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Background: The Swedish population is aging [1] and malnutrition is a common problem among elderly people [2]. A method called food registration is used to monitor the patients? nutritional intake, with the purpose of reducing the risk of patients deteriorating in nutritional status during hospitalisation. However, the current method is not satisfactory and many food registration lists are incomplete. [3-6] Thus, patients do not receive a qualitative nutritional care since the assessment of the patients? nutritional status is based on incomplete documentation.Purpose: The purpose of this master thesis is to increase the quality in the nutrition monitoring process in the geriatric units B72 and B74 at Karolinska University Hospital in Huddinge, Sweden. This should be done by increasing the prospects of providing caregivers with correct information about the patients? nutritional intake and make the food registration more complete by introducing a new working system based on Lean Healthcare principles. The new working system should consist of a prototype of a food registration application and a new working approach with clear and standardised responsibilities for all occupational groups and shifts.Problem: Is it possible to create a visual and standardised working system that will increase the effectiveness and safety of the nutritional monitoring process?Methods: The current nutrition monitoring process was investigated by observations, interviews and timings. In addition, 100 registration lists were scrutinized and errors and missing information were noted and prototype of a food registration application was created using usability inspection methods. The prototype was tested in a usability test and evaluated in a survey that contained a standardised usability index called The System Usability Scale (SUS).Results: The review of old registration lists revealed that 59 per cent of the food registration lists missed information on how much the patient had been served and/or had consumed at one or more occasions. On average, each list contained 9.4 errors or points of missinged information. The SUS test generated a usability score of 86.75 out of 100, which is equivalent to an A in the A-F grading system. [7] During the usability test an average of 8.2 errors per test were made, though as 4.4 of these were corrected the net average was 3.8 errors per test. The three most common errors, which accounted for 69.5 per cent of all 82 errors, were to forget to specify quantity (36.6 per cent), to press ?done? before everything had been registered (18.3 per cent) and to not find the correct item (14.6 per cent).Conclusion: Hopefully, in the future, more food registrations will be correctly performed due to the built in mistake proofing systems of the food registration application and the introduction of the new working approach. The hope is that the new working system will provide caregivers with accurate information on the patients? nutritional intake so that the patients? nutritional care can be based on complete documentation. In this way, the quality and safety of the nutrition monitoring process will be increased.