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

Food Service Manual for Health Care Institutions
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as a preferred preventive measure for high-risk populations such as women, children, and the
elderly. For the elderly, in particular—a population already shown to be growing—improvement
in quality of life and minimization of the ongoing need for health care is a decided priority.
It is within this context of assessment and intervention that the role of nutrition
specialists takes on added significance.
Shorter lengths of stay also will increase the number of individuals served by alternative
health care delivery systems such as nutrition management. Despite this projection, dietitians
have yet to be “legitimized” by the federal government and other third-party payers as a necessary
adjunct to the home health team. It is through the support of dietitians that the nutritional
needs of home health care patients can be assessed and a plan developed to eliminate or
minimize patient readmissions. Dietitians play a major role in long-term care facilities in both
the nutrition care of residents and the smooth operation of facilities’ kitchens.
Another environmental trend discussed earlier in the book, one that affects nutrition specialists,
is the average consumer’s heightened awareness of the nutrition–health ratio. Although
selecting healthier foods over nutritionally inferior ones has not yet become routine, today’s
health care consumers are asking more questions and requesting more products to meet their
nutritional needs.
This chapter examines the dual role of the nutrition manager in health care operations:
service manager and service provider. The first part of the chapter discusses the management
of nutrition services with an emphasis on requirements unique to the planning, organizing,
leading, and controlling functions of management. The second segment presents information
relevant to providing nutrition services to various customer types. These services include
screening for nutritional risks, assessing nutritional status, developing a nutrition care plan
(critical care paths, patient education, discharge planning), and documenting nutrition care.
Managing Nutrition Care Services
The nutrition care manager is responsible for managing human and other resources to accomplish
the objective of delivering high-quality and cost-effective nutrition care to patients. The
nutrition manager’s roles encompass the following activities and skills:
• Ensuring compliance with the Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) and other regulatory bodies
• Maintaining open lines of effective oral and written communication
• Providing leadership as a liaison with medical, nursing, and allied health professionals
as a member of the interdisciplinary team
• Developing standards of care
• Developing patient educational material
• Developing long-range plans and implementing objectives
• Developing departmental policies and procedures
• Applying clinical nutrition training, knowledge, and expertise
• Overseeing staff development, evaluation, job descriptions, and counseling
• Keeping abreast of departmental productivity, budget, and other control measures
• Assisting in marketing of the organization’s nutrition services
• Monitoring department operations such as patient tray system, food spoilage and inventory,
vendor relations, menu planning, and so forth
• Maintaining competency by participating in professional activities, continuing education,
literature review, and so forth
• Serving as a change agent for improving performance to meet measurable outcome goals
Some responsibilities within each of the four management functions—planning, organizing,
leading, and controlling—require a unique application of skills. These responsibilities are
reviewed here in detail.