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

quality. In recent years, food service directors have investigated the option of tray service by
their own department’s employees, resulting in a decrease in time between the delivery of the
tray to the appropriate patient unit and presentation of the tray to the patient. Whichever
department personnel delivers the patient trays, the personnel needs to be trained in customer
services. This includes at least the following:
• Be well groomed without any perfume or aftershave
• Distribute the trays promptly once they are received on the unit
• Verify that the correct tray is reaching the correct patient (follow all Health Insurance
Portability and Accountability Act rules, a broad and complex set of federal privacy
rules established by the federal government and the organization)
• Assist patients only if trained to do so (open milk carton, and so forth)
• If a patient has a question or request, refer to nursing staff or dietitian
Regardless of the approach, there must be cooperation between these two departments to minimize
delays.
Additional Tray-Line Concerns
In a health care organization, challenges always occur in providing the patient meal service.
The type of menu system, changes in diet orders, and lengths of stay all influence patients’ satisfaction.
The selective menu system can be a problem, especially for the written and spoken
menu. Patients may be too sick to select, they cannot read the menu, they are unavailable to
select because of being out of their room, they have been newly admitted and missed the
advanced selection time, or their diet order has been changed. When any of the above happens,
patients receive a meal tray that may not meet their expectations. When the likes, dislikes, and
allergies of a patient are known, the clerk’s office will complete a menu based on this information,
which helps in patient satisfaction.
In hospitals, the average length of stay has steadily decreased from 7 days to 4.5 days.
Some patients may be in longer or others for just a day. Some of the shorter-stay patients may
not receive any meal service other than liquids, and others may not have the opportunity to
select their food items because of reasons previously mentioned.
Patients can become confused when using a written selective menu because of the advanced
selection required, which is usually for the next day. They select a meal in advance, and when the
tray is received, patients are disappointed because they did not receive what they thought they had
selected. This colors their perception of the operation because they think a mistake has been made.
When using the written selective menu system, the clinical staff needs to communicate effectively
to patients how the system works. When the spoken menu is used, this problem is reduced.
Patients may not have been told that their diet order has been changed or that an ordered
test will interfere with meal service. They may perceive when they do not receive the food they
selected that a mistake has taken place. Because of some last-minute changes, patients may receive
a late tray. Late trays are usually served after all other patients’ meal trays have been served.
Monitoring for Performance
Accuracy, quality, and productivity for patients’ meal service can be objectively measured. One
method that is frequently used is trays per minute. Tray per minute is defined as how many
trays are produced during each minute of a tray assembly process. The simple calculation
would be as follows: the time the tray line started, the time the tray line ended, and the total
number of trays assembled. To calculate, determine the time in minutes and divide the number
of trays by the total number of minutes. For example, the tray line starts at 11:00 A.M. and was
finished at 12:30 P.M. This would be a total of 90 minutes, during which 400 trays were assembled.
Trays per 90 minutes (400) are divided by 90, equaling 4.4 trays per minute. This figure
can be used as a benchmark among peers and to determine if changes need to be made.
Distribution and Service
677