Our Departmental Features are being run monthly, up to Employee Recognition Week. This initiative aligns with our Hospital’s strategic priority of Staff Experience, by recognizing and celebrating the work that our staff is doing every day. This month we are looking at the Nutrition & Food Services Department! To see past Department of the Months, please visit our Employee Recognition Week web page.
How the Nutrition & Food Services Department runs
It starts with patient admission, then a diet entry into Meditech, this interfaces with CBORD; a piece of software that captures every patient’s dietary information and organizes it into menus and tallies for production. Then comes the patient preferences, sometimes written into the comment section of Meditech, and sometimes after a dietitian referral and appointment, these notes are recorded in the Registered Dietician section. The dietary assistant takes these notes and manually enters them into the patient’s preference section in their card file in CBORD. If any of the notes are not compliant with the patient’s current diet, an email is sent to the dietitian, or a phone call is placed to the unit where the patient is admitted. Sometimes the items are written in if medically appropriate. The dietary assistant prints menus, tallies, records essential numbers for informatics, answers email, cross-checks diet entries and food allergy entries made by ward clerks and medical staff, answers the phone, and assists everyone working in the office and kitchen.
Production (dietary aids, cooks, portioning staff)
Our team takes the tallies produced by CBORD and makes the correct amount of entrees, vegetables, desserts, thickened beverages, fruit portions, hot cereals, sandwiches, and snacks. Production staff pads these numbers to ensure that if the hospital has a population spike, every patient is still fed medically appropriate foods. At tray assembly time (three times a day) the dietary aids make hundreds of trays, each having its unique menu. The room in which they assemble trays is refrigerated to ensure food safety. After a tray is assembled, it is loaded into a retherm cart to be heated to exactly the correct temperature to prevent any foodborne illness. Our supervisors are always taking temperatures of fridges, trays, retherm carts, and dishwashing machines, ensuring that all equipment is in working order, and as a result, the food that is produced by this department is safe for the patients to consume. Once the trays are heated in the retherm carts, they are ready to be delivered to the units. Most units receive bedside tray delivery. Two dietary aids deliver trays to each unit getting a total of 15 minutes to deliver to stay on time. Dietary aids are unable to do bedside delivery for patients on droplet precautions. 1 hour after tray delivery patient’s trays are collected, then stripped and washed. Trays are collected after 1 hour due to food safety policies. Currently, the dish room is being renovated, if you have walked down the hallway leading to Stores, you will have seen us stripping trays along the wall. A portion of our main kitchen was reallocated for a makeshift dish room.
While delivering trays dietary aids will take comments and concerns from patients including preferences and pass this information on to the dietary assistant. Pre-pandemic dietary aids formally took food orders for lunch and dinner and general food preferences utilizing the program, expressly for you and our department are hopeful that we can restart soon. In the interim patients who require food, preferences taken can be reported to the nutrition and food services office and a member of staff will see the patient as soon as possible. More challenges for Food and Nutrition due to the pandemic have been the infant formula shortage and supply chain problems with food suppliers. As a result, when food orders are placed we constantly have to replace staple items such as dry cereal, salt packages, oral supplements, and crackers. Supervisors have had to run to the store and purchase items for the hospital so that patients do not go without them. Another frequent challenge is staffing due to the pandemic, often staff including supervisors are playing multiple roles to ensure the work is completed on time and patient trays are delivered on time, and dishes and workspaces are clean.
Our department, Nutrition, and Food Services, is complicated, ever changing, and full of daily challenges, but I am proud of all that we accomplish. My coworkers work as a team and stay true to our mission statement of patient-centered care. Dietary aides, cooks, dietary assistants, Registered Dietitians, food service supervisors, and our managers are always willing to answer a question, an email, or jump into the kitchen and wash dishes or cut up vegetables or deliver a tray after cut-off time to a hungry patient. Our team works hard, completes daily tasks with determination and intelligence, and are always willing to do a little something extra for a patient or a co-worker.
