Food-Service-Manual-for-Health-Care-Institutions

Food Service Manual for Health Care Institutions
132
Departments
The formation of departments, or departmentalization, can fall into any of several categories:
functional, product, geographical, customer, process or equipment, and time. In the past, only functional
and time departmentalization were relevant to food service departments in health care
institutions. However, changes in health care focus have made product, customer, and process
departmentalization pertinent components of a facility’s structure. For departmentalization to
be effective, the concept of separation and reintegration must be taken into account when
deciding how to form an organization. Separation represents division of labor by pulling the
organization apart and making it more complex. The value of separation becomes evident
when groups are reintegrated, forming the support structure for operations. Reintegration
refers to the degree of coordination, cooperation, and communication that flow among units
in the organization.
Usually top-level managers determine which department structure is appropriate for their
institutions. Most likely, a combination of categories will be the best choice. Six departmentalization
types are briefly described here.
Functional Departmentalization
Functional departmentalization groups jobs into departments or units in which employees perform
the same or similar activities. Most units within hospital food service departments are
organized according to function, such as nutrition services, food production, purchasing and
storage, and nonpatient services (Figure 6.1). A manager or supervisor is usually in charge of
each unit’s activities. Functional departmentalization makes sense from the standpoint of having
like functions centralized. For example, although decentralizing meal service may be desirable,
it does not make sense to decentralize food preparation.
Functional departmentalization can cause conflicts between departments in meeting customer
demands. Those closest to patients (for example, nurses) have a unique perspective
of patients’ requirements and may fault another department, such as food service, whenever
patients’ needs go unmet. Because food service staff are removed from the customer, they may
not comprehend the urgency of nurses’ requests. For example, interrupting a work activity to
get an item requested by a nurse interferes with getting items ready for the tray line. This type
of functional cross-purpose does not allow employees to engage in the full cycle of their work.
In this example, a conflict occurs between nursing and food service. However, if the food service
employee was involved in the full cycle of fulfilling a patient’s dietary needs, he or she would
understand that both tasks are of equal importance. The employee could then understand that
the choice is not between completing a department task versus a nursing request but a choice
of meeting an immediate patient need and scheduling or postponing a task for a future need.
With the patient in clear focus, the food service staff could see that the positive consequences
of meeting the patient’s need would outweigh the negative consequences of not having all items
ready for the tray line to start.
Product Departmentalization
Product departmentalization creates work units based on the product or service the unit delivers.
This form of departmentalization is used most often in large manufacturing companies and
financial institutions. In recent years, health care institutions have experimented with productline
departmentalization, defined by body system units or by the traditional nursing care units.
Therefore, product lines may include cardiac care, obstetrics, oncology, or orthopedics, among
others.
The idea of product-line departmentalization is to coordinate the efforts of all health professionals
involved in caring for a particular patient type. This coordination enhances the quality
of care and improves costs associated with that care. Product-line management is further
enhanced by critical paths that standardize the intervention at various stages of a patient’s stay.
(Critical paths are covered in detail in Chapter 4 on quality management.) Dietitians are among