Hospital Foodservice Research Articles

Prevalência de sintomas osteomusculares entre trabalhadores de um Serviço de Nutrição Hospitalar em São Paulo, SP

RESUMO OBJETIVO: identificar a prevalência de sintomas osteomusculares entre trabalhadores de um serviço de nutrição de um hospital público. MÉTODO: estudo epidemiológico transversal com aplicação de questionários para 115 trabalhadores (representando 89% do quadro de pessoal) do serviço de nutrição de um hospital de cardiologia, em São Paulo, em 2007. O instrumento utilizado foi baseado no Questionário Nórdico de Sintomas Osteomusculares de Kuorinka et al. (1987) para identificação de dor ou desconforto relacionados ao trabalho, localização e tipo de queixa, além de caracterizar a frequência, a intensidade e a duração dos sintomas. RESULTADOS: a média da idade dos trabalhadores foi de 37 ± 9,8 anos, 81% eram do sexo feminino, 58% possuíam Ensino Médio e o tempo médio de trabalho foi de 9,3 ± 7,5 anos em jornada de trabalho de 40 horas semanais. Do total de participantes, 89% referiram dor ou desconforto relacionados ao trabalho no último ano em membros inferiores (65%), ombros (55%), região lombar (39%), região cervical (37%), mãos/punhos/dedos (29%), coluna (28%), antebraço (28%) e cotovelos (10%). O movimento de andar e transportar carga foi a causa mais citada para os sintomas (31%). CONCLUSÃO: entre os trabalhadores do serviço, a prevalência de sintomas osteomusculares foi alta, principalmente nos membros inferiores e nos ombros. Recomendam-se novas pesquisas que incluam a avaliação do ambiente e das atividades desenvolvidas pelos trabalhadores.

Food safety control practices in in-house and outsourced foodservices and fresh vegetable suppliers

The volume of meals produced by foodservices has been increasing. However, there have been cases of food poisoning associated with these establishments, and they are sometimes caused by the consumption of vegetables. The objective of this study was to verify if in-house and outsourced foodservices implement food safety control practices and supplier development strategies. Companies in Campinas and its four districts were studied because of the large foodservice market. A total of 39 foodservices were investigated (22 outsourced and 17 in-house; of these, 12 were hospital foodservices). Good Manufacturing Practice was used by 53.8% of the sample and of these, 15.4% also used Hazard Analysis and Critical Control Points. Companies that produce more than 600 meals per day are more likely to use prerequisite programs and Hazard Analysis and Critical Control Points. Of the companies that use some food safety control practice, only 8 (26.7%) carried out vegetable supplier development. Strategies are needed to promote the use of food safety control practice and suppliers development.

Satisfying Customers and Lowering Costs in Foodservice: Can Both Be Accomplished Simultaneously?

Tech-savvy and consumer-focused, successful registered dietitians (RDs) prove every day that customer service and cost-control are not necessarily oil and water. From public school systems marketing their services with Web-based menus, to research hospitals juggling sheer diversity through multicultural kiosks, the winning strategy is one that caters to the customers in a profitable manner to stave off cost increases. Meanwhile, guiding and educating the customer base is a crucial element to meeting its expectations, and celebrating one's accomplishments makes for good advertising. This article provides information on satisfying customers in both school foodservice and hospital foodservice settings while providing ways to lower expenditures.

Environmentally Friendly Health Care Food Services: A Survey of Beliefs, Behaviours, and Attitudes

