HACCP implementation in public hospitals: A survey in Crete, Greece

Abstract

In the island of Crete, Greece, 7 major hospitals offer their services in conjunction with a number of public health centers. Between 2004 and 2009, personnel of the Technological Education Institute (TEI) of Crete, visited these hospitals and carried out food safety surveys. Our basic aim was to evaluate the degree of compliance to food safety and to investigate the actual difficulties that exist during the HACCP implementation process, in hospital mass- catering systems. Evaluation was based on personnel interviewing, checklist screening and microbiological analysis of food and water samples. Two of the hospitals we surveyed were already following HACCP methodology, two had just started to introduce the system and the remaining three were planning HACCP introduction at the time. Some potential problems were detected and unfortunately actual food-safety problems did occur in these hospitals in the same period. The overall results of the above screening have been only partially presented to the moment. Based on the actual findings and experiences of our survey, as well as relevant literature research we emphasize some elements, crucial for implementing and successfully operating HACCP systems in hospitals, as: Managerial commitment; availability and enforcement of risk-informed regulations; hospital registered-dieticians, food technologists, and hygienists involvement; patients menu's planning; hospitals kitchen and food-management personnel training; integration of HACCP procedures with other hospital functions; hygiene supervision by central and regional public health authorities; external food delivery/introduction into the hospital; handling of minimally processed food; regular inspections of kitchenware; food storage conditions; food remaining disposal etc. Last but not least, a crucial element was the absence of HACCP certified suppliers for all food products, especially in the smaller cities.