet the sensorial preferences and nutritional needs of older patients and the preparation, storage and transport of these products

• revised roles of people involved in the provision of food

• a system for delivering foods to patients that maximises sensorial quality of food

• modifications to the older patients eating environment (furniture, eating implements, ambient environment) to facilitate physical ability to eat and to enhance appetite

• a computerised system to facilitate efficient and accurate monitoring of food (and thereby nutrient) intake by older people.

The prototype will inform future hospital design, resource allocation, catering requirements and training requirements. The outcomes will inform professional bodies concerned with food provision in hospital and care settings of a feasible and acceptable approach for revising practices with respect to roles, places, new food products and the environment in which the patient eats.

• Aspects relating to the actual food product will help dieticians and speech therapists in devising patients’ diets especially those with eating difficulties. The outputs will also provide opportunities for producers of foods to manufacture special needs products for older people

• For hospital food providers and caterers the prototype will inform on means to maximise the sensorial quality of food

• Aspects related to the food journey from production to patient will be of interest to those involved in hospital design, caterers and ward staff. It will provide opportunities for manufacturers to manufacture new systems for effective delivery of the new food products

• Aspects related to the patients’ eating environments will inform those involved in hospital design and be of interest to a broad range of medical staff, in particular occupational therapists and nurses. These outputs will also provide a range of manufacturers with the opportunity to manufacture new products for the hospital environment

• Aspects relating to computer assisted recording of patients’ food intake will be of key interest to dieticians, nurses and other members of the care team as well as computer manufacturers.

To maximise the impact of the project a series of launches/exhibitions are planned to be held in each of the three main study centres. It is planned to promote the findings at conferences of key learned and professional societies and to a wider audience by issuing a series of press releases.