Some hospital food and nutrition directors are reporting decreased costs and increased patient satisfaction ratings as a result of menu changes. However, a dearth of published empirical data exist regarding the impact of patient foodservice models, specifically spoken menu models, on efficiency and effectiveness. In this study, data were collected on two patient units during three phases: Phase I - current patient foodservice model; Phase II -spoken menu model; and Phase III - new patient foodservice model, which included a spoken menu and additional features. Efficiency was assessed through analysis of labor, late and wasted tray data; effectiveness was assessed using substitution, patient and nursing satisfaction data. Results included increased percentage of attendant time spent on patient interaction during Phases II and III; decreased percentage of late trays from Phase I to Phases II and III; increased percentage of wasted trays from Phase I to III due to Phase III model characteristics; a significant increase in nursing satisfaction from Phase I to III; and consistently high patient satisfaction during all phases. Both Phases II and III were more efficient and effective than Phase I. The distinction between Phases II and III is less clear without cost data regarding resources used.