Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly

Malnutrition is common in residential care facilities for older adults and is often caused by inadequate food intake. This study aimed to develop a validated set of quality indicators to measure the quality of meals and meal services in such settings. Through a literature review and the expertise of a multidisciplinary team, a list of 20 potential indicators was created and assessed in two Delphi rounds by eleven experts (including dietitians, caregivers, and chefs). This process resulted in 13 validated indicators and 25 criteria, categorized into structural, process, and outcome indicators. The set covers domains such as food, service, choice, and nutritional screening. These indicators are intended to support quality improvement projects in collaboration with kitchen staff and healthcare professionals. The ultimate goal is to improve food intake and reduce the risk of malnutrition. The feasibility of the set in practice still needs to be tested, as does its applicability across various institutions and contexts. Further implementation requires engagement with relevant stakeholders.

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