Policy update: Summary of the new Victorian nutrition and quality food standards for health services

By Mina Berlandier APD

After 13 years, the long-awaited Food Standards for Victorian Public Hospitals and Residential Aged Care Services (RACS) are finally here! Access to nutritious foods is essential for optimal patient and resident treatment, recovery, supports healthy ageing, health and wellbeing and prevents malnutrition. These new food standards replace the Victorian Food Standards from 2009 and are essential to ensure menus for regular and texture-modified foods meet the nutritional requirements of the average adult person within a Victorian Public Hospital and Residential Aged Care Service setting.  For the first time in Victoria, we also have Food Standards for Paediatric patients in Public Health Hospitals.

In addition, the standards can be adapted specifically to a facility’s population demographics to ensure that food and fluids meet their nutritional, cultural, religious, choice, dignity, safety, appearance and quality standards. 

Key updates to the new Victorian food standards

Introduction of inaugural paediatric food standards

The most significant addition to the food standards is the introduction of the Nutrition and Quality Food standards for Paediatric Patients in Victorian Hospitals. These standards are the first of their kind in Victoria and take into account the very different nutritional and dietary needs of children across the age spectrum compared to adults.

Whilst it is preferable that hospitals provide a stand-alone paediatric menu, the new food standards recognises that it may not be feasible for most adult-based hospitals providing paediatric inpatient services. In these instances, it may be appropriate for a short order menu to be integrated into the main menu to cater for paediatric patients. Both integrated short order menus and stand-alone paediatric menus are required to still meet the Paediatric Standards.

Providing further guidance on nutritional adequacy for regular meals and texture modified foods 

There is an increased focus on the minimum nutritional provision of meal and mid meal items for not only patients in hospitals, but those living in public sector residential aged care. The new food standards have updated nutrient banding for more menu items, ensuring minimum nutritional standards and minimum choice options from a variety of meal components, along with minimum energy and protein to be provided per serve size. The new enhancement applies to a wider range of diets including regular, full ward diet and texture-modified diets (TMD). There is an emphasis on aligning the terminology for TMD food with the globally recognised International Dysphagia Diet Standardisation Initiative (IDDSI). This will provide patients with swallowing difficulties foods that are safe to chew and swallow whilst being nutritionally adequate.

Embracing cultural and social aspects of food and meal environment

This is important for patients in hospitals and vital for those in public sector residential aged care facilities. These facilities are their homes, and as such should provide them with comfort, dignity, opportunities to engage socially,  and familiarity with culturally appropriate food in a homely environment.  The meal environment is as important as the food itself, and should consider ambience, and adequate staffing to assist and support wellbeing during mealtimes.  Trained staff are also highlighted in the food standards as key to improving oral intake and preventing or reducing malnutrition in both environments.

Emphasis on continuous quality improvement

The standards provide a framework to adopt continuous quality improvement (CQI) processes, using the Plan/Do/Study/Act (PDSA) cycle to document improvement actions and outcomes. Best Practice guidelines have been adopted to ensure CQI in governance, quality assurance, with regular CQI recommended for menu reviews, mealtime environment audits, trayline or point of service meal quality auditing, consumption and food waste audits, as well as patient and resident feedback in these processes. This is an important part of the National Safety and Quality Health Service (NSQHS) Standards and Aged Care Quality Standards (ACQS) accreditation requirements.

Modern food system for Victorian health services

Food systems which encompass meal production, menu ordering systems, meal delivery models, and collaboration between allied health and food service workforce are considered in these standards. In order to optimise the food system, the food standards outline the importance of advancements in food service technology, trained workforce and adequate staffing ratios.  These can all affect the food system and can impact quality and safety assurance and it is important to minimise vulnerability within the health services.

What needs implementing?

We welcome these new changes to the nutrition and quality food standards, as these are crucial tools to guide public health service menus. The introduction of the paediatric nutrition and quality food standards will further provide better health outcomes for paediatric patients in Victoria. However, a majority of the updated recommendations in the food standards are not mandatory and instead are ‘recommended’ and ‘suggested’ standards for health services to adopt. In order to provide better health outcomes for all Victorians using these services, more of the food standard recommendations need to be mandated.

 

Where do I get more information?

You can find the Victorian nutrition and quality food standards for health services here.

By Mina Berlandier APD

Mina Berlandier is a Lecturer at Monash Nutrition and Senior Food Service Dietitian at Eastern Health. Mina has over 25 years in Public Hospital Dietetics, previous Private Practice and many years working alongside Food Service. Mina is passionate about the link between best practice dietetic care and food service, to ensure better health outcomes for all consumers

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