Room service represents a revolution in hospital patient dining. More menu options, more flexibility in meal delivery, increased food quality, and more personalized service resulted in improved nutritional intake among patients receiving room service. The purpose of this study was to identify key aspects hospital foodservice directors (HFDs) considered when deciding to implement room service and determined the importance of each aspect.

A mixed methods study was conducted to address the objectives of this study. Responses from a key informant interview and HFDs on open-ended questions were utilized to develop a web questionnaire. A web questionnaire was e-mailed to 845 HFDs for both groups (who had and had not implemented room service) and HFDs were asked to rate the importance of 28 aspects of room service implementation. Of the 28 aspects, 14 were rated important, very important or extremely important. Factor analysis on 28 aspects revealed four room service factors: cost allocation, human resources and facilities, food quality, and patient satisfaction. Food quality and patient satisfaction factors were perceived as more important by HFDs who had implemented room service than who had not. Cost allocation was the most important factor reported by HFDs who had not implemented room service. Perception on the importance of the patient satisfaction factor differed between hospital type as well as hospital size.

Possessing experience and knowledge regarding the nature of room service, HFDs who had implemented room service perceived the customer-oriented meal delivery concept, the availability of menu selections based on patients' preferences, and great food quality served as more important to the success of room service implementation. The cost factor was not as important to those HFDs who had implemented room service as compared to who had not. This may be explained, partially, by the fact that HFDs have already experienced implementation and seen cost savings such as reduction of food waste along with improved patient satisfaction ratings.