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Catering Services in a Hospital Slide 1 Catering Services in a Hospital Slide 2 Catering Services in a Hospital Slide 3 Catering Services in a Hospital Slide 4 Catering Services in a Hospital Slide 5 Catering Services in a Hospital Slide 6 Catering Services in a Hospital Slide 7 Catering Services in a Hospital Slide 8 Catering Services in a Hospital Slide 9 Catering Services in a Hospital Slide 10 Catering Services in a Hospital Slide 11 Catering Services in a Hospital Slide 12 Catering Services in a Hospital Slide 13 Catering Services in a Hospital Slide 14 Catering Services in a Hospital Slide 15 Catering Services in a Hospital Slide 16 Catering Services in a Hospital Slide 17 Catering Services in a Hospital Slide 18 Catering Services in a Hospital Slide 19 Catering Services in a Hospital Slide 20 Catering Services in a Hospital Slide 21 Catering Services in a Hospital Slide 22 Catering Services in a Hospital Slide 23 Catering Services in a Hospital Slide 24 Catering Services in a Hospital Slide 25 Catering Services in a Hospital Slide 26 Catering Services in a Hospital Slide 27 Catering Services in a Hospital Slide 28 Catering Services in a Hospital Slide 29 Catering Services in a Hospital Slide 30 Catering Services in a Hospital Slide 31 Catering Services in a Hospital Slide 32 Catering Services in a Hospital Slide 33 Catering Services in a Hospital Slide 34
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Catering Services in a Hospital

Catering Services in a Hospital

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Catering Services in a Hospital

  1. 1. Assignment Topic : Catering Services  Group Members of EPGDHA Batch 2013-2014 1. Dr. Susan Fernandes 2. Dr. Allan Pereira 3. Dr. Sreya Joseph 4. Mrs. Elizabeth David 5. Ms. Diana Vincent 6. Mr. Tapan Doshi 7. Mr. Sameer Shinde
  2. 2. Hospital Catering Services  Hospital catering services are an essential part of patient care.  Good-quality, nutritious meals play a vital part in patients’ rehabilitation & recovery, & limit the unnecessary use of nutritional supplements.  Hospital catering services should be cost effective & flexible enough to provide a good choice of nutritious meals that can accommodate patients’ specific dietary requirements & preferences.
  3. 3. Core Objectives of Catering Department 1. Control catering budget & contract: food, beverages & snacks 2. Choose & order ingredients . 3. Develop Recipes, menu’s taking into consideration dietetic advice, patients age, culture, religion & medical condition. 4. Prepare food to Quality approved standards 5. Deliver food to wards, patients & staff restaurants 6. Serve food to patients at ward level (Nurses/ Hostesses) 7. Provide snacks 8. Maintain & supervise food hygiene at all times. 9. Consider development of patient restaurants or other novel food delivery / outlets. 10. Control cost & monitor waste 11. Audit &develop service delivery
  4. 4. Services provided by a Catering Department
  5. 5. Hospital Layout
  6. 6. An Open Floor Plan Layout of Catering Department for a Hospital
  7. 7. Location & Size  The Catering Service Department should ideally be in the ground floor  Away from normal traffic flow.  Access to trolleys & lorries coming to unload regular supplies.  The area requirement for the kitchen varies as per the type & size of the hospital. 1. Upto 200beds = 20sqft/bed 2. 200- 400 beds = 16sqft/bed 3. 500 & above = 15sqft/bed
  8. 8. Additional Physical Facilities Physical facilities can be divided into two components:  Peripheral component 1. Collection of diet demand 2. Distribution of diet  Central component 1. Administrative area 2. Cooking area 3. Preparation area 4. Service area 5. Receiving area 6. Dry Ration storage 7. Cold rooms for perishable food items 8. Garbage collection area 9. Toilets 10. Washing Area a. Dish Washing area b. Trolley Washing area
  9. 9. Environmental Adequate ventilation Gas pipeline Garbage disposal Enough light Water Supply Solid Stainless flooring Steam supply Environmental Planning
  10. 10. Cutting equipments Dish Cleaning Chapatti making machine Grinding machine Weighing machine Mixing machine Cooking ovens Distribution trolley Distribution trolley Equipments
  11. 11. Hospital Catering Services Policy at Individual Ward level or Specialist Unit Level
  12. 12. The diagram is used to show where groups such as the Nutrition support team & the Hospital steering committee sit in this structure
  13. 13. Organogram Medical Superintendent CMO I/C Kitchen Chief Dietician Senior Dietician Dietician Steward Store Keeper Clerk Head Cook Dietician Head Cook Assistant Cook Masalchi Trolley Bearer Store attendant Cleaner Cook Additional Medical Superintendent
