Reflecting back - 10 years of the Future Hospital Programme.

A decade ago, The Future Hospital Programme was created following the publication of the Future Hospital Commission (FHC), to demonstrate how Future Hospital (FH) principles could be implemented and embedded within the NHS. Ten years on, we reflect back on each of the development sites and the programme itself. What were the successes and what are the current challenges? Indeed, in the current NHS, is it feasible to deliver in 'real world environments' the FH principles and make sure that patient care is safe and effective? The last decade has seen financial constraints and inevitable (albeit often short-term) changes to manage the COVID pandemic. How have these affected each of the development sites and what else do we need to do to ensure that we get care right for our patients within our future hospitals?

Trends in hospital capacity and utilization in Puerto Rico by health regions, 2010-2020.

Like many under resourced, island communities, most of the municipalities in Puerto Rico are medically underserved. However, there is limited information about changes in hospital capacity and any regional disparities in availability of hospital services in Puerto Rico, especially given the multiple public health emergencies the island has faced in recent years (e.g. hurricanes, earthquakes, and COVID-19). This study described the trends in hospital capacity and utilization for the Island of Puerto Rico and by health regions from 2010 to 2020. We analyzed the 2021-22 Area Health Resource File (AHRF) and aggregated the data by seven health regions, which are groupings of municipalities defined by the Puerto Rico Department of Health. Ten-year estimates for hospital utilization were adjusted for population size by health region. During the more recent five-year period, there were decreases in hospitals, hospital beds, and surgeries, which represent a shift from the earlier five-year period. Over the 10 years of the study period, there was an overall decrease in population-adjusted measures of hospital utilization on the island of Puerto Rico-despite multiple disasters that would, theoretically, increase need for health care services. We also found variation in hospital capacity and utilization by health regions indicating the rate of change was not uniform across Puerto Rico. The capacity of Puerto Rico's hospital system has shrunk over the past decade which may pose a challenge when responding to recurrent major public health emergencies, especially within specific health regions.

Promoting professionalism through humanities-based transformation.

INTRODUCTION: In the last two decades, academic medical centers in the United States have faced a new challenge, dealing with breaches of medical professionalism in their staff, house staff, and medical students. Medical education settings have largely directed their professionalism efforts toward responding reactively to negative outliers. DISCUSSION: This paper contends that the warrant of medical education mandates a transformative path forward. While negative behavior must be responded to meaningfully, so, too, must positive role models of professional behavior be publicly lauded for their consequential culture change in their institutions, and promoted as positive role models. Further, the promotion of medical professionalism must be part of this culture by proactively engaging all learners and health care providers with medical ethics and humanities-based knowledge, critical thinking skills, and role modeling. CONCLUSION: Professionalism programs should be vested with the authority to implement an affirmative educational program intended to nurture and promote medical professionalism in each medical student, resident, fellow, and attending and utilize methods to that end employing both virtue and care ethics.

Medical professionalism is the foundational concept grounded upon scientific- and humanities-based knowledge and skills, directed toward the promotion of patient benefit with the rejection of self-interest, delivered with excellence in comportment, and the adherence to a covenant of trust with society.Medical educators who solely emphasize the detection and punishment of negative outliers are missing essential elements in promoting medical professionalism.Medical professionalism should be comprehensively addressed through a systematic addressing of teaching fundamental knowledge, skills, and virtue, promote excellence in role modeling and mentorship, and the redress of those lacking insight in their professional conduct.

Cybersecurity Frameworks in Healthcare Data: Short Literature Review.

The importance of cybersecurity in healthcare, with a focus on safeguarding sensitive patient information from unauthorized access, use, or disclosure, cannot be overstated Security breaches in this sector can have significant consequences due to the widespread use of electronic health records (EHRs) and interconnected medical devices, creating opportunities for exploitation. This work presents a first step to analyzing and organizing healthcare-specific cybersecurity problems and existing security frameworks. Special focus is put on the security risks associated with data integration centers while recognizing their role as hubs for innovation.

Quality of nursing care: Predictors of patient satisfaction in a national sample.