There is increasing global interest in sustainability and the environment. A hospital/health care food service facility consumes large amounts of resources; therefore, efficiencies in operation can address sustainability. Beliefs, attitudes, and behaviours about environmentally friendly practices in hospital/health care food services were explored in this study. Questionnaires addressed environmentally friendly initiatives in building and equipment, waste management, food, and non-food procurement issues. The 68 participants included hospital food service managers, clinical dietitians, dietary aides, food technicians, and senior management. Data analysis included correlation analysis and descriptive statistics. Average scores for beliefs were high in building and equipment (90%), waste management (94%), and non-food procurement (87%), and lower in food-related initiatives (61%) such as buying locally, buying organic foods, buying sustainable fish products, and reducing animal proteins. Average positive scores for behaviours were positively correlated with beliefs (waste management, p=0.001; food, p=0.000; non-food procurement, p=0.002). Average positive scores for attitude in terms of implementing the initiatives in health care were 74% for building and equipment, 81% for waste management, 70% for non-food procurement, and 36% for food. The difference in food-related beliefs, behaviours, and attitudes suggests the need for education on environmental impacts of food choices. Research is recommended to determine facilitators and barriers to the implementation of green strategies in health care. As food experts, dietitians can lead changes in education, practice, and policy development.

Ergonomic Intervention in a Hospital Food Service in São Paulo, Brazil, and Its Effects on Musculoskeletal Symptoms

Introduction: Hospital food service workers have high level of physical, cognitive and mental demands that are associated with musculoskeletal disorders. The objective of this study was to introduce improvements in the working conditions in a hospital food service and to evaluate the workers’ perceptions and its effects on musculoskeletal symptoms. Method: this study was performed in a public cardiac hospital in Sao Paulo, Brazil, after its approval by the Ethics Committee. The data were collected by questionnaires and ergonomic analysis of the work. The questionnaire included: socio-demographic, work-history, work conditions, musculoskeletal symptoms and job satisfaction. A hundred and fifteen questionnaries were applied from 130 workers. The work ergonomic analysis was carried out in accordance with Guerin et al (2001), by means of interviews, observations of kitchen working conditions and biomechanical analyses. Based on the results, interventions have been undertaken by means of a participatory ergonomic approach over one year. After this, another ergonomic analysis was carried out and 89 workers (77%) answered a new questionnaire that also included questions about their perception of the improvements. Data analysis descRitoRes: Engenharia humana. Servico hospitalar de nutricao. Trabalhadores. Doencas profissionais. Transtornos traumaticos cumulativos. Saude do trabalhador. Condicoes de trabalho. Questionarios. Saude, Etica & Justica. 2008;13(2):106-8. Isosaki M. Intervencao nas situacoes de trabalho em um Servico de Nutricao Hospitalar de Sao Paulo e repercussoes nos sintomas osteomusculares.

Room Service Increases Nursing Satisfaction with Hospital Food Services

Participants will be able to determine the impact of an on-demand patient meal service on nursing satisfaction with hospital food services.

A Hospital Food Service Program to Improve Customer Service and Consumer Satisfaction Scores

A Hospital Food Service Program to Improve Customer Service and Consumer Satisfaction Scores

Room Service Implementation: Important Aspects Identified by Hospital Foodservice Directors

Room Service Implementation: Important Aspects Identified by Hospital Foodservice Directors

Hospital Foodservice and Patient Experience: What's New?

In 2003, hospital food quality ranked lowest of 10 items measured on a scale of satisfaction, according to a Press Ganey survey of 1.8 million patients ( 1 Press GaneyPress Ganey survey shows patients see room for improvement in hospital quality. Health Care Strategic Management. 2003; 21: 6 Google Scholar ). Since then, hospital foodservice has dramatically remade itself, employing chefs, using more fresh and seasonal ingredients, offering cook-to-order room service, and increasing the number of choices for each meal ( 2 Hill M. Hospitals try cooking up better food for patients. http://news.yahoo.com/s/ap/20110310/ap_on_re_us/us_fea_food_hospital_cuisine_1 Google Scholar ). At California-based Kaiser Permanente, for example, the menu includes citrus-marinated pork loin and barley pilaf, grass-fed beef, and fresh produce straight from farmers' markets ( 2 Hill M. Hospitals try cooking up better food for patients. http://news.yahoo.com/s/ap/20110310/ap_on_re_us/us_fea_food_hospital_cuisine_1 Google Scholar ). Grilled salmon, tilapia, quesadillas, stir-fry, pot roast, and roasted vegetable lasagna are some of the menu items offered at hospitals in Baystate Health in Springfield, MA; Hendricks Regional Health in Danville, IN; and Saint Francis Health System in Tulsa, OK. “There has definitely been a big change from your two-entrée selections to more of a restaurant-style menu,” says Lisette Coston, MBA, RD, LD, director of nutrition and foodservices at Saint Francis Health System in Tulsa, OK, for the last 13 years, and a member of the board of directors for the Association for Healthcare Foodservice. “It follows what we see in our society, with the trend toward much more eating at restaurants. At hospitals patients expect to see the same choices and quality.”