  14. 14. Staffing : Differs as per the size of the Hospital.10-30% extra for the casual leave Sr. No Type of staff 300 bedded 500 bedded 750 & above 1 Chief Dietician 0 0 1 2 Senior Dietician 0 0 1 3 Dietician 1 1 1 4 Assistant Dietician 3 5 7 5 Steward 1 1 1 6 Diet Clerk 0 1 1 7 Head Cook 1 1 1 8 Therapeutic cooks 2 2 3 9 Cooks 8 10 16 10 Assistant Cooks 6 8 10 11 Masalchi 6 8 10 12 Store Attendant 1 2 2 13 Trolley Bearer 8 10 16 14 Cleaner 2 2 3
  15. 15. Roles & Responsibilities of Staff  Chief & Senior Dieticians: 1. Making Policies regarding indents, standardization, Quality control, Receipt, Issue & Disposal. 2. Supervisory record keeping, Physical Stock verification 3. Menu Planning, Budget Planning & Cost Accounting 4. Diet Counseling , Diet charts Education & Training 5. House Keeping & Sanitation 6. Personnel Management & preparation of therapeutic diets 7. Uniforms, work schedule, time of food delivery 8. Supervision of personal hygiene of staff, cleanliness of cooking & serving area  Steward: 1. Over all supervision and control of kitchen activities. 2. Preparation of diet demands 3. Collection of ration from stores for cooking 4. Supervision of food distribution in wards 5. General sanitation & Hygiene of kitchen
  16. 16. Roles & Responsibilities of Staff  Store Keeper: 1. Indent & receipt of dry & wet rations. 2. Proper storing of ration & perishable items in cold storage area. 3. Accounting, issuing & record keeping. 4. Pest control.  Head Cook: 1. Over all supportive supervision of cooks. 2. Kitchen hygiene & Food Quality. 3. Checks pilferage 4. Receipts of kitchen supplies eg: chicken, bread, Eggs, vegetables. 5. Maintaining Kitchen discipline  Assistant Cook: 1. Distribution of raw materials, food to different places 2. Assist in preparation, cooking, grinding, peeling, grinding 3. Assist in cleaning & drying utensils.  Masalchi: 1. Maintenance of cleaning in kitchen area. 2. Washing of utensils 3. Proper Disposal of waste  Cooks: 1. Preparation of general & therapeutic diets
  17. 17. Hospital Catering Process
  18. 18. Coordinated workflow of Catering Department with other Hospital Departments
  19. 19. Stages & Staff involved in delivering Hospital Catering Services
  20. 20. Food Management & Processing
  21. 21. Dietary Service Management Management Diet & Menu planning Quality Control Financial Management Personnel Management Food Management Equipment management Raw material management Area management
  22. 22. Food & Nutrition  Eating well is important for everyone’s health, well or ill. Providing appropriate nutrition in the hospital setting is a particularly challenging task due to the diverse dietary needs of the population.  Food in Hospitals is one important part of an integrated programme for improving nutritional care in hospitals. It is fundamental that hospitals provide appropriate food, fluid & nutritional care to manage any nutritional risk, to improve nutritional health, well-being & optimise the wider clinical management of all patients.  Food not only needs to meet individual nutritional requirements, should be appropriate for different age groups, religious, cultural & social backgrounds and different medical conditions.  The diversity of nutritional needs within the hospital setting has two sets of nutrient-based standards: 1. Standards recognising those patients who are ‘nutritionally vulnerable’(those with poor appetites, increased risk of malnutrition) who require a diet that is energy & nutrient-dense. 2. The other standards acknowledge ‘nutritionally well’ patients, whose needs are in-line with the healthy balanced diet.
  23. 23. Recognizing Patient Needs  When a person is admitted to hospital, an assessment is carried out, both on admission & on an ongoing basis. A care plan is developed, implemented & evaluated as follows: 1. Eating and drinking likes & dislikes 2. Food allergies & need for therapeutic diet 3. Cultural/ethnic/religious requirements 4. Social/environmental mealtime requirements 5. Physical difficulties with eating & drinking 6. The need for equipment to help with eating & drinking
  24. 24. Menu Planning Diet Soft Diet Diabetic Diet Liquid Diet Nephrotic DietHigh Calorie DietHigh Protein Diet Distribution timings (7:00, 8:30, 12:00, 16:00, 19:00) General Full Diet
  25. 25. Menu Planning  Menus should be planned to ensure that they meet patients' needs & are nutritionally sound.  Planning the menu should, therefore, be carried out by a group of people who bring their own expert knowledge to the process.  (Catering Manager, Dietician, Nurse & Doctor/Clinician)  The Menu analysis should be done in three stages: 1. An analysis of the nutritional value of each menu item. 2. Comparison of these values against the recommended minimum nutritional content. 3. An analysis of the entire menu to ensure that it is nutritionally balanced.