AIM: To assess patients' satisfaction with the quality of nursing care and the relationship between patients' characteristics and their level of satisfaction. DESIGN: A descriptive correlational cross-sectional design was used in this study. METHODS: Convenient sampling was utilized to include 1014 inpatients from six hospitals in Jordan: three private hospitals; two governmental hospitals; and one university-affiliated hospital. The data collection process occurred from September 2022 to January 2023. The data were collected using the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire. The data were analysed using Pearson correlation, t-test, one-way ANOVA and multiple hierarchal regression. RESULTS: The study included 1014 patients with an average age of 51.3 (SD = 18.6), and 59.9% were females. More than two thirds of the sample reported having health insurance, and 62.7% were unemployed. The mean total score of patients' satisfaction with nursing care quality (NCQ) was 68.2 (SD = 12.9), indicating high satisfaction. Higher-income levels (p < 0.001), higher education levels (p = 0.003), having health insurance (p < 0.001), being admitted to private hospitals (p < 0.001), being admitted to critical care units (p = 0.002), being in a single room (p = 0.001), excellent perceived health status (p < 0.001) and willingness to recommend the hospital to family and friends (p < 0.001) were significant predictors of patients' satisfaction with NCQ. CONCLUSIONS: Patient and hospital environment characteristics affected patients' satisfaction with NCQ. Hospital management should consider these characteristics to improve patient satisfaction and outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Policymakers and hospital management should consider improving the physical environment of their facilities to improve patients' satisfaction. Continuous professional development should emphasize nurses' communication skills to enhance their abilities to deliver information to their patients. IMPACT: This study examined levels and predictors of patients' satisfaction with the quality of nursing care. The results indicated that improving patients' satisfaction can be achieved by focusing on areas of nurses' communication skills and explaining information to patients. REPORTING METHOD: The study adhered to STORBE guidelines for reporting observational studies. PATIENT OR PUBLIC CONTRIBUTION: Hospitalized patients contributed to the data of this study. Hospital administrators facilitated its implementation.

Restraint of patients in psychiatric hospitals in England and Wales.

The restraint of patients is one of the important aspects of the regime in psychiatric hospitals. It has been an issue in hospitals over the years because it interferes with the personal freedom of patients. Most recently it was one of the matters raised in X NHS Foundation Trust v RH [2024] EWCOP 150. This paper aims to add to the awareness of it by looking at what it means, the forms it may take and the justifications for it. It is concluded that restraint of patients is controversial but reasonable and necessary at times in the interests of the patient's own health/safety or that of others.

Development and psychometric testing of the nursing practice difficulty scale for nurses caring for patients with dementia in general hospitals.

Objective: As aging in the Chinese population increases, the hospitalization rates of patients with dementia have also risen. Research on the difficulties of nurses who care for patients with dementia in Chinese general hospitals is limited. This study aimed to develop a scale to measure the difficulties nurses face in nursing patients with dementia in Chinese general hospitals and to verify its reliability and validity. Methods: Guided by the biopsychosocial theory, an initial scale was created through a literature review, qualitative interviews, and expert consultation. A web-based survey for psychometric testing was conducted with 394 nurses from 11 general hospitals during September to November 2021. Validity was verified using content validity, exploratory factor analysis, the known-groups method, and concurrent validity. Cronbach's α coefficient and split-half reliability were used to assess reliability. Results: The Item-level Content Validity Index was 0.833-1.000. The Scale-level Content Validity Index was 0.929. Twenty-one items with four factors were extracted from the item analysis and exploratory factor analysis. According to the known-groups method, the difficulty of the experienced group and the group with training experience was significantly lower than that of the less experienced group and the group without training experience. Based on external standards, the correlation coefficient was 0.387 with the Nursing Job Stress Scale and -0.239 with the Dementia Care Attitude Scale. Cronbach's α coefficient for each factor ranged from 0.889 to 0.905, and the total was 0.959. The split-half reliability for each factor ranged from 0.814 to 0.894, and the total was 0.911. Conclusion: This study discovered a four-factor structure related to the difficulty scale of dementia nursing practice, and the scale's reliability and validity were confirmed. The scale can be utilized to assess the difficulty of dementia nursing practice in general hospitals and may be employed in future research to improve dementia nursing practices.

Development of Preliminary Integrated Health Care Clinical Competencies for United States Doctor of Chiropractic Programs: A Modified Delphi Consensus Process.