Sustainability in Hospital Foodservice

This research documented hospital foodservice sustainable practices, examined foodservice directors' perceptions and attitudes on sustainability, and explored intention to adopt sustainable practices. Results indicated that recycling fat, oil, grease, cardboard, and paper were the most common sustainable practices. Least common practices were composting and serving organic and locally grown foods. Sustainable practices differed based on director age, gender, registered dietitian status, region of the country, and number of foodservice employees. Perception of others (subjective norm), directors' personal sense of obligation (personal norm), and perceived control (perceived behavior control) had the greatest influence on intent to implement sustainable practices.

A qualitative difference. Patients’ views of hospital food service in Iran

Undernutrition and food acceptability in hospitals form a worldwide problem, but existing studies offer a predominantly Western perspective. This research investigated inpatients’ satisfaction with meals in five Iranian hospitals, using focus group discussions, interviews and meal observations. The main problem areas included food quality and quantity, nutritional control, meal arrangements and staff attitudes. Iran's hospitals follow a Western model, which may be appropriate for medical systems, but is less so for patient feeding, due to budgetary constraints and cultural factors. Understanding patients’ experience makes it possible to improve feeding arrangements, with a positive impact upon patients’ nutrition.

Analysis and Valuation of Hospital Foodservice Quality: Tha Perugia Case Study

The hospital catering is characterized for the necessity to satisfy the nutritional and dietetic principles, and the several therapeutic requirements of the patient.The main problem is to coordinate the production with the always various number of the requirements. On the other hand,emerging of competition forms in the sanitary field,based on the possibility of chosen of the structure cure from the customer and on the prices and tariffs system,has open new spaces for the recovery of a strategic perspective of the public sanitary companies respect private sector. Always mainly,the hospital companies must centralize own ttention so is minimal the difference between planned quality, distributed quality and perceived quality. The present work offers,through a public opinion pull on a specific case, a first attempt to tie the satisfaction or not satisfaction of a consumer regarding the sanitary service,on the base of some qualitatative variable. The innovation of this work consist of a index series created from the hospital documents and patient judgment (questionnaire) to establish a gap between planned and perceived quality.

The Italian “new deal” of dietetics and clinical nutrition structures

Dear readers, On December 17, following the establishment of a board of experts on hospital and nursing home foodservices at the General Directorate for Food and Nutrition Safety, in which the Italian Association of Clinical Dietetics and Nutrition had an essential role, the State-Regional Conference of the Ministry of Health (the Italian Institution which works to promote cooperation between the activities of the state and the autonomy system) approved the Ministry of Health document regarding ‘‘National Guidelines for hospital and nursing home foodservices’’ (downloadable at: http://www. governo.it/backoffice/allegati/61509-6459.pdf) published on G.U. no 37 February 15th, 2011 with the aim of disclosing a model to propose at the national level, in order to homogenize hospital foodservice activities and the activities of the Dietetics and Nutrition Structures in this context. Such document establishes the need to provide the patient with a homogenous process ranging from evaluation of nutritional risk and nutritional state to oral and artificial nutrition (artificial enteric or parenteral nutrition) integrated with adequate overall management of foodservices. In fact, in the document, the Ministry confirms the essential role of operating units of clinical dietetics and nutrition which, by means of foodservice processes and clinical-nutritional practice, can plan and carry out the intense nutritional control essential for achieving overall quality. The document stresses the activity connected with clinical dietetics and nutrition highlighting the frequent dishomogeneity among the various clinical dietetics and nutrition programs, especially notable among the Italian regions and, often, within the same region. Topics treated: nutritional intervention, malnutrition, screening for risk of malnutrition in hospitals and in local structures, nutritional therapy, hospital and extra hospital foodservices, evaluation of nutritional needs, qualitative aspects of foodservices and of the activities of clinical dietetics and nutrition structures. For this purpose, with the aim of evaluating the implementation and efficacy of the national guidelines for hospital and nursing home foodservices in hospitals and local health service facilities, the Ministry requires the activation of a national network of health facilities, in particular of the health directorates, of hospitals and/or local facilities, of hospitalization and care facilities, public and private, of the regions, aimed at monitoring the quality of service, the satisfaction and health condition of the patients as well as health and management costs. Such monitoring must consider:

