Improving Snack and Beverage Delivery in Acute Care
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Dry peas
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Lentils
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Dry Beans
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Chickpeas
- On the job causes
- Community causes
- Personal causes
- Circumstances of the leave or days taken from work i.e. sickness, death or personal reasons.
- Procedures to be followed in event of absence, including, doctor’s assessment and notification, death certificate, or any other documentation specific to the employees absence.
- Disciplinary actions and guidelines to be followed if non-compliance and the offer of employee counseling.
- Employee and family assistance programs including counseling. Employees need to be aware of programs like this in their workplace.
- Individual interventions, these are effective and remain an important part of managing workplace stress. Employees may think that they cannot talk to you; however, if you make yourself approachable and introduce the subject with possible solutions and different ways of thinking, these are very effective way of dealing with specific stress situations.
- Having a pro-active approach to training. This could be safety related, increasing knowledge base of employees, or simply refreshing and assisting them with current stress and tasks at hand.
- Giving employees the option of having occupational health and safety assess the ergonomics of their job, this may help with workplace injury and repetition in their job.
- Where possible having flexible hours. A stressor for women with small children is often the hours worked, i.e. they need to take an entire day off to take their child to the doctor. By providing flexible work hours, where possible, as food service is run on a tight schedule, you may be able to decrease absenteeism.
- Why is the resident being fed?
- Where are they being fed? Why?
- Can the resident speak? – If yes, can they communicate with staff Re: food preferences?
- Is there any anger or reassessment taken out on caregiver?
- How much time does it take for resident to be fed?
- How much of the meal did the resident intake?
- How do the resident and the caregiver interact? –how was the caregiver positioned?
- Rate the experience of the resident: pleasant, neutral, unpleasant?
- Other things that may have affected the feeding experience, e.g. was the resident wearing a bib? – was there special utensils, so the resident could feed with supervision? The level of independence that the resident was given? Any distractions for either the caregiver or the resident during feeding time?
- Everyone seems to have their own style when feeding a resident. Some take time and have compassion. This including interacting with the resident and having small chats with them. This often resulted in better eating habits of the residents.
- Control for the residents is a big factor. The more control you can give to someone the better they will receive helps. This means that if they can hold a special utensil and feed them with supervision; this resulted in better eating habits and a well received meal time experience.
- Time is always a concern when feeding multiple residents with small amount of staff. Although this is a time management issue, quality of life always has to be considered and every resident should get the same amount of attention.
- Feeding in a patient room vs. feeding in a communal area. Preconceived notions of feeding in a communal area are often case, because feeding time is such a social time for people. However, I have also observed that nursing and nursing aids tend to be more distracted in dining settings and chatting amongst themselves, where as if residents are fed in their rooms they get more attention and have a better feeding experience.
- Capital avoidance associated with the replacement of existing tray lines (in need of replacement due to age or length)
- Less staff to operate – depending on the current benchmark, the facility could save between 15-30% in labour at the tray line
- Improved ergonomics for the staff – often seen as a soft cost but in some cases the cost of illness due to repetitive strain, or absence due to muscle ache due to poor working conditions (twisting, crouching) can be quantified and B-Lean reduces these environmentally related injuries or non-productive time
- Less space is required which often allows the operation to give back space or use the space for revenue generating activities or other essential, value oriented initiatives
- Improved tray accuracy – in a recent B-Lean study, tray accuracy improved by 20% after Lean principles were put in place
- Less maintenance cost with B-Lean equipment (B-Lean 1 and 2) than traditional electronic equipment and less down-time. All this is less risk overall.
- Greater flexibility to adapt to the future as well as greater flexibility to adapt throughout the day to each meal period’s special requirements
What Are Pulses & How Can They Improve Your Menu?
February 12th, 2013When you hear the word “Pulse” I bet you think of a heart beat just like I did the first time I heard it, however, you would be wrong.
It refers to a group of foods that we often refer to as legumes, beans or peas.
The word pulse actually refers to the edible seeds of legumes which include:
Pulse Canada has recently come out with new recipe books, new website and is great teachers when it comes to the educating of foodservice professionals regarding pulses and how they can be implemented within industry and healthcare environments. Having recently been at one of the Pulse Canada presentations I can safely say that as a past operator, these recipes could be easily adapted for production faculties, as well as bulk retherm facilities.