Background: There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training. Objective: The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education. Methods: A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies. Results: Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration. Conclusion: We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment.

Trends in Performance of Thrombectomy for Acute Ischemic Stroke Patients in Teaching and Non-teaching Hospitals.

OBJECTIVES: The value of thrombectomy in patients with acute ischemic stroke cannot be understated. As such, whether these patients get access to this treatment can significantly impact their disease outcomes. We analyzed the trends in thrombectomy adoption between teaching and non-teaching hospitals in the United States, and their impact on overall patient care. MATERIALS AND METHODS: We conducted a retrospective analysis of hospital admissions in the Nationwide Inpatient Sample with a diagnosis of acute ischemic stroke between 2012 and 2020. We compared the annual total number and proportion of patients undergoing thrombectomy between teaching and non-teaching hospitals, and their corresponding outcomes. RESULTS: 3,823,490 and 1,875,705 patients were admitted to teaching and non-teaching hospitals during the study duration, respectively. The proportion of patients who underwent thrombectomy increased from 1.60% to 7.02% (p-value for trend p<0.001) in teaching hospitals and from 0.32% to 2.20% (p-value trend p<0.001) in non-teaching hospitals. The absolute increase in the number of acute ischemic stroke patients undergoing thrombectomy was highest in teaching hospitals particularly those with large bed size, an increase from 3635 patients in 2012 to 24,730 patients in 2020. Higher rates of intravenous thrombolysis and patient transfer prior to thrombectomy were seen in teaching hospitals compared with non-teaching hospitals. CONCLUSIONS: The study highlights disparities between teaching and non-teaching hospitals, with teaching hospitals showing a disproportionately higher rate of thrombectomy adoption in acute ischemic stroke patients. Further studies are needed to understand the barriers to the adoption of thrombectomy in non-teaching hospitals.

[What about extending Specialised Health Training to architecture and engineering?] / ¿Y si ampliamos la Formación Sanitaria Especializada para la arquitectura e ingeniería?

Projects and construction management in healthcare facilities are usually assigned to architectural firms and engineering companies with previous experience. However, there is no evaluation system to ensure their level of competence in the healthcare sector. In the past, this was also the case for clinicians when they were self-appointed specialists without any supervision. Currently, the Specialised Health Training (SHT) programme in Spain is the only official specialisation pathway and consists of a period that combines training and paid healthcare practice. Similarly, but from Argentina, hospital residencies in architecture have been carried out for specialised postgraduate training. The aim of this article was to show the experience in Argentina and to propose the extension of the SHT in Spain. Our proposal consists of a programme of residencies in architecture and engineering to be developed in healthcare centres. We believe that this initiative has great potential to address health from its multiple disciplines and to reinforce the maturity of a National Health System in constant change.

Los proyectos y la dirección de obras en los centros sanitarios se suelen asignar a estudios de arquitectura y empresas de ingeniería con experiencia previa. Sin embargo, no hay un sistema de evaluación que asegure su nivel de competencia en el sector sanitario. Antiguamente, esta situación también se daba en los profesionales clínicos, cuando se autotitulaban especialistas sin ningún tipo de supervisión. En la actualidad, el programa de Formación Sanitaria Especializada (FSE) en España es la única vía de especialización oficial y consiste en un periodo que aúna formación y práctica asistencial remunerada. De manera similar, pero desde Argentina, se llevan realizando unas residencias hospitalarias de arquitectura para la formación especializada de posgrado. El objetivo de este artículo fue mostrar la experiencia en Argentina y proponer la ampliación de la FSE en España. Nuestra propuesta consiste en un programa de residencias en arquitectura e ingeniería a desarrollar en centros sanitarios. Consideramos que esta iniciativa tiene un gran potencial para abordar la salud desde sus múltiples disciplinas y reforzar la madurez de un Sistema Nacional de Salud en constante cambio.

Impact of Inaccurate Clinical Coding on Financial Outcome: A Study in a local hospital in Najran, Saudi Arabia.

