Qualitative analysis of the implementation of a hospital room service in a large metropolitan hospital: foundations for transformation

Background: Room Service is a hospital meal service model with demonstrated improved nutrition intake, reduced wastage and cost benefits in some settings compared with traditional models. However, uptake across public hospital settings appears low; the underlying reasons require exploration. In 2019, Room Service was introduced in a Queensland Hospital and Health Service site. The aim of this paper is to identify the barriers and enablers to implementing Room Service to provide recommendations for future implementation of this model. Methods: This qualitative descriptive study utilised semi-structured interviews with staff involved in implementation of the Room Service meal delivery model at The Prince Charles Hospital (Queensland, Australia). A purposive sample of project members and key stakeholders were recruited. Interviews explored project experiences from commencement to completion, barriers and enablers to implementation, strategies to overcome challenges and recommendations for implementation at other sites. Interviews were coded to identify themes and sub-themes. Results: Nine participants were interviewed. Key themes with associated sub-themes were (I) Foundations of transformation; (II) Navigating implementation; and (III) Embedding sustainable practices.Conclusions: This study adds rich information to understand factors that support the implementation of a room service model in a large public hospital. Future implementation of room service should not only consider measuring quantifiable outcomes, but also the importance of qualitative descriptive studies surveying project members and key stakeholders to further explore experiences, barriers and enablers to implementation and develop strategies to overcome challenges to assist further sites implement this model.