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

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Food Service Manual for Health Care Institutions 356 Hazardous Waste Management Handling and disposing of hazardous waste present unique challenges to the health care industry. Even though hazardous materials make up only 10 to 15 percent of hospital waste, waste management procedures have become more complex and costly following enactment of the Medical Waste Track Act of 1988, an amendment to the Resource Conservation and Recovery Act. The cost of hazardous waste disposal is three to five times more per ton than for other types of waste generated. Hazardous materials include infectious waste; diagnostic equipment batteries; laboratory solvents and acids; therapeutic radioactive chemicals; and chemicals used for cleaning and sanitizing equipment, surfaces, service ware, utensils, and so on. Medical waste disposal has been a sensitive public issue since 1987 when hypodermic syringes, containers of blood, and other medical effluvia washed ashore on East Coast beaches. After enactment of the Medical Waste Track Act, the EPA issued “Standards for the Tracking and Management of Medical Waste” (codified at 40 CFR § 259). These standards provide health care facilities and other operations generating medical waste with definitions and procedures for disposal, transportation, incineration, and management of this type of waste. In general, the food service department is not directly affected by these regulations, what with its limited (if any) contact with medical waste. Nonetheless, managers should be familiar with their organization’s policies and procedures regarding medical waste. Either the food service director or a department representative should participate on the facility’s infection control committee or continuous quality improvement team and provide input regarding service of meals to patients in isolation and the handling of soiled service ware and leftover food (in most instances, isolation trays are handled the same as other medical waste). The director should see to it that policies and procedures for handling and disposing of infectious waste are communicated to all food service employees. Food service departments are influenced more by hazardous chemicals, defined by the Occupational Safety and Health Administration (OSHA) as “any chemical [that] is a physical hazard or health hazard.” Hazardous chemicals require the director to implement specific policies and procedures for purchasing, storing, handling, and disposing of all chemical compounds used in the operation. In addition, OSHA standards (known as “hazardous communication standards”; also referred to as the “right to know”) mandate that all employers provide information to their employees concerning hazardous chemicals through an established hazardous communication program. In turn, manufacturers and importers of chemicals are mandated to assess the hazard potential of the chemicals they produce or import, information that is communicated to end users on material safety data sheets (MSDSs). (See Chapter 14 for more information.) Part of a sample MSDS is shown in Exhibit 12.5. When ordering chemicals (for example, detergents and other cleaning compounds), the purchasing agent should request MSDSs for products for which none are already on file at the facility. Multiple copies of each MSDS are helpful so that a copy is available in the work area where the chemical is used as well as being on hand for use in developing training materials and instructional guides for using a particular chemical. (The recommended content of a training program and the food service director’s responsibilities related to OSHA’s hazardous communication are discussed in Chapter 14.) Some distributors of cleaning supplies have developed training materials and MSDS manuals for their products. In addition to cleaning and sanitizing chemicals, the food service director should be familiar with and have on file MSDSs for chemicals used by exterminators. (Storage of chemicals is discussed in Chapter 13.) The food service manager will need to work with facility maintenance or the waste hauler to determine how to dispose of empty chemical containers. In most instances, these should be disposed of following the same procedure as for other hazardous waste. Chemical containers should never be rinsed and used to store food.
Exhibit 12.5. Material Safety Data Sheet (Excerpt) Source: U.S. Department of Labor, Occupational Safety and Health Administration, 1985. Environmental Issues and Waste Management 357
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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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Patients’ tray cards can be print
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een entered into the menu, each ite
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Bibliography Alexander, J. Selectin
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Page 334 and 335: Food Service Manual for Health Care
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Page 354 and 355: Sample Monthly Operating Statement
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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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