Background: Coding in medical procedures is crucial for patients, and errors made by hospital administration during the coding process can have an impact on both the financial results and the course of therapy. The present study aims to assess the accuracy of diagnostic and procedural codes as recorded by the hospital's coders and to also evaluate their impact on the hospital's revenue. Methods: In a local hospital in Najran, Saudi Arabia, a cross-sectional observational analysis was conducted on patients with a clinical coder. The percentage of precision and error following the re-coding of cases was calculated using a statistical analysis. Results: Primary diagnosis was incorrectly coded in 57 (26 per cent) records, and secondary diagnosis was incorrectly coded in 21 (9.9 per cent) records. Inaccurate medical labelling has been seen in emergency rooms, operating rooms, and gynaecology facilities. Discussion: The percentage of records with the most incorrect coding was found to be 16 (7.5 per cent) in the emergency room, 10 (4.7 per cent) in the surgical clinic, and 5 (2.3 per cent) in the gynaecology/OBS clinic. Six (2.8 per cent) records in the private clinic had inaccurate secondary diagnoses, followed by four (1.9 per cent) and two (1 per cent) records in nephrology. Conclusion: The percentage of inaccurate clinical codes in primary diagnoses reached (26.8 per cent) and the percentage of incorrect clinical codes in secondary diagnoses reached (9.9 per cent).

Veterans Affairs Training Experiences During the COVID-19 Pandemic-Trainee Satisfaction and Interest in Future Veterans Affairs Employment: A National Survey.

Introduction: The emergence of COVID-19 caused a sudden, unexpected disruption in the clinical training experiences of nurse trainees at the US Department of Veterans Affairs (VA), the largest clinical training setting in the US for nurses. Purpose: To understand associations between COVID-19 and nurse trainees' satisfaction with their training experiences and the likelihood that they would consider future VA employment. Methods: A cross-sectional design was used to assess 7,890 nurse responses from the VA's Trainee Satisfaction Survey for academic years 2018-2021. Results: After the pandemic, trainees reported decreased training satisfaction (95.06% vs. 93.46%; P = .0028). Willingness to consider future VA employment was unchanged. Patient case mix, the onboarding process, and challenges with other staff were the most common reasons for dissatisfaction. Conclusion: Nurse trainees expressed a small but statistically significant degree of dissatisfaction with their clinical learning environment during this study period but their willingness to seek employment with the VA remained high.

Specialist intellectual disability liaison nurses in general hospitals in England: cohort study using a large mortality dataset.

OBJECTIVE: Intellectual disability liaison nurses in general hospitals could enhance access to high-quality, adapted healthcare and improve outcomes. We aimed to explore associations between the input of intellectual disability liaison nurses and the quality of care in people with intellectual disability who are admitted to hospital. DESIGN: Retrospective analysis of a national dataset of mortality reviews. SETTING: General hospitals in England. PARTICIPANTS: 4742 adults with intellectual disability who died in hospital between 2016 and 2021 and whose deaths were reviewed as part of the Learning from Lives and Deaths mortality review programme. OUTCOME MEASURES: We used logistic regression to compare the sociodemographic and clinical characteristics of those who did, and did not, receive input from an intellectual disability liaison nurse. We explored associations between liaison nurse input, care processes and overall quality of care. RESULTS: One-third of people with intellectual disability who died in hospital in England between 2016 and 2021 had input from an intellectual disability liaison nurse. Intellectual disability liaison nurse input was not evenly distributed across England and was more common in those who died of cancer. Having an intellectual disability liaison nurse involved in an individual's care was associated with increased likelihood of reasonable adjustments being made to care (adjusted OR (aOR) 1.95, 95% CI 1.63 to 2.32) and of best practice being identified (aOR 1.37, 95% CI 1.17 to 1.60) but was not associated with a rating of overall quality of care received (aOR 0.94, 95% CI 0.78 to 1.12). CONCLUSIONS: Intellectual disability liaison nurses see only a minority of people with intellectual disability who are admitted to hospital in England. Increasing the availability of intellectual disability liaison nurses could improve care for this disadvantaged group.

An Online Transverse Study of Nurse Leaders' Cultural Humility in Nursing Practice as Perceived by Hospital Nurses.

