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

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Food Service Manual for Health Care Institutions 346 institutional, and industrial sources.” Thus, all the waste generated in food service operations, excluding chemicals, is municipal solid waste. Increased disposal fees, landfill shortages, government regulations, and consumer demands for a safer environment are cited as priorities that require immediate action on the part of health care food service facilities. During the 1990s, the cost of placing waste materials in a landfill, called a tipping fee, more than tripled in some localities. Tipping fees (the costs of transporting and discarding municipal solid waste at transfer stations or landfills) increased about 5.9 percent during 1992. They are expected to continue to escalate as stricter government regulations have been passed that are associated with Subtitle D of the Resource Conservation and Recovery Act (42 USC, chapter 82), federal legislation that was adopted in 1976 and amended in 1984 by the Hazardous and Solid Waste Amendments. This act is the statutory basis the EPA used to establish a comprehensive program to control hazardous waste from generation to its final disposal. Because the amendments are enforced, local and state governments must develop solid waste management plans at the same time that the cost and difficulties of siting new landfills are increasing. Methane gas from landfills can pollute the area. Toxic leachates can contaminate water supply. Approximately 50 to 65 percent of the waste (weight and volume) generated in commercial and noncommercial food service operations is food waste. Paperboard and corrugated cardboard are two materials that contribute most to the volume of packaging waste. Other packaging materials found in health care food service waste include tin, plastic, aluminum, glass, and styrofoam. Some factors influencing the volume of each type of material disposed of include the type of service ware (reusable or disposable) used for the service of patient and nonpatient meals; type of production system; availability of volume reduction equipment such as compactors, pulpers, and disposals; accuracy of forecasts and production and service controls, such as use or disposal of leftover food; portion control; and reuse of plastic and glass containers after sanitization. The waste management industry estimates that from 0.5 to 1.5 pounds of total waste is generated per meal served, depending on the type of food service operation. Research at noncommercial food service facilities found an average of 0.39 to 0.61 pound per meal, or 0.002 to 0.03 cubic yard per meal of total waste (production, service, and packaging). Table 12.1 compares the composition of waste generated in two noncommercial operations. The volume of packaging waste can be reduced by about 50 percent if corrugated cardboard boxes are collapsed and tin cans are crushed. Because most health care operations are charged on the basis of dumpster capacity and waste disposal pickup frequency, their waste disposal costs would be reduced if waste volume were decreased. However, the cost of waste management equipment (such as compactors and balers) and labor costs must be analyzed and compared with waste-hauling expenses. An integrated waste management system designed to decrease the quantity of waste to be disposed of is recommended. About 80 percent of municipal solid waste is landfilled, 10 percent incinerated, and 10 percent recycled. According to the EPA, the term integrated system refers to “complementary uses of a variety of waste management practices to safely and effectively handle the municipal solid waste stream with the least adverse impact on human health and the environment.” In such a system, renewable natural resources are not disposed of as waste but are reused, recycled, and composted. Incineration is one option for reducing the volume of waste while capturing energy. In an integrated system, burying waste in landfills should be the last alternative. Figure 12.1 illustrates the components and order of preference of an integrated solid waste management system. A brief discussion and examples of source reduction and reuse (recycling and composting) are presented in the following sections because these are options that food service directors can implement. The food service director needs to assess the feasibility of combusting packaging materials if the health care facility has an incinerator. Because of its water content, food waste usually is not combusted.
Table 12.1. Percentage Volume of Materials Disposed of by Two Noncommercial Food Service Operations Environmental Issues and Waste Management Material College or University Study, % a School Study, % b Cardboard 44.6 27.5 Food waste from production and service 21.3 22.9 Paper 13.1 8.4 Paperboard 8.6 23.4c Plastic (including film) 7.5 4.0 Metal (including tin and aluminum) 4.3 6.8 Miscellaneous (including wood, glass, and so on) 0.6 7.0 aUniversity food service operation is a centralized conventional food production system serving an average of 3,300 meals per day. Data are based on a fourteen-day waste-stream analysis, excluding liquid waste. bSchool data are based on analysis of average waste generated for ten days in six schools serving an average of 4,500 lunches per day. cGable-top milk cartons made up greatest percentage of waste. Note: Volume is uncollapsed because facility had no compactor. Figure 12.1. Integrated Solid Waste Management System Source Reduction Reduce the amount of solid waste generated through source reduction efforts and reuse of containers or materials Recycling Recycle and compost appropriate components of waste stream, including food waste and packaging materials Combustion Combust the balance of waste that cannot be reduced or recycled Landfill Bury waste that cannot be reasonably reduced, recycled, reused, or burned 347
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Food Service Manual for Health Care
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Contents Figures, Tables, and Exhib
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Figures Figures, Tables, and Exhibi
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8.3. Excerpt from a Performance Eva
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19.1. Flow of Products in Food Serv
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6.2. Sample Job Description and Job
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Foreword It is truly an honor for m
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Preface The health care environment
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Acknowledgments The following indiv
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Introduction This edition of Food S
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Chapter 14 explains safety, securit
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Part One Management of the Food Ser
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Chapter 2 Leadership: Managing for
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oriented or people oriented and tha
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in an orderly manner, to manage the
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so as to anticipate and plan for fu
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Planning Through planning, the futu
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Reward or punitive power is the str
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• Building a team mind-set • Co
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of these three factors jeopardizes
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McClelland claims that “in some b
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• Define limits of what situation
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who have seen programs, processes,
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Leebov, W., and Scott, G. Health Ca
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Chapter 4 Quality Management A prim
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Figure 4.2. Deming’s PDCA Cycle A
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Move to CQI in Health Care The term
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care. Often these choices conflict.
