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

Food Service Manual for Health Care Institutions
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The nutrition host or hostess serves trays and nourishments to patients and may be
involved in some food preparation. He or she also answers simple questions about the menu
and the services the food service department offers.
Both nutrition assistants and hosts may have completed an approved organization’s onthe-job
training program. Most associates and assistants are high school (or equivalent) graduates.
These individuals are generally supervised by the nutrition manager in institutions that
employ a large nutrition staff or by the director in institutions with small nutrition staffs.
All members of the nutrition team have an influence on, and a responsibility to, patients.
They need to know and practice good guest-relations skills, which include being friendly and
polite to patients and greeting them by name. Members of the team need to be knowledgeable
enough to answer questions about the hospital, provide guidance as needed, and promote a
positive impression of the facility.
At all times, the team must protect patients’ right to confidentiality. Confidentiality should
be stressed in training programs for team members, and the policy should be reviewed at least
annually. Some organizations are requiring staff to sign confidentiality statements.
The nutrition staff interacts with many other health care providers in the hospital, including
physicians, nurses, unit secretaries, pharmacists, therapists, and medical records personnel.
R.D.s (or, in some institutions, skilled and experienced dietetic technicians and C.D.M.s) may
be asked to communicate individual nutrition histories and care plans at patient care conferences,
on rounds, during family conferences, and in other situations.
Nutrition care managers also may be involved in outpatient and community services.
Outpatient services continue to grow in importance with decreased lengths of stay and the
increased number of patients seen in outpatient clinics. There are many advantages to instructing
patients in an outpatient setting. The dietitian is notified of the need for an instruction in
adequate time to provide the patient or family members (or both) with the details needed for
success. Early discharge may result in a patient’s not being emotionally prepared to accept drastic
changes in his or her lifestyle as they relate to food. An R.D. can provide more relaxed and
informative medical nutrition therapy instruction if the patient can be scheduled to return at a
later date.
Patient-Centered Care
In the past several years, special interest has been placed on developing patient-centered care
units to replace traditional nursing units. The principle behind such units is to centralize staff to
the units, thus minimizing the number of caregivers who interact with a patient. This allows the
caregivers to provide a better continuation of care and increases the patient’s comfort level. The
patient and family become familiar with caregivers and can expect to see them on a daily basis.
Patient-centered care units have implications for nutrition care and food service delivery.
Duties typically provided by a dietetic technician, or hostess, may be assumed by unit staff. For
example, a patient care assistant may be responsible for conducting nutrition screening. A support
person assigned specifically to the unit may assume the responsibilities of passing trays,
assisting with menu selection, producing and delivering between-meal feedings, and preparing
late trays. The nutrition care manager will have to consider the number of duties to be assumed
by these personnel and adjust staff accordingly. He or she also will have to assist with monitoring
the activities of these persons to ensure that the patient receives the appropriate level of care.
Clinical Manager as Leader
Providing leadership to the nutrition staff is a central function in that the nutrition care manager
must direct the staff to accomplishing the outcome goals (as discussed in Chapter 2). As
always, interpersonal skills and technical expertise are critical.
A high level of trust in the manager is necessary for managers to create a vision that leads the
nutrition staff to goal accomplishment. Trust in the leader’s knowledge is especially important