In fact, Saskatoon Health Region recently went one step further and partnered with Pulse Canada to create large scale recipes for the food service industry! There are 13 recipes posted on Pulse Canada website, including the story behind the project that is worth the read.
http://www.pulsecanada.com/food-health/foodservice/scale-up-recipes
Most food service professionals know that Pulses are great sources of protein, fibre and are low in fat; in fact most hospitals have a variety of casseroles for their vegetarian and gluten free clients for those reasons. That being said, facilities especially smaller ones, are forced to buy out sourced products as they simply do not have the volume for producing these in house. Pulse Canada has gone over and above the regular chili’s and chickpea casseroles and has developed recipes not only using the whole beans, peas or lentils, but also using flours from these products that result in gluten free and some vegetarian alternatives that are also great for heart healthy and diabetic diets. With the above diets being more prominent in health care, it is safe to say that these recipes would be a great addition to any regular hospital or long term care menu!
One of my FAVORITES that would work great in the Multigen Oven system is the Chocolate Brownie made with Black bean flour coming in at only 166calories per serving with 3 grams of protein! (There is also a large scale recipe similar, called “Black Bean Brownie” but is not gluten free.
For more information and to learn more about Pulse Canada visit their website at:
Greek Yogurt, Worth the Hype or Just Another Trend?
February 1st, 2013I was recently touring the food service operations at a hospital and could not help but notice that there was Greek yogurt on the menu instead of the normal bland strawberry, vanilla combinations. I thought to myself, why is this? Normally hospital food service does not follow trends in the market place, especially in Canada where the focus is on nutritional value and keeping the cost as low as possible. That being said from what I have heard, Greek Yogurt is more expensive and has a higher fat content, so is there more to Greek yogurt than just the trend? What are the health benefits to this new fad?
As it turns out, Greek Yogurt absolutely has some great benefits that may explain why it is a first choice for hospital food service. How do they do it? The Greek culture developed a way to strain the yogurt extensively to get rid of excess liquid, in turn this takes a lot of the extra whey, lactose and sugar content out of the yogurt, leaving you with a creamier, less sweet, less lactose option. Not to mention because Greek yogurt has more density, it makes sense that it would have double the protein in the same size serving (this is true for most brands but it is always good to check the nutrition label before buying it) This makes it a great choice for vegetarians and people that are trying to add protein to their daily meal regime.
Overall, this looks like a great product that can incorporate a true market place trend to help patients identify with the food they are being served and has increased health benefits for those that are in the hospital and need the extra nutrition.
The Dishwasher Dilemma – High Temp or Low Temp?
November 9th, 2010With energy and environment issues at the forefront of the food service industry and cost cutting and food safety at the forefront of the healthcare industry, commercial dishwasher companies introduced a low temperature dish machine to the market. What advantages does this untraditional machine have that its high temperature cousin does not?
The difference between these two options is in the rinse cycle of both machines. The high temperature option uses a built in “booster” to bring the final rinse up to 180oF for sanitizing and assisting with drying; whereas the low temp uses the existing kitchen water heater and has a chemical sanitizing agent that has usually has a drying agent in it.
These machines both have advantages and disadvantages and it is important that operators ensure that due diligent research is done with chemical companies, small ware manufactures and equipment supplier. Because hospital food service is a unique industry in itself, key components need to be analyzed.
These points include:
• What affect will the chemical sanitizer have on the dishes, cutlery, pans and glasses?
• Does the hospital contracted chemical company have the appropriate chemical needed and at what cost?
• What affect does this chemical have on the environment compared to energy and water savings? Where does the hospital drainage water go for disposal?
• Often low temp are slower, how will this affect my operations and staffing?
There are advantages to both dishwasher systems. For a high temp dishwasher when looking at cost cutting and food safety, the decreased cost of chemicals and flash drying aspect of the high temp need to be considered. For a low temp dishwasher, a cost comparison for energy and water saved vs. the cost of the chemical should be done and the testing of the chemical on dishware to ensure that a higher replacement percentage will not drive cost up.
How to Manage Absenteeism in the Workplace
October 15th, 2010Absenteeism is not a unique problem to food service operations, however is usually present. This is due to increased presence of the union environments and changing economic times. People, even in a “recession” seem to have choices, rights and more options than before. With these in mind, Absenteeism has become not only an issue, but a cause of lower production, decreased quality of work and increased costs of labor. In this article we will discuss some common causes of absenteeism and how to handle it.
Absenteeism is caused by one of three reasons:
All of the above causes tend to be followed by the word “stress”. So for example, on the job causes could be inadequate supervisors, repetition or increased workloads. Home life can have a dramatic impact on days missed from work, some of the related causes could be: financial worries, death or illness in the family and relationships. Health Canada reported through a survey about Absenteeism that 26% is believed to be related to stress. Taking reasons and impacts of Absenteeism into account moving forward how does a manager track and support employees with these stressors in their life to reduce absenteeism and implement health promoting initiatives.
In an article by Fay Calderone, an associate at a law firm in England. She outlines 3 important steps in documenting and tracking employee absenteeism. In knowing that these employees are probably facing issues it is important for these issues to not go unnoticed. The 3 steps can be applied to any operation for any manager.