INTRODUCTION: The term "cultural humility" is often used, but both society and professionals, including nurses, lack a clear understanding of its meaning. This study examined the relationships, predictors, and differences of nurse leaders' cultural humility in nursing practice, as perceived by hospital nurses. METHODOLOGY: A quantitative transverse and correlational study was implemented with a convenience sample of 350 Jordanian registered nurses (RNs). RESULTS: Nurses "agreed" on the presence of nurse leaders' cultural humility in nursing practice, but it was low. Working rotating shifts, holding a Baccalaureate degree in nursing or less, and having graduated from a private university predicted the perceived nurse leaders' cultural humility in nursing practice. Most differences in perceived nurse leaders' cultural humility in nursing practice came from nurses who worked rotating shifts when compared to those who worked day shifts. DISCUSSION: Nurse leaders must practice open communication and embrace a receptive mind-set, as this will help eradicate the tendency of nurse leaders to believe they know "know-it-all."

Starting continuous improvement; creating a common understanding of stroke care delivery in a general hospital.

BACKGROUND: Continuous improvement is based on fostering practitioners' suggestions to modify their own work processes This improvement strategy is widely applied in healthcare but difficult to maintain. The cross-disciplinary nature of many care processes constitutes an extra impediment. METHODS: The study had an explorative design with a qualitative single-case approach. The case presents a project to improve the treatment of patients with thrombotic stroke. Data was obtained via hands on involvement, documents, observations, and interviews with participants in a cross-functional improvement group. A thematic analysis method was employed. RESULTS: Through learning how tasks were carried out in other disciplines, the participants developed a common understanding of why it took so long to provide treatment to stroke patients. These insights were used to implement practical changes, leading to immediate improvements in stroke care delivery. The results were fed back so that successes became visible. Participants' understandings of the local context enabled them to convince peers of the rationale of changes, setting in motion a permanent improvement structure. The participants considered that mapping and then assessing the entire workflow across disciplines were relevant methods for improving the quality of patient care. CONCLUSION: Starting an improvement project in a cross disciplinary environment requires deep engagement on the part of professionals. A quintessential prerequisite is therefore the realization that the quality of care depends on cross-disciplinary cooperation. A facilitated learning arena needs to (1) create insights into each other's colleagues' tasks and process interdependencies, (2) increase understanding of how the distribution of tasks among specialist units affects the quality of care, and (3) frequently report and provide feedback on results to keep the process going.

Exploring the Association Between Behavioural Modification in Response to the Prevailing Economic Crisis and Mental Health Outcomes of Nurses from Teaching Hospitals, Sri Lanka.

Introduction: The nursing profession is a cornerstone in the healthcare workforce. Yet, it remains vulnerable to severe mental health challenges, stemming from a complex interplay of social and occupational factors. It is evident that crisis situations have profound influence on the mental-wellbeing of nurses. Objective: To explore the association between behavioural modification in response to the prevailing economic crisis and mental health outcomes of nurses from teaching hospitals, Sri Lanka. Methods: This cross-sectional study was carried out among nursing professionals (n = 261) who are employed in distinct teaching hospitals (n = 7) in Sri Lanka. Considering the bed-capacity of each hospital, participants were purposively selected and invited to complete an online-based self-administered questionnaire to collect demographic characteristics and lifestyle modifications to deal with the economic crisis, while Depression, Anxiety, and Stress Scale (DASS-21) a set of three self-reported scales to assess the level of depression, anxiety, and stress, was used. Data was analyzed using the SPSS 23.0 version, Descriptive analysis was performed to present frequencies of both demographic characteristics and lifestyle and symptoms of depression, anxiety, and stress, while the Chi-square test was used to determine the association between selected independent variables and mental health outcomes. A multivariate regression model was performed to determine the predictors of mental health outcomes of the study participants. Results: There were a total of 261 participants, 86.2% were married, and 66.2% had children. The proportion of mild to extreme depression, anxiety, and stress were 58.2%, 65.9%, and 72.0% respectively. In response to the economic challenges, 91.6% of study participants reported reducing expenditures on general household needs, while the proportion of participants who curtailed spending on food, monthly savings, and entertainment were 75.9%, 79.3%, and 73.6% respectively. Notably, 81.6% of participants initiated the process of applying for overseas employment, and 50.6% pursued academic programs to be eligible for foreign placements. Conclusion: The present study observed a higher level of depression, anxiety and stress among nurses from teaching hospitals in Sri Lanka. It was noted that nurses had taken steps to respond to financial strain by reducing essential elements of their routine. Additionally, study participants chose to seek foreign placements as a solution to the economic burden, as a result just over half of the respondents completed an academic program in order to be qualified for jobs abroad. Further, these initiatives are significantly associated with negative emotional disorders of the participants. Therefore, interventions should be implemented to promote positive mental health outcomes of nursing professionals in Sri Lanka.