Serving High-Risk Foods in a High-Risk Setting: Survey of Hospital Food Service Practices after an Outbreak of Listeriosis in a Hospital

Prepared ready-to-eat salads and ready-to-eat delicatessen-style meats present a high risk for Listeria contamination. Because no foodborne illness risk management guidelines exist specifically for US hospitals, a survey of New York City (NYC) hospitals was conducted to characterize policies and practices after a listeriosis outbreak occurred in a NYC hospital. From August through October 2008, a listeriosis outbreak in a NYC hospital was investigated. From February through April 2009, NYC's 61 acute-care hospitals were asked to participate in a telephone survey regarding food safety practices and policies, specifically service of high-risk foods to patients at increased risk for listeriosis. Five patients with medical conditions that put them at high risk for listeriosis had laboratory-confirmed Listeria monocytogenes infection. The Listeria outbreak strain was isolated from tuna salad prepared in the hospital. Fifty-four (89%) of 61 hospitals responded to the survey. Overall, 81% of respondents reported serving ready-to-eat deli meats to patients, and 100% reported serving prepared ready-to-eat salads. Pregnant women, patients receiving immunosuppressive drugs, and patients undergoing chemotherapy were served ready-to-eat deli meats at 77%, 59%, and 49% of hospitals, respectively, and were served prepared ready-to-eat salads at 94%, 89%, and 73% of hospitals, respectively. Only 4 (25%) of 16 respondents reported having a policy that ready-to-eat deli meats must be heated until steaming hot before serving. Despite the potential for severe outcomes of Listeria infection among hospitalized patients, the majority of NYC hospitals had no food preparation policies to minimize risk. Hospitals should implement policies to avoid serving high-risk foods to patients at risk for listeriosis.

‘Going Green’ in Food Services: Can Health Care Adopt Environmentally Friendly Practices?

Sustainability and the environment are issues influencing individual and organizational choices on purchasing, waste management, and energy-saving practices. The food service industry and related stakeholders have reported active pursuit of initiatives to reduce environmental impacts. We examine reported environmentally friendly practices being implemented in the food service industry and consider ways in which health care or hospital food services can adopt some of these programs. Building and equipment, waste management, food, and non-food supplies and procurement are considered. Suggestions are made for small changes to start the green initiative in each of these areas. A health care food service department is a large consumer of resources, and therefore food service workers, managers, dietitians, and administrators can make a significant difference by supporting and adopting environmentally friendly practices. Further studies are needed to determine which practices are currently being implemented in health care facilities in Canada, as well as perceived facilitators and barriers to these practices in the food service area.