1. Develop and implement, or consistently enforce an existing policy in regards to absence from work. This should include:
2. Keep records and paperwork as it pertains to the employee including any phone calls or meetings with the employee. This may also include offering them a union representative present.
3. Consult Human Resources and seek their advice when unsure about any procedure and/or actions by yourself or the employee. If you do not have an HR department, consult your administration and legal advice if necessary.
If the above process is already in place, that is a good starting place to see the trends in absenteeism in your department. By doing this exercise, you can determine what the needs are of your particular employee group and move forward with making your workplace a health promoting environment. Some sample initiatives are easy and accessible to your department through already existing programs from Human Resources. These could include:
In conclusion, there are a lot of policies, procedures and initiatives available for managers to work from and develop their own. These policies and procedures are necessary in managing absenteeism and promoting a healthy work environment. Some resources available are:
http://www.cflri.ca/eng/statistics/surveys/documents/pam2006_003.pdf
This is trends, barriers and actions put forth by the Canadian Fitness and Lifestyle Research Institute.
http://www.emondharnden.com/publications/other/slides/2004TheInvisibleEmpoyee.pdf
Edmond –Harnden outline the steps in creating and managing a absenteeism policy and procedure.
http://www.bnet.com/2410-13056_23-59947.html
This is a BNet Editorial that also has mathematical equations to show the cost of absenteeism to your operation. It also has a great case study and the different approaches to absenteeism.
To Glove or to wash; the debate and risks of using just one method in your kitchen
October 8th, 2010Glove usage has become a controversial and hot topic in the food service industry in the past couple years, glove supporters have tried to make it legislation that it be mandatory for food handlers to wear gloves; this point is argued by Operators seeing the immediate benefits of creating a barrier between the handler’s hands and the prepared food. However, what are the risks associated with relying solely on glove usage and what is the best method of preventing food borne illness through disease transmission via hands? There are benefits of both sides and within this article it will be determined that a combination of both is the best practice.
When discussing the issue of gloves vs. hand washing, it is important to discuss the reasons for having a procedure in place when working with food directly. There are 2 main ways that food can become contaminated and cause food borne illness. The first is that the person preparing food has an illness or is directly carrying a transient microbial organism. This is caused by coming into direct contact with a bodily fluid and then transferring it to food. The second is disease transmission through a contaminated object, meaning that the food handler touched money for example, that was contaminated and then touched food that was being served.
The argument for glove usage is that there is a high percentage of employees in the food service industry that do not wash their hands adequately or timely to eliminate the bacteria off their hands. However, this being said if the manger is relying solely on glove usage to prevent transmission, than if there is a tear or rip in the gloves, the handler has a high risk of transmitting any bacteria to the food and to increase this risk, it has been proven by the bioscience laboratories, that glove juice sampling has a higher bacteria count due to the ideal growing environments inside the glove! To further educate managers, vinyl food grade gloves often come with pre-existing puncture holes already in them. This means that without proper hand washing prior to glove application, there is already a higher risk of disease transmission.
Hand washing has numerous components that need to be in place in order for this process to be effective against bacteria. The first is the actual mechanical removal of microorganisms and the second is the killing of the microorganisms with the soap or gel used to do so. Therefore proper training and signage around hand washing stations is critical and the proper soap or gel provided by the manager or the hospital is necessary. Therefore, with a human factor variable, is hand washing considered safe on its own? Defiantly not.
Therefore, in research and observation, it is clear that the best practice is to have an effective hand washing program in place with educational materials and ongoing monitoring system as well as providing gloves to those food handlers directly coming in contact with ready to eat product. BioScience laboratories have also listed some critical points in having a food safe environment and decreasing the risk of food borne illness being transmitted in your operations.
They include:
1. Hand washing and gloving should be utilized by high risk employees coming in direct contact with food; where possible sanitized tongs and other serving utensils should be used.
2. Mandatory training and ongoing support should be provided to employees working and preparing ready to eat foods.
3. Food service operators should have a hygiene policy in place with necessary disciplinary actions as a result of non-compliance. This policy should include bathing and showering on a regular basis, fingernail maintenance and jewelry should all be included in this policy.
4. The monitoring and accountability of the above recommendations must be complied to and enforced.
More resources and actual lab studies are available at:
Bioscience Laboratories:
http://www.biosciencelabs.com/pages/Publications
Or visit Bioscience labs blog!
http://biosciencelabs.com/blog/
Photo Credit: SCA Svenska Cellulosa Aktiebolaget via Compfight cc
Food Sensitivity and Feeding in Long Term Care Facility
October 5th, 2010There are many special considerations when it comes to feeding residents within a long term care facility. These residents were once able to feed themselves and have now lost that ability, yet another piece of their independence has been taken away.
Meal time for residents can be the highