Transition from quality assurance to quality improvement: A dietetic department model

Abstract

As JCAHO transitions to quality improvement, the challenge of dietetic departments is to continuously evolve their programs. A comprehensive departmental program is presented which includes quality assessment and quality control indicators that met with the approval of 1993 JCAHO surveyors. Quality assessment results are tracked on numerous indicators, such as: patron, inpatient and outpatient nutrition clinic customer satisfaction; patient tray accuracy and temperature; and nutrition clinic appointment waiting time. One indicator, patient tray accuracy and temperature, developed into a Total Quality Management process improvement team project. Team composition includes eight personnel from all levels in the department, such as dietitians, trayline supervisors, and food service workers. Team recommendations to improve tray accuracy resulted in reorganization of food items on the patient selective menu, reallignment of food service equipment, and reorganization of trayline positions and duties. Quality control indicators are: training, kardex and menu accuracy, financial data, quarterly inventory level, supply budget versus actual, safety incidents, meals served, recipe pricing, and utilization of the dining room by customer group. A year by year transition is shown, 1991 to 1994. Current data is presented and displayed using graphics, such as trend charts and bar graphs, to analyze trends and identify further areas for improvement. The overall department program continually changes based on results and future needs and opportunities for improvement.