Participatory ergonomics: Understanding the contributions of reflection groups in a hospital food service

Aim To identify how the methodology of Reflection Groups (RG) can contribute to approach social-psychological problems, so often observed as obstacles in PE efforts. The objective was also to verify the contributions from RG to the implementation of ergonomics recommendations, which were a starting point and organized group discussions. Method A concrete case was used as an illustration, and studied in depth: RG with administration and production workers’ representatives from the Department of Nutrition and Dietetics of a cardiologic hospital in São Paulo, Brazil. RG are temporary thinking groups, taking place outside the workplace and having delegative and consultive participation. They make use of Operative Groups, an adapted form of tripartite group, activity as an instrumental resource, group dynamic techniques and videotaping. In 2007, 31 meetings took place during paid working hours with 7 groups of different composition, ranging from 1.5 h to 3 h. Results Additionally to the positive effects in communication and psychosocial environment, RG could also contribute to changes in interpersonal relationships, cooperation, personal and work behaviours. By dealing with aspects which could hinder the explicit task: fears, conflicts, and stereotyped beliefs and behaviours; resistance to change could be broken and group members could learn. RG allowed input about new risks; continuous information and feedback about ongoing ergonomics interventions so that immediate corrective action could be taken. The main form of participation was in administrative, organizational, and psychosocial problems which required a better clarification and identification of their real causes, commitment, and elaboration of strategies and negotiation of different stakeholders in their solution. Conclusion RG takes advantage of homogeneous and heterogeneous groups, in face to face communication. The interactions in the groups are task-oriented (explicit task) but attaining groups’ goals depends on a relational interaction (implicit task). Relevance to industry Reflection groups can bring important contributions to ergonomics and industry because they favour the discussion, disclosure of problems and incorporation of solutions, enabling interventions in working organization, psychosocial environment and relationships in a collective and participatory approach, promoting health and social integration.

Analysis of Intakes and Satisfaction of Patient Foodservice in Mid-Sized Hospital Settings

The purpose of this study was to investigate dietary intake and to evaluate patient satisfaction toward the quality of hospital foodservice. Questionnaires were distributed to 203 hospitalized patients in 3 hospitals having 300 beds. The intake rates for served amounts of rice, side dishes, and soup were 72.5%, 68.2%, and 62.6%, respectively. The main reasons for left-overs were ‘no appetite’ (25.8%) and ‘not salty enough’ (19.9%). The rate of patients eating outside food was about 33.5%. The average score for quality satisfaction of meal characteristics was 3.34 ± 0.61, and the average score for quality satisfaction of sanitation and service characteristics was 3.58 ± 0.61. ‘Seasoning’ showed the lowest score and ‘temperature’ showed the highest score for quality satisfaction of meal characteristics. In the quality satisfaction of sanitation and services, ‘explanation of meals’ showed the lowest score and ‘exactness of meal times’ showed the highest score. The patients hospitalized for 10 days showed significantly lower average scores than those hospitalized over 60 days for quality satisfaction of meal characteristics. The patients with ‘little appetite’ and ‘regular appetite’ showed significantly lower average scores than those with ‘much appetite’ for the quality satisfaction of meal, sanitation, and service characteristics. The patients who ‘rarely had leftovers’ showed significantly higher average scores than those who ‘always had leftovers’ and ‘often had leftovers’ for quality satisfaction of meal characteristics. Meal characteristic scores were significantly correlated with age (r = 0.216), length of admission (r = 0.310), appetite (r = 0.251), leftovers (r = 0.233), and intake of soup (r = 0.205). Also, sanitation and service characteristics scores were significantly correlated with age (r = 0.327), education (r = -0.202), length of admission (r = 0.168), and appetite (r = 0.155). Thus, it would seem to be desirable that hospital foodservices improve the taste and seasoning of meals and provide appropriate nutrition education and counseling in mid-sized hospitals. (Korean J Nutr 2011; 44(4): 326 ~ 337)

Level of Knowledge and Compliance of Mexican Food Code among Hospital Foodservice Employees in Guadalajara, México

Contamination of food may occur at any point during the food distribution channel. However, mishandling of food at the last segment of food distribution where food is prepared for consumption often causes outbreaks. Keeping food safe in hospitals is particularly imperative because of the population they serve and the potentially hazardous environment. This article presents the results of a pencil and paper self-reported survey on the knowledge of Mexican food code, NOM-093-SSA1-1994, and field observation of the compliance of the code among the hospital foodservice employees in Guadalajara, Mexico. One hundred twenty-seven employees from six public and private hospitals participated in the study. Of the respondents, 81.5% were aware of the importance of personal hygiene in food safety. Professional attire including hair restraints and mouth cover were always used. These participants, however seldom used thermometers, and only 37% of respondents knew the correct temperatures for refrigeration. In most hospitals correct procedures for sanitizing food contact surfaces that were prescribed by the sanitizing chemical manufacturers were practiced. Only 25% of the participants knew that their work was defined by the food code. Strategies for dissemination of the food code, and food safety training of the employees are urgently needed. Commitment and support of the hospital are needed in order to improve safe food handling practices in these hospitals.

Importance and Performance of Dietitian's Task at Long Term Care Hospital Foodservice in Busan · Kyungnam Area

The purpose of this study was to evaluate importance and performance of dietitian’s task at long term care hospitals foodservices in the Busan·Kyongnam area. The research was performed through using questionnaires and conducted from June 11 to July 16, 2010 for 186 dietitians at 141 long-term care hospitals. Seventy-two percent of hospitals had two dietitians and 69% of them had a dietitian's office. Fifty-two percent of dietitians has worked for less than 2 years at long term care hospital, and 37.1% of them worked additional tasks. Seventy-three percent of hospitals conducted a therapeutic diet program and the therapeutic diets frequently provided were diabetic diet > tube feeding diet > dysphasia diet > sodium controlled diet. Mean score for the importance (4.36/5.00) and performance (3.91/5.00) of dietitian's tasks were significantly different (p < 0.001). The importance and performance grid showed that the purchaseinspection management and sanitation-safety management were high scores to the importance and performance (doing great area), menu-foodservice management and cooking-working management were low scores to the importance and high scores to the importance (overdone area), and nutrition management was low scores to the importance and performance (low priority). Forty-three percent of dietitians agreed with the needs for role separation between foodservice dietitian and clinical dietitian. (Korean J Community Nutr 16(5) : 602~612, 2011)

Food safety risk factors in a hospital food service unit serving low microbial diets to immune-compromised patients.

The objective was to investigate the food safety and hygienic status in a hospital food service unit (FSU) serving low microbial diets (LMDs) to immune-compromised patients, by means of an audit (questionnaire) and bacterial samples to validate the audit findings. The primary research was done in a FSU of a 350-bed hospital in Gauteng, South Africa. One audit was done in ten areas (for receiving, storage, preparation, serving/distribution, customer, premises and equipment hygiene, staff dress code, staff premises and rest areas, and quality assurance/records procedures) of the FSU using a pre-tested form based on Hazard Analysis Critical Control Points (HACCP) principles/standards. The audit form consisted of a set number of questions for each one of the ten areas, with a possible maximum score of two (2) for each question. A set of five (5) questions for the staff premises was set, with a possible maximum score of 10. If a score of only two (2) were then reached, a % was calculated to score the area, in this case 20%. In addition to the audit, four surface swabs (patient food serving tray, chef′s gloved hands, chopping board for salads and sandwiches, microwave oven door handle) and four food samples (green beans and potatoes, chicken gravy, cold meat cuts, quiche) were randomly taken during the survey. The samples were tested to assess the microbiological safety of the foods prepared for Total aerobic plate count (TAPC), Escherichia coli, total Coliforms, Staphylococcus aureus and Salmonella spp. The results of the audit, surface and food samples were used to evaluate possible food and safety risks in the FSU according to internationally approved HACCP standards. All ten areas audited were below the set standard (> 80% value) with an average score of 41.1%. The service and distribution area had the highest score (69.4%), while the quality procedures and records division had the lowest score (5.6%). The microbiological tests showed relatively high microbial counts for a number of samples. The results of this study suggests, that even though so called safety procedures were in place, they were not followed, which could have severe health implications for the critically ill. The results of the study support the important role of food and safety protocols in FSUs to lower food safety risks when providing food that is safe for immune-compromised patient use.