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Day-to-day activities of clinical dietitians working in the inpatient and outpatient settings in a group of New South Wales public hospitals: The results of a direct observational study


  • M. Milosavljevic, BSc(Hons) Dip Nut Diet, MBA, APD, Doctorate of Business Administration candidate, Manager of Clinical Nutrition Services
  • G. Noble, B.Ed, MBA, MCom(Hons), PhD, AFAIM, Associate Dean of Business Faculty of Commerce and Director of Centre for Social Marketing Research, Academic supervisor of Doctorate
  • C. Zaremba, MSc(Nutr and Diet), Clinical Dietitian of Illawarra Shoalhaven Local Health District



To describe the daily tasks undertaken by dietitians working within the inpatient and outpatient sectors within the NSW public hospital system.


This study used an ethnographic methodology that employed a direct, non-participatory, discontinuous, observational technique to observe hospital dietitians, in both outpatient and inpatient settings, during a typical work shift. Trained volunteer observers collected the data over a three-year period (2008, 2009 and 2010). The data were combined and then sorted into five categories including: direct patient care, indirect patient care, communication, administration and education of self or others.


A total of 609 hours and 21 minutes were observed across a three-year time period 2008–2010. On average, the dietitians in both inpatient and outpatient settings spent 18.3–32.2% of their time in direct patient care activities. The majority of time was spent in indirect patient care activities such as: information collection, documentation and discussion with other health-care professionals. A comparison between the two work settings showed that those dietitians working in the inpatient setting spent less time in direct patient care (18.3% vs 33.1%, P < 0.05), and more time in indirect care activities (41.7% vs 23.3%, P < 0.05) and in communication about patient care (22.7% vs 14.4%, P < 0.05).


The findings show that dietitians spend most of their time doing activities that support patient care, but these activities occur away from the patient.