Health Care Foodservice Operations Research Articles

Development, Validation, and Testing of a Self-Assessment Tool to Measure Food Safety Beliefs, Attitudes, and Behaviors in Health Care Food Service Operations

The neutropenic diet has long been a dietary prescription for immunocompromised patients. However, its effectiveness and consistency have been constantly challenged. Researchers and health care policymakers call for liberalization of the neutropenic diet, which shifts risk management strategies from excluding "high-risk" food items to focus on safe food handling. The responsibility of food safety falls on food service workers in a health care setting. The objective of the present study was to develop and conduct psychometric testing to determine the validity and reliability of a self-assessment survey instrument tool targeting beliefs, attitudes, and behaviors of health care food service workers regarding safe food handling practices. This survey validation study was conducted in four phases. First, the tool was developed based on the Theory of Planned Behavior. After the initial draft, the survey was tested to establish face validity and test-retest reliability to measure temporal stability. The 40-item survey was then pilot tested to assess internal consistency and construct validity. Pilot testing was conducted over a 16-month period on 211 health care food service workers across six acute care hospitals that serve immunocompromised people. The original survey comprised 46 items. Six items were removed due to low content validity scores and temporal instability. Pilot testing revealed acceptable internal consistency (Cronbach's alpha = 0.79). The linear regression model was a good fit (P ≤ 0.0001) after assumptions were tested and met to predict behavior from attitude. A reliable and valid self-assessment survey instrument tool was developed for use in a health care food service operation. Results of this tool can help organizations pinpoint areas in which they can improve food safety practices of food service workers who serve immunocompromised people.

Influence of Nutrition Information Pre- and Post-Purchase in Retail Healthcare Foodservice Operations

Influence of Nutrition Information Pre- and Post-Purchase in Retail Healthcare Foodservice Operations

Time-varying production efficiency in the health care foodservice industry: A Bayesian method

Abstract Cost containment, budget control, and improvements in efficiency are key drivers of the way health care foodservice operations (internal hospital foodservice departments that produce/reheat food and deliver them to patients) will respond to emerging economic and population trends. These factors are the motivation for this study, which aims to assist health care policy makers in identifying operational strategies for efficiency improvements. The study applies a Bayesian method in deriving to efficiency estimates, using panel data on key Australian hospitals. The results show that the model satisfies the theoretical economic requirements. Important relationships are identified between the level of meal production and other input and environmental variables. The efficiency results indicate that the performance of health care foodservice operations is improving over time and reached its highest level in the operating year 2007. The paper identifies some factors related to efficiency improvements, and offers some suggestions for future improvement strategies.

Improving the accuracy of DEA efficiency analysis: a bootstrap application to the health care foodservice industry

This article analyses the efficiency of health care foodservice operations and its determinants using a Data Envelopment Analysis (DEA) bootstrapping approach. The purpose of using the bootstrapping approach is two-fold: first, to obtain the bias corrected estimates and the confidence intervals of DEA-efficiency scores and second, to overcome the correlation problem of DEA-efficiency scores and to provide consistent inferences in explaining the determinants of health care foodservice efficiency. The approach was implemented on a sample of 89 health care foodservice operations. The results showed the presence of inefficiency in the sample, with an average efficiency level of 72.6%. Further, the results from analysing the determinants of health care foodservice operations provided policy implication regarding the factors that might improve the efficiency of health care foodservice operations.

A bootstrapped metafrontier model

The major aim of this article is to apply the bootstrapping methodology to the estimation of the metafrotnier model. The article has two parts. The first part deals with the technical details of the metafrontier model, and the second presents the application of the model using cross-sectional input/output data on health care foodservice operations. The results obtained by bootstrapping the metafrontier model are presented and discussed.

Overcoming the limitations of efficiency modeling in the health care foodservice industry

PurposeThis paper aims to reflect on the sources of the technical inefficiency of health care foodservice operations, using a sample of Australian and American hospitals.Design/methodology/approachThe paper applies the stochastic frontier model to reflect on the technical inefficiency and its sources. The advantage of the model is that it allows the simultaneous parameters estimation of technical efficiency as well as the factors that explain variations in technical efficiency. A set of hypotheses are tested to ensure the applicability and suitability of the suggested model. Then the model parameters are estimated, discussed and checked against the theoretical requirements and the literature.FindingsResults show that all the variable coefficients are correctly signed and that the average technical efficiency is around 83 percent for Australia and 80 percent for the USA.Practical implicationsThe technical efficiency results, according to the introduced model, suggest that health care foodservice operations in both countries are not operating at a full efficient level. The results also reveal that factors such as manager's education, manager's experience, and size have a direct impact on reducing the level of technical inefficiency of these operations.Originality/valueThis paper overcomes the limitations of the existing efficiency techniques in the area of health care foodservice and also provides policy implications by emphasizing on the sources of technical inefficiency of health care foodservice operations for Australia and USA.

