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

• Room service for inpatients and visitors
• Storefront nutrition assessment facilities
• Outpatient weight reduction and fitness programs
• Nutrition education publications and programs
Changes in health care will continue, not only in the ways in which care is provided, but
also in the ways services are marketed to consumers. Patient-centered, cost-effective care will
remain a driving force. Thus, services must be designed around the opinions and perceptions
of patients, medical staff, and the public.
Nutrition and food service departments must determine strategies to promote patient satisfaction
and enhance the reputation of the facility and the department. Improving hospitality
services, providing patients what they want to eat when they want to eat it, and offering good
basic nutrition information should promote a facility’s favorable public image. On discharge,
patients tell their families and friends about the quality of food and service they received while
hospitalized. In some cases, these word-of-mouth reports influence the choices of potential
patients.
All nutrition and food service employees are responsible for providing and promoting
appropriate quality of care for patients. This can be accomplished best when all employees
work toward a common mission and goal. The nutrition manager is responsible for marketing
nutrition services to patients, physicians, other health care providers, and administrators of
their facilities. (Refer to Chapter 3 for ways in which the nutrition manager can incorporate
marketing into the department’s planning functions.)
Organizing and Staffing
Organization and staffing functions include creating the structure needed to provide nutrition
services and recruiting, retaining, and developing the staff necessary to implement these services.
Staffing of the nutrition management unit of the food service department mandates hiring
clinically competent people who can be trained to provide high-quality patient care.
Depending on the size and organizational structure of the institution, the nutrition staff
may include all of the staff members shown in Figure 9.1 or only registered dietitians and nutrition
assistants. For example, in a small health care institution, patient nutrition services might
be managed by a registered dietitian, with nutrition assistants and aides processing diet changes
or serving meal trays.
In a major organization such as the one illustrated in Figure 9.1, several levels of employees
might fulfill specific duties in the nutrition care of patients. The nutrition team might
include registered dietitians, dietetic technicians, nutrition managers, nutrition hosts and hostesses,
and nutrition assistants and aides. (In many institutions, nutrition assistants and aides are
called clerks. Their functions are basically the same, even though the job titles are different.)
Each team member has specific responsibilities in patient care, but responsibilities merge to
serve all of the patients’ needs, as delineated in Table 9.1.
Role Responsibilities
The nutrition care manager monitors day-to-day nutrition care activities and usually supervises
other dietitians, dietetic technicians, and dietary managers, as well as patient nutrition hosts or
hostesses, associates, and assistants. In large organizations, the nutrition care manager usually
is a registered dietitian. In smaller or extended care facilities, this person may be a dietetic technician
with management skills or a certified dietary manager (C.D.M.). Many facilities are
adopting a flatter organizational structure, requiring the nutrition manager to assume additional
management responsibilities. This is especially the case in medium-sized facilities where
the manager may be responsible for patient service and nutrition management (Figure 9.2).
Clinical Nutrition Care Management
253