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

Figure 9.2. Organizational Chart—for a Medium-Sized Facility
Line
servers
Patient feeding
supervisors
Cleaning
technicians
Registered
dietitians
Registered
dietitian/manager
Registered
dietetic
technicians
Diet
clerks
The registered dietitian (R.D.) functions as the team leader and is responsible for developing
nutrition care plans, performing nutrition assessments, counseling patients, formulating
educational materials, and performing research. Dietitians often function either as a nutrition
specialist or as an administrative or management specialist. Whether the dietitian selects nutrition
or management as an area of focus, he or she may be employed in hospitals, extended care
facilities, fitness centers, outpatient clinics, weight management clinics, home health care, food
and nutrition product or equipment sales, or with food service management companies. A dietitian
who selects health care as an area of employment must have management abilities,
whether his or her focus is in the nutrition or administrative area. To provide effective quality
nutrition services, dietitians must network and work with colleagues in the community.
Employment in health care nutrition may be full-time, part-time, or on a consultant basis.
The dietetic technician works with the dietitian to provide nutrition care services to
patients. A registered dietetic technician (D.T.R.) is technically skilled in nutrition care and has
an associate’s degree from a program approved by the American Dietetic Association. In addition,
the dietetic technician must pass a registration examination administered by the
Commission on Dietetic Registration. The D.T.R. is often responsible for conducting nutrition
screening, menu editing, planning between-meal feedings, and nutrition counseling. The role
of the D.T.R. varies significantly depending on the size of the organization. In smaller facilities,
the D.T.R. may have supervisory responsibilities in addition to the nutrition care of patients.
The certified dietary manager has completed a course of study and passed a national certifying
examination. The type and size of an organization and the state where a C.D.M. is
employed will determine his or her role in nutrition care. He or she may gather data for use by
an R.D. or a D.T.R., conduct interviews with families and patients for nutrition histories, conduct
routine nutrition assessments, identify problems and needs, implement diet orders, use
standard nutrition care procedures, chart in the patient’s medical record, and be a member of
the nutrition team.
Patient nutrition associates and assistants process patient menus, diet order changes, nourishment
orders, and late tray requests. In some facilities, especially those with decentralized
meal service, these positions may assume the roles outlined for the nutrition host or hostess. In
other facilities, they may assume duties strictly within the department and are referred to as
diet clerks.
Clinical Nutrition Care Management
Hosts or hostesses
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