Patient Food Delivery Error in the Hospital: A Case Study in Thailand

Abstract

Food service provided in hospitals has considerable significance, as it is part of the medical treatment. In a sample hospital, food delivery error occupied 37.4% which was the highest complaint among all problems in 2017. This problem has never been investigated for its root causes and there has been no measures established against it. Therefore, the purpose of this research is to investigate for the causes of the discrepancies in the food service provided for the inpatients. Root causes of the inpatient food delivery error are identified by triangulation of quantitative data by survey & complaint analysis and qualitative data by focus group. The first set consists of questionnaire responded by nutrition unit staff, experts in food service and hospital directors, in total of 71 respondents. The questionnaire was modelled after the four types of medication errors[1], [2]. The second set was the review of the food service error from inpatient complaint files recorded during January-December 2017. The third set was focus group interview among 71 hospital staff. The service blueprint was used in search of the pain points. The three methods showed consensus results. Both survey and complaint results revealed that the error were caused by 1) transcribing (61.3%, 54.3%) 2) administration error (25.8%, 32.6%) 3) dispensing error (10.1%, 10.9%) 4) prescription error (2.7%, 2.2%). Furthermore, the survey of the relation between the means of importance and the actual performance in each process revealed that transcribing error and administration error were the root causes at 95% confidence level. In addition, focus group interview with the 71 hospital staff confirms the finding. Transcribing error included miscommunication and data transference across the departments. Administration error arises during the delivery process. Dispensing error occurred in the food preparation and food trays, for example, wrong delivery. Lastly, prescription error was caused by the doctors who were in charge of ordering the patient's dietary requirements. Next, the authors conducted in-depth case study analysis by using service blueprint with 217 food delivery case studies. We found that the root cause was the operation of data transference across the departments. Results from this paper urge the need for process innovation in assuring quality of patient food delivery.