The Hostile Hospital: Exploring Hospitality, Violence, and the Doctor-Patient Relationship.

Lévinas and Derrida speak of the ontological context of human relationships in the context of the absolute priority of the Other and the unconditional law of hospitality. This has direct implications for doctor-patient relationships in the context of health care. This paper explores these philosophical and practical implications in light of a paradox that exists in all hospitality: that hostility is inevitably intertwined with hospitality. The paper explores three ways hostility can present in doctor-patient relationships: in physical violence, through paternalism, and through the violence of categorisation. While acknowledging the paradox, and the complexity of solutions, the paper considers ways to minimize this hostility. In so doing, it encourages HCPs to overcome whatever is possible so as to do the impossible: provide unconditional hospitality.

Reducing sickness absence: a work environment intervention in Norwegian hospitals.

BACKGROUND: High rates of sickness absence is a challenge within the healthcare sector, highlighting the need for effective interventions. Despite this, limited research has been conducted on the impact of such interventions within the healthcare context. This study evaluates an intervention aimed at improving the work environment influences sickness absence rates in Norwegian hospital units. The intervention is a comprehensive framework for discovering and tailoring solutions to each units' specific needs, with a focus on employee involvement and collaboration between leader, union representatives and safety delegates. METHODS: We employed two methodological approaches. Method 1 involved using HR-registered sickness absence data to track changes in sickness absence across all intervention units and matched control groups over a three-year period. In Method 2, we used a pre- and post-survey design in 14 intervention units, focusing on employees' job satisfaction and self-reported health. RESULTS: The results of the intervention were mixed. There was a significant decrease in total sickness absence in the intervention units the first year after the intervention, and a significant decrease in long-term sickness absence both in the first and second year after the intervention, measured with HR registries. However, we did not see a significant larger decrease in total sickness absence in the intervention units compared to the control units and only partial support for a larger decrease in long-term absence in the intervention units. In the subsample of units that also participated in the survey, we observed significant improvements in employee job satisfaction post intervention. CONCLUSIONS: There is a need for research on effective interventions to reduce sickness absence in the healthcare sector. "Where the shoe pinches" provides a potential methodological framework for reducing sickness absence by addressing challenges in the work environment, however with uncertain results. Further exploration is warranted to refine strategies for effectively managing sickness absence within healthcare organizations.

Green hospitals: Mitigating water footprint and greenhouse gas emissions through sustainable menu planning in Turkish state university hospitals.

Considering the importance of sustainable nutrition, it is important that hospitals' meal menus are planned to ensure the lowest possible environmental footprint. In this study, we aimed to evaluate the environmental effects of hospital menus and the changes that may occur when these menus are planned according to the Turkey Dietary Guidelines and Mediterranean diet recommendations. In this context, first, the yearly environmental footprints of the standard meal menus of the state university hospitals in Turkey (n = 42), including water footprint (WF) and greenhouse gas emission (GHGE) values, were determined. Second, changes in the environmental footprint as a result of arranging the standard meal menus of state university hospitals according to the Turkey Dietary Guidelines and Mediterranean nutritional models were evaluated. It was determined that the average WF and GHGE values of hospital menus were 137,280 ± 18537.2 L/month and 140.0 ± 18.4 kg CO2-eq/month, respectively. Adjusting state university hospitals' standard meal menus according to Turkey Dietary Guidelines and Mediterranean nutritional models reduced WF by 24.8% to 103206.7 L/month and 37.8% to 85420.5 L/month, and GHGEs by 31.7% to 95.5 kg CO2-eq/month and 49% to 71.3 kg CO2-eq/month, respectively. In addition, it was determined that hospital meal menus planned according to the Turkey Dietary Guidelines and the Mediterranean nutritional model contained lower saturated fat and cholesterol and higher dietary fiber. In conclusion, planning hospital menus according to the Turkey Dietary Guidelines and Mediterranean nutritional recommendations can reduce the environmental footprint of hospital food services.