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Supplier Partnerships A customer or
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analysis. Key benefits to having a
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Exhibit 4.1. Team Documentation For
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Figure 4.3. CQI Flowchart Quality c
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Exhibit 4.2. Inspection Criteria fo
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Once the departmental strategy is w
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Before hiring a consultant, managem
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selected for the issue in question.
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Figure 4.6. Cause-and-Effect Diagra
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not identical. CMS standards vary i
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the concurrent stay using critical
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Garvin, D. A. Managing Quality: The
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Chapter 6 Organization and Time Man
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Figure 6.1. Functional Organization
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Process departmentalization allows
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Characteristics of High-Performance
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outcome. Team building should conce
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necessary to assure that food servi
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Figure 6.4. Organization of a Small
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Figure 6.9. Organization of a Food
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skilled-nursing unit in the hospita
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service operations other than the c
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Distributing Authority Authority, t
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• What types of service does the
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Exhibit 6.1. (continued) Why? Which
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Exhibit 6.2. Sample Job Description
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equires, and the best means of moti
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Calculating FTE Needs Full-time equ
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Exhibit 6.3. Sample Productivity Fo
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Figure 6.10. Example of a Daily Sch
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Figure 6.12. Example of a Work Sche
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Figure 6.13. Example of a Manager
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Figure 6.14. Example of a Food Serv
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Lane, B. Managing People. Sunnyvale
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Chapter 9 Clinical Nutrition Care M
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Planning As already shown, a manage
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• Room service for inpatients and
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Figure 9.2. Organizational Chart—
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among professional staff whose memb
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Designing a Nutrition Services Paym
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Nutrition service professionals can
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Figure 9.4. (continued) Food histor
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Figure 9.6. Goal of Nutrition Scree
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Table 9.3. Physical Signs Indicativ
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• A constant and valuable source
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earlier, the patient may need to be
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• Assessment: what the data mean
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• Gives patients greater protecti
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Chapter 10 Management Information S
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Elements of an MIS In addition to t
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automatically to report all vending
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Usually, systems investigation is t
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Function Function refers to the spe
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located in a relatively clean envir
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Figure 10.2. Sample Purchase Order
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Figure 10.3. (continued) Inventory
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Figure 10.5. Beef Barley Soup, Scra
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Page 350 and 351: Excerpt from Annual Food Service De
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Figure 13.6. HACCPs for Cook-and-Ch
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Restaurant-Style Health Care Menu f
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Chapter 16 Product Selection Produc
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Figure 16.2. Procurement Subsystem
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The USDA organic seal appears on fo
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Figure 16.5. Grade Stamps and Inspe
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A carcass of good grade is blocky a
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e accomplished by scalping, which p
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Table 16.1. (continued) Meat Descri
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harvesting and processing. This tas
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Poultry Poultry products or domesti
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Weight and Size of Shell Eggs Shell
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Table 16.3. Manufacturing and Inspe
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Eggnog Eggnog contains milk product
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Natural, Processed, and Imitation C
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Table 16.4. Common Cheeses Cheese D
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• Bamboo shoots • Bean sprouts
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Celery Celery, mainly the Pascal va
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Size is another factor that affects
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Fruit and Vegetable Specifications
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Corn, , sunflower, and safflower oi
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Organic Flour Organic flour is from
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Relatively small quantities of wild
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Herbal Tea Herbal teas do not come
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alloy, the result is stainless stee
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Summary Food service purchasers mus
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U.S. Department of Agriculture, Agr
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Chapter 18 Receiving, Storage, and
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Figure 18.1. Receiving System Items
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Merchandise Receipt Receiving, Stor
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Receiving, Storage, and Inventory C
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disposed of promptly. The storeroom
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Issuing of Food and Supplies Receiv
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A perpetual inventory record alone
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Inventory Turnover Slow inventory t
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Figure 18.2. Comparison of Par Stoc
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Receiving procedures must ensure th
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Appendix 19.1 A Culinary Glossary
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Hors d’oeuvre Side dish or relish
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Chapter 20 Distribution and Service
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• What is the best type of servic
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Figure 20.1. Typical Tray Makeup Li
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Tray Delivery Because the point of
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quality. In recent years, food serv
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carrying their filled trays to thei
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plate is not used. Place coffee or
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minimized. The type of meal service
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Standards that should be monitored
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Exhibit 20.2. Sensory Assessment fo
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Herz, M. L. Analysis of Alternative
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Index A ABC method, 603 Absenteeism
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CDC (Centers for Disease Control an
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Delivery of products, 575-576 Deman
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Exit interviews, 239, 240e Exotic v
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described, 461; developing, 461-463
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Horizontal communication tract, 194
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Main-dish salads, 652 Maintenance-m
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Nutrient analysis, 296 Nutrition aw
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PERT (program evaluation and review
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(1993), 4, 203; Federal Employee Po
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Standing operational planning. See
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Waste audit, 349 Waste-handling equ
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