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

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Food Service Manual for Health Care Institutions 670 Table 20.1. Alternative Systems for Food Service to Patients Production Assembly and Distribution Reheating and Service Cook–serve Cook–chill Cook–freeze Assemble–serve Cook–chill Cook–freeze Assemble–freeze Customers Kitchen reheat Cold plating Source: Adapted from Herz, 1977. Insulated tray (insulated components) Unitized pellet Hot-cold cart Split-tray cart Tray heater cart Enclosed car or galley refrigeration Refrigerated cart Insulated cart Open or enclosed monorail cart Galley reheat Specialized dish-automated reheat module Insulated tray or refrigerated-reheat cart Not required Convection ovens Microwave ovens Infrared ovens Conduction ovens Distribution and service constitute the third functional subsystem. The distribution of the produced food to the customer depends on the following: • The type of production system used • The time and effort of meal assembly before service • The distance between the production and service areas • The amount of time between completion of production until service to the customer Equally important is knowing who the customers are. A customer is someone who purchases the goods offered by food service, such as food, or receives services offered, such as nutrition counseling. Customers are classified as external customers and internal customers. External customers are the end users of the products made by an organization. In a health care system, external customers are the inpatients and outpatients and their families. Internal customers are the individuals who provide direct service to the external customers; they belong to the organization that produces the service. Internal customers in health care are employees, suppliers, physicians, nurses, and other health care providers. Another type of customer, the captive clientele, is rare today because of our mobile society. Captive clientele are customers who must use a product or service because they have few to no other options. Customers, both internal and external, have other choices of where to purchase goods and services. Health care facilities exist to provide services to their customers. As a result, the food service department, in concert with nursing and other interdisciplinary professionals, needs to ascertain the following: • What is the best time to serve meals that will not interfere or delay other provided services? • How many meals should be served: three, four, or five?
• What is the best type of service to offer the customers: tray, dining room, or buffet? • What types of food should be served to meet the nutritional needs of the customers as well as religious, cultural, and other needs? • Where will the meal be served? • What department personnel will serve the meal? Nursing? Food service? Others? Health care food service may be in competition with other retail and commercial operations that are vying for the same customers. Employees may eat in the facility cafeteria, at an outside food service operation such as a fast-food outlet, or they may call out for services such as pizza. It is important for health care food service operations to maintain a certain percentage of participation. The participation rate refers to the proportion, usually a percentage, of a potential customer group that actually uses the facility’s food service operations. The participation rate has a significant effect on the operation’s revenue. Providing products and services that meet the needs of the customer also means that customers are loyal to the operation. When they enjoy the product and service, it means repeated patronage. What are the needs of customers? What do customers need, want, or like? Of course, the answer varies but includes some of the following: • Cost of product. The cost of the product must be priced to meet the financial capability of the largest majority of customers. • Preferences. Preferences, as the word implies, are very personal and they change with age, health, or financial status. • Choice, variety and expectations. Customers want a choice of food items made by a variety of food production methods as well as a variety of methods of service, such as buffets, self-service bars, and the like. Customers rate food against what they expect to purchase. • Medical conditions. Customers’ medical conditions can change their needs. Medical conditions may affect appetite, taste, and the enjoyment of the food. Special attention needs to be given to these customers. • Religious, cultural, and ethnic needs. Other factors besides hunger play a role in customers’ expectations and perceptions of the food service. It becomes the food service director and the dietitian’s job to provide food and service that may affect customers’ religious, cultural, and ethnic needs. Foods that will meet these needs should be incorporated into the menu. • Lifestyle and personal values. Personal values play a role in accepting food and service. Because of the hectic pace of today’s lifestyles, many customers eat in their automobiles while traveling from one place to another. The “grab-and-go” lifestyle needs to be addressed. Personal values such as vegetarianism, which is not based in religious beliefs but may be due to health reasons, moral beliefs, or other reasons, have increased with the baby boom generation. These preferences need to be addressed. • Comfort foods. Other preferences that may need to be addressed include the need for comfort foods to meet the emotional needs of customers, especially when they are stressed, afraid, or ill. • Language barriers. Language barriers may present a problem if a customer does not understand the menu items, has a problem hearing or seeing or other illness, or does not read or speak the language. • Other changes. Illness, medication, or age can cause changes in taste or food preferences. It is difficult to meet all the needs and expectations of all customers. However, food service directors need to recognize that providing food and service that meets the needs, wants, and perceptions of customers and does not harm them is not only their job but should also be considered a privilege. Distribution and Service 671
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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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Excerpt from Annual Food Service De
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Sample Monthly Operating Statement
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Labor Cost Analysis 334 Figure 11.5
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336 Exhibit 11.6. Example of a Mont
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Part Two Operation of the Food Serv
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352 Exhibit 12.2. Selection of Wast
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354 Exhibit 12.4. Selection of Wast
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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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Page 648 and 649: Food Service Manual for Health Care
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Page 705 and 706: quality. In recent years, food serv
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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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