The “new cook-chill” system in the operation of hospital food services is done with the cooking system which can cope with a labor shortage in cooking that it is premeditated. The subject of this study is the actual situation in the operation of hospital food services with the “new cook-chill” system of the hospital and was intended to examine problems of hospital food services. We collected information by a meeting or an email from the person in charge of the nourishment section targeting at 6 hospitals of the “new cook-chill” system introduction. Among 6 hospitals, only 1 hospital provided all meals by “new cook-chill” system, and 5 hospitals provided a meal by combination with the cook and serve system. It was 2 hospitals that provided all dishes of the breakfast by “new cook-chill” system. 4 hospitals provided staple food and soup of the breakfast by the cook and serve system and performed work to insert in a reheating cart after the cool-down. A characteristic might vary according to the factor including a limit to a menu in the “new cook-chill” system, the models of the reheating cart to use. And the situation not to be ready to carry out the effective use of the “new cook-chill”system enough became clear.

Given the revision of the medical service fee in the fiscal year 2022, a new inpatient nutritional management system with an additional 270 points (on the first day of hospitalization and at the time of discharge) was established by the Ministry. The requirements include the placement of a full-time registered dietitian in each ward to provide patients with detailed nutritional management. To meet the requirements for medical service fees in the gynecology ward, our hospital has established a nutrition management system in a dedicated staffing ward, incorporating interviews during admission and meal rounds. Patients requiring intervention were more likely to have advanced cancer and were more likely to be malnourished or at risk of malnutrition on admission. Our findings have suggested that energy and protein sufficiency rates could be improved in these patients when a dedicated dietitian selects appropriate dietary content and nutritional supplements on admission and conducts regular monitoring. The system has also enabled seamless nutritional management from hospitalization to outpatient care, including providing nutritional guidance at discharge. It was also inferred that having a registered dietitian actively make dietary adjustments to accommodate allergies and chewing and swallowing functions could be useful for task-shifting and task-sharing with doctors and nurses.