  26. 26. Material Management The daily ration is estimated on the previous day census. The list is collected every day in the morning & no. of diets of various types are calculated & accordingly the ration is collected from stores. 50% cooked in morning & 50% cooked in evening. Dry Ration procured on monthly basis & perishable items on daily basis. Maintenance of equipments, cold room CMC & AMC Material Management Daily/ Monthly Demand Estimation & Indenting Storage Issue to Kitchen on Daily Basis
  27. 27. Costing of Catering Services  Costs of the catering service vary significantly with the majority of hospitals. (Net cost per patient day & food , beverages cost per patient day).  Budgets are set for the catering service as a whole taking the patient service & meals provided to staff & visitors (non-patient catering) together.  Income generated from non-patient catering is used to reduce the overall cost of the catering service.  The largest proportion of catering departments (42%) base their catering service budget on historical information. Other catering departments are basing their budgets on target patient cost per patient week (32%), daily food allowance (18%) & contract price (8%)  Budgeting is based on account of pay rises and increases in the cost of food & beverages.  Income generation targets are likely to be increased each year to offset these increased costs & may be set even higher to reduce the overall catering budget.  Expenditure on catering service includes the costs of food & beverages (42%), staffing (50%), other indirect costs such as cleaning materials & a proportion of trust overheads ( 8%).
  28. 28. Food Wastage  The levels of food wastage affects the cost of a catering service.  Food waste occur at any or all of the following stages: production, unserved meals at ward level, uneaten food left on patients’ plates & food wasted in the staff dining room.  The best controls over food waste are when wastage levels are regularly monitored, wastage targets are set & wastage levels & values measured against these targets.  Remedial Measures to avoid food wastage: 1. Using different sizes of trays when portioning meals for delivery to wards. 2. Plated meal services 3. Use of menu card System for all meals ensures that all patients receive a meal of their choice and food wastage is kept to a minimum. 4. A white board on each ward details all planned admissions and discharges for the day. Nursing staff note on the board the actual times of each admission or discharge & the time at which the kitchen were informed. This aids communication between the wards & catering department reduces the amount of unserved meals at ward level
  29. 29. Food Safety & Hygiene is Everybody’s Business The provision of safe & nutritious food in hospitals for patients & staff is a major undertaking based on points listed below: 1. A food safety control system in place with specific guidelines & policies in placed. 2. Food is prepared & served in accordance with recognised food safety procedures & legislation 3. Combination of Good Management Team. 4. Staff trained in safe hygiene practices & catering skills, 5. Appropriate Quality Controls 6. Monitoring of Food quality temperature failures at the point of serving meals to patients. 7. Using microwaves at ward level 8. Schedule of cleaning of kitchen area & implementing pest control program. 9. Health checkup of staff & vaccination status at time of recruitment & periodically. 10. Periodical inspection & auditing of the catering department
  30. 30. Challenges & Remedial Measures in Managing Catering Services  Challenges faced by management 1. Sickness absence, 2. Staff turnover rate 3. Staff vacancy rates  Remedial Measures to overcome the challenges: 1. Incorporate career development opportunities or 2. Boost employee morale & motivation by awarding a bonus depending on the department’s performance & sickness absence of the individual, against the prior year’s budget. 3. Hospital management should monitor staff vacancy & turnover rates on a regular basis 4. Survey to be conducted to analyze pay rates offered by local competitors, the nature of the work, the location of the hospital & incentives offered to staff for retention policy.
  31. 31. Performance Indicators  Various Indicators used for Evaluation: 1. No. of Complaints on Food Received 2. No .of Cases of Food Poisoning 3. Instances of False Diet Distribution 4. Non Serving/ Inadequate Serving Complaints 5. Wastages & Pilferage Incidences 6. Pest & Rodents 7. Feedback Proforma 8. Interview at the time of Discharge
  32. 32. Conclusion .....Cost is not always a barrier to higher quality.  To improve the quality of the catering service to patients' nutritional needs are to be identified & fulfilled, timeliness of meals, provide dietary assistance.  More effective communication between the catering department & other staff involved in the catering chain will be crucial in raising & then maintaining the quality of service delivered.  Continual improvement, patient satisfaction must be closely monitored.  Audit Mechanism to be incorporated to keep a check on food quality & services provided.
  33. 33. References Research Articles  AUDIT COMMISSION (2001) Acute hospital portfolio: Review of national findings, Wetherby: Audit Commission Publications.  Review Article on Catering for Patients prepared for the Auditor General of Scotland ,November 2003.  Food in Hospitals National Catering and Nutrition Specification for Food and Fluid Provision in Hospitals in Scotland published by the Scottish Government, June, 2008  Food service in hospital: development of a theoretical model for patient experience and satisfaction using one hospital in the UK NHS as a case study. H.J. Hartwell, J.S.A. Edwards and C. Symonds.  Managing Food Waste in NHS copyright 2005  Hospital Catering and Patient Nutrition: Report presented by the Auditor General for Wales to the National Assembly for Wales on 24 March 2011  Organization of food & nutritional support in hospitals: Bapen Advancing Clinical Nutrition.  Patients’ nutritional care in hospital: An ethnographic study of nurses’ role and patients’ experience, Final report May 2005 Websites  
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Catering Services in a Hospital


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