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[Risk management and hospital food service: food safety quality system in healthcare].

In this article we describe a project about reorganisation of dietetic and hospital food service which aims to implement a food safety quality system from the prospective of risk management approach. The main objective is to develop structural and systematic activities from the medical direction point of view on all those activities concerning with hospital food service and dietetic with the following actions: 1) epidemiologic surveillance, 2) monitoring and output control, 3) education, training and information for staff and patients. The operative context is particularly complex for many reasons: the prevalent tendency to outsourcing for food service, the involvement of many professionals and several medical and non medical units. Actually after the redefinition of the main tasks (food hygiene and dietetic are the first functions) the organizational analysis, we have already done the corrective actions finalized to the improvement of quality and it is going to be ready a list of quality indicators to evaluate and continuous monitoring efficacy on the same corrective actions.

Food Service, Hospital↗
PubMed2006

Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002-2003.

BACKGROUND: Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes. AIM: The purpose of this study was to investigate whether the increased focus on nutritional problems in patients and nursing home residents has resulted in measurable progress. DESIGN: A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n=96) and nursing homes (n=898) in 1995 and 2002/3 (n=90) and (n=682), respectively. The study used compliance with selected issues in the official Danish recommendations for institutional food service as an indicator for progress. The issues included: using nutrient calculated recipes/menus, offering menu choice options, using feedback routines on acceptability of menus, maintaining nutritional steering committees, employing food and nutrition contact persons, employing official recommendations and offering choice between three different menu energy levels. RESULTS: Hospitals had a higher compliance compared to nursing homes. In 1995, this was the case for all questions asked and differences were statistically significant. Also in 2002/3, hospitals had a higher compliance, except in the case of established feedback routines. Differences were statistically significant. The results indicate that nutritional care is higher on the agenda in hospital, than in nursing homes. However, very little progress can be seen in compliance when results are analysed over the 8-year period. The only progress for nursing homes was that more homes had implemented feedback routines on acceptability of food service in 2002/3 than in 1995. The difference was statistically significant. For hospitals, however, no progress was found between 1995 and 2002/3. CONCLUSION: The attempts to improve the nutritional status of hospital patients and nursing home residents seem to have failed. Still, the initiatives taken to improve the situation seem relevant. Especially the nursing homes might benefit from advantage of these experiences.

Denmark↗
PubMed2004

Knowledge, attitudes, and practices of food service staff regarding food hygiene in Shiraz, Iran.

BACKGROUND: The practice of safety measures by the food service staff in hospitals is necessary for the prevention of food-borne outbreaks. Hospitalized patients are more vulnerable to potential hazards, and neglecting these principles can lead to increased morbidity and mortality. METHODS: We assessed the knowledge, attitudes, and practices of food service staff regarding food hygiene in government and private hospitals in Shiraz, Iran. Two questionnaires were designed, one for food service staff and the other for supervisors. Thirty-one hospitals were approached, and the response rate was 99.5%. Four models were developed regarding knowledge, attitudes, and practices, and a multiple logistic regression analysis was performed. Comparison among the government and private hospitals was done. RESULTS: This study showed that personnel had little knowledge regarding the pathogens that cause food-borne diseases and the correct temperature for the storage of hot or cold ready-to-eat foods. Older personnel had better attitudes and practices. Females practiced safety measures less often than did males. Personnel working in hospitals with fewer than 300 beds also had better practices. Most of the personnel had positive attitudes, but disparity between attitude and practice was noted. CONCLUSION: There is a dire need for education and increased awareness among food service staff regarding safe food handling practices.

Adult↗
PubMed2004

A protocol for quantitative measurement of light intensity levels in food service operations.

Food service workers conduct informal inspections of food service operations to ensure that food contamination does not occur. This activity requires proper lighting. Compliance with lighting standards is usually assessed by a qualitative, visual inspection method. Recent studies suggest, however, that qualitative inspections only minimally reduce risks of foodborne-disease outbreaks. To evaluate the efficacy of qualitative lighting level assessments, this study quantitatively measured lighting in walk-in coolers and at food preparation counters in 57 food service establishments. Measurements were conducted alongside regular sanitarian inspections. Of the 55 walk-in coolers evaluated, 12 had fluorescent and 43 had incandescent lighting. The geometic mean (GM) light level at the center of coolers with fluorescent lighting was 15.3 foot-candles (ft-c) (range: 6.4-85.5). Seventy-five percent of these coolers met the standard of 10 ft-c. The GM level at the center of coolers with incandescent lighting was 3.43 ft-c (range: 1.0-16.7). Seven percent of the incandescently lit coolers met the standard. Inadequate cooler illumination was indicated on only four sanitarian inspection reports. The GM level at 185 food preparation counters was 38.7 ft-c (range: 2.9-196.8). At 47 percent of the establishments, no counters met the 50 ft-c standard. Twenty-three percent of the establishments met the standard at all evaluated counters. Inadequate counter illumination was noted only once by a sanitarian. Qualitative assessments did not identify most of the lighting standard violations. Additional training and integration of quantitative assessments into inspections are warranted. Fluorescent lighting produced significantly higher light levels and pass rates in coolers and should become the lighting type of choice. Finally, gaps in the standards were identified and should be addressed.

Food Contamination↗
PubMed2003

Food retailing and food service.

The food retailing and food service sector is not only an important component of the food marketing channel but is also vital to the United States economy, accounting for more than 7% of the United States gross domestic product in 2001. The business of food retailing and food service is undergoing salient change. The authors argue that the singular force driving this change is the consumer. To understand the linkages in the food marketing channel, this article provides information on the farm-to-retail price spread and the economic forces that influence their magnitude. Examples are given of farm-to-retail price spreads for red meat and dairy industries. In addition, the economics behind the provision of retail services and the growth of the food service industry are discussed. Further, the authors demonstrate that the structure of the food market channel is consumer driven, and present three characteristics of convenience (preparation, delivery, and service) and identify four food distribution channels in terms of convenience (complete convenience, traditional food service, consumer direct, and traditional retail).

Animals↗
PubMed1998

The "take a nurse to lunch" program. A unique focus group improves and promotes food services.

Dan Booth is the director of hospitality services for MaineGeneral Health. For this 450-bed health care organization, he directs six departments, which include environmental services, food and nutrition, security, laundry services, telecommunications, and transportation. In this article he describes how his Take a Nurse to Lunch program operates, what its benefits are, and how it was implemented.

Focus Groups↗