Patricia Jakubec

Plate Waste Study

A study reviewed found waste levels were highest on gastroenterology and
surgery floors (Dias-Ferreira, Santos, & Oliveira, 2015). The reasoning for the higher
rates was attributed to issues with the digestive system affecting the ability to eat and
appetite. Likewise, patients recovering from surgery often have less appetite. It is
known over the course of the lifespan a change in appetite is not unusual. With age,
several factors can contribute to a loss of appetite. For some, there is a general lack of
interest in food due to changes in the taste buds, depression or loneliness. A loss of
appetite due to health conditions and medications is common.
During hospitalization, various factors may decrease appetite leading to an
increase in food waste. There is limited research regarding geriatric patients and their
contribution to plate waste while hospitalized. A plate waste study was conducted on
the elderly acute care floor at Tampa General Hospital (TGH). The purpose of this plate
waste study was to gain insight into the geriatric population contributions to plate waste
during hospitalization.
Methods:
This study observed plate waste during two meals on the geriatric acute care
floor at Tampa General Hospital. Meal trays removed from patient rooms are placed in
the food services cart. Trays remain in the cart until all trays are collected and are then
transported to the dish room for cleaning. During the two observation meals, trays were
removed from the cart one by one and assessed for food waste. A 5-point visual scale
(0, 1/4, 1/2, 3/4, 1) was used to evaluate the amount of food left on the plate. All
edible items on the plate (not the entire tray) were observed. Two observers were used
for consensus and consistency in the data collected. Patients were not made aware of
the study to avoid possible skewing of the results.
Data:

Plate waste visual scale key

0 No food left on the plate
1/4 ¼ plate of food left
1/2 ½ plate of food left
3/4 ¾ plate of food left
1 Full plate of food/food
untouched
 Breakfast Lunch
Tray number Plate waste Tray number Plate waste
1 ¼ 1 0
2 ½ 2 0
3 ¼ 3 0
4 0 4 ¼
5 ¼ 5 ¼
6 0 6 ¼
7 0 7 ¾
8 0 8 0
9 ½ 9 0
10 ½ 10 ¾
11 ½ 11 ¼
12 ¾ 12 ¼
13 0 13 0
14 0 14 ¾
15 0 15 ¼

Breakfast # % # Lunch %
Plate Waste Breakfast
0 7 46.7 6 40
1/4 3 20 6 40
1/2 4 26.7 0 0
3/4 1 6.7 3 20
1 0 0 0 0

Results:
This plate waste study provides a snapshot of plate waste on the geriatric acute
care floor at Tampa General Hospital. Data collected after breakfast meal service
indicated 46.7 % of observed plates (n=7) contributed zero plate waste. Plates with
one-fourth to one-half of waste were 20 % (n=3) and 26.7 % (n=4) respectively. Only
one tray contained three-fourths plate waste during the observed breakfast.
Observations after the lunch meal service found 40% of observed plates having
zero waste (n=6). Plates with one-fourth to one-half of waste were 40 % (n=6) and 0
% (n=0) respectively. This indicates of the fifteen plates observed twelve plates (80%)
contributed minimal plate waste. Only three plates were found to have three-quarters
of plated food remaining. During both meals, no plates were observed to have been
untouched by the patient.
Discussion:
In short, 8 of the 15 observed after breakfast, and 9 of the 15 after lunch had
some degree of plate waste. Based on this brief study it would appear there was
greater plate waste than food intake. However, many factors contribute to this not
necessarily being true. The short time frame of the study, a limited number of plates
observed, and the food waste not being quantified or weighed make this assumption
unreliable.
Although other meal tray items were not specifically observed in this study, both
oatmeal and grits were the most frequent food waste item on the trays observed.
These items were not included in data collection; therefore, the information is
anecdotal. Without data to indicate how often the oatmeal and grits went untouched no
recommendations can be made.
The product specifically indicated for plate waste measure at the lunch meal was
the brown rice pilaf. Upon observation, no brown rice pilaf was left on any of the 15
plates sampled during the lunch meal. It should be noted not all 15 trays previously
contained the regular Tuesday lunch meal and would not have contained the brown rice
pilaf. Of the plates observed which did contain the regular Tuesday meal, the most
common observed plate waste item was broccoli.
It became clear during the data collection phase the study design was weak and
contained limitations. To get a reliable indication of plate waste the study design should
consider all food items on the meal tray. A study of this magnitude would measure
plate waste by weighing food items to get a reliable picture of the amount of waste
occurring. For the purposes of this study weighing waste was impractical to employ.
Such a design would require considerable preplanning and involvement of TGH staff. By
not engaging patients in the study, no reasoning for uneaten food can be determined.
While reasons were not the aim of this study, it was a limitation that if included could
have provided a broader insight for recommendations.
Conclusion:
In the hospital setting the overall concern with the elderly is providing adequate
nutrition while counteracting the factors contributing to appetite loss. This delicate
balance may contribute to food waste. Strategies to provide adequate nutrition for the
elderly while reducing potential plate waste could include talking to the patient about
their usual intake, discussing the portion sizes of food provided by the organization
while assessing how much the patient can consume at each meal. Measures to
customize meals for these patients may include ordering half size portions, ordering
smaller meals more frequently while also allowing the patient to order foods they
prefer.