Meal ordering system design and its influence on hospital food waste: A comparison of paper-based and electronic systems

Food waste (FW) remains a major challenge for institutional foodservice systems, undermining resource efficiency and the transition toward more sustainable production and consumption. Evidence linking foodservice system design to FW across both production and consumption stages is limited. This study evaluated the impact of transitioning from a paper-based meal ordering system (PMOS) to an electronic meal ordering system (eMOS) on hospital FW. Standardised before-and-after audits conducted across a full menu cycle quantified kitchen FW (spoilage, preparation waste, unserved food) and plate waste, using leftovers as a proxy for patient consumption, across 2214 PMOS and 2388 eMOS meals. Absolute kitchen FW increased from 134.1 to 161.4 kg/day, reflecting higher meal production following hospital expansion between audit periods. However, kitchen FW per meal produced decreased by 27% (170.4 to 124.0 g/meal), driven by reductions in preparation waste (20.7 to 8.7 g/meal) and unserved food (149.3 to 113.7 g/meal), indicating improved production efficiency and stronger demand-production alignment. Plate waste remained largely unchanged at approximately 0.7 kg/patient/day (41% PMOS; 40% eMOS), with only modest improvements for breakfast and among patients receiving special diets. These findings suggest that eMOS may improve production efficiency by reducing kitchen FW intensity (g/meal) but is unlikely, on its own, to substantially influence plate waste and patient consumption. Additional, complementary strategies may be required to meaningfully reduce plate waste. By evaluating both absolute and efficiency-normalised kitchen FW alongside plate waste, this study provides evidence to inform more resource-efficient hospital foodservice systems and support progress toward SDG 12.3.