Creating Sustainability Strategic Plans for Healthcare Foodservice Operations

Creating Sustainability Strategic Plans for Healthcare Foodservice Operations

A metafrontier model to assess regional efficiency differences

PurposeThe major aim of this paper is to model, estimate and compare the technical efficiency and technology gap ratios of health care foodservice operations that operate in different Australian regions.Design/methodology/approachThis paper uses a metafrontier model to analyse the difference in health care food efficiency across the various Australian regions. The interesting feature of this model is that it allows for the estimation of firms' efficiency in of various groups that might differ in technology and other production environments. In testing the model, cross‐sectional input/output data were used reflecting on the operational characteristics of health care foodservice operations.FindingsThe estimation process was initially supported by a hypothesis test which confirmed the validity of the metafrontier model in comparing the efficiency of the different outlined groups. Results showed that operations in the states of NSW and Victoria are producing on average 85.6 per cent of their potential output with respect to the metafrontier technology. The ratio is lower in other states with an average of 73.4 per cent. The average technical efficiency for operations in NSW and Victoria is also higher both in terms of local (87.8 per cent) and metafrontier technologies (66.6 per cent).Originality/valueThe paper is the first to introduce the metafrontier model to the health care foodservice area, especially for Australian regions.

Cost efficiency modeling in health care foodservice operations

Cost efficiency and cost data in the health care foodservice sector have many interesting features. Traditional productivity approaches and empirical studies are yet to address many of these features, as they are limited to partial ratios and restricted parametric techniques. In this paper, we introduce and demonstrate the Stochastic Frontier Approach to this sector, and analyze the level of cost efficiency and its determinants. The approach is tested in a cross-sectional data set from a sample of 101 health care foodservice operations in Australia and the USA. Results indicate that the average level of cost efficiency is around 76.5% which suggests that health care foodservice operations could reduce their input costs by as much as 23.5% without decreasing their total output. Further, the coefficients of the inefficiency component, estimated simultaneously with the stochastic frontier model, indicate that both the level of manager's experience and the level of manager's education are significant determinants of cost efficiency.

Benchmarking in health care foodserviceoperations

Benchmarking in health care foodserviceoperations

Trends in the Convenience Store Industry

ABSTRACT Noncommercial foodservices are operating convenience stores to meet consumer demand, remain competitive, and increase revenue. College and university, business and industry, and healthcare foodservice operations are revolutionizing outmoded cash operations by incorporating convenience store concepts. Noncommercial foodservice operations increasingly view commercial food-services as their competitors. Shrinking budgets under the current political climate motivate noncommercial foodservices to develop innovative strategies for generating revenue. The convenience store offering branded quick-service food is emerging as a solution. Food-service directors employed by colleges and universities, business and industry, and healthcare should keep abreast of opportunities and innovations occurring within the convenience store industry. Operators should incorporate continuous quality improvements with a focus on satisfying consumer demand within all components of their operations, including convenience stor...

Patients Respond Enthusiastically to Nutrition Assistant Program

LEARNING OUTCOME: To describe a service program which increases patient satisfaction with foodservice.Patient satisfaction is a key outcome indicator for Healthcare foodservice operations. Measurement of satisfaction with foodservice is complex and is more than a matter of food quality. Attitude of the staff who deliver menus and meals correlates highly with patient satisfaction. Patients’ perception of the attitude, warmth, efficiency, attentiveness, helpfulness, knowledge, and courtesy of staff influences their overall satisfaction with foodservice.To enhance patient satisfaction with nutrition services at this 420-bed acute care facility, an interdisciplinary team was formed. Using continuous quality improvement methods, the team established the mission of the Nutrition Assistant (NA) program, the NA job responsibilities, qualifications, and training process. Interviews were conducted using an established format and NAs were selected and trained. Nutrition Assistants are assigned to specific patient care units and provide all meal-related services to the patients. The NA for a given unit serves all three meals for the day, assists patients with menu selections, places orders for room service via the computerized order entry system. Duties also include daily inventory and replenishing of floor supply. Nutrition Assistants work collaboratively with the nursing staff and the dietitian or dietetic technician assigned to their unit.Patient satisfaction with Nutrition Services staff has risen significantly with the NA program. Nutrition Assistants regularly receive letters of appreciation from patients and their families. The program has demonstrated enhanced service in this era of cost containment.

Value-Added Services Provided to Healthcare Foodservice Operations

Foodservice distributors have introduced a variety of value-added services to enhance their competitiveness in the healthcare market. Value-added services as defined for this study are unique services which extend the opportunity to the foodservice distributor to provide a variety of offerings which will develop a partnership with the customer. The availability and importance of selected value-added services provided to the healthcare foodservice market were determined. Examples of value-added services currently available to healthcare foodservice operations include direct mainframe tie-ins, product cutting, rebate tracking, product specialists, and volume incentives. A validated questionnaire was mailed to a national sample of 473 healthcare foodservice administrators and 818 distributors' divisional offices. A total of 231 and 97 foodservice administrators and distributors, respectively responded to the survey. Descriptive statistics, analysis of variance, Chi Square, and Mann Whitney U were used for data analyses. Foodservice administrators and distributors rated the nutritional analysis, optimum window for regular deliveries, and volume incentives as the most important value-added services available to the healthcare market. Mean importance rankings were significantly different between the two groups. Foodservice respondents rated valued-added services that could result in cost savings to the operation or provide a competitive edge as most important. Most foodservice respondents were not aware of the availability of many of the value-added services. The majority of the foodservice respondents indicated that they were not willing to pay for value-added services. At least 35% of the respondents noted that they would be willing to pay for custom computerization and software, sanitation certification, and operational consulting. These results indicated a need for distributors to more effectively market their value-added services and for foodservice directors to investigate the cost effectiveness of obtaining additional value-added services currently available and to communicate the types of services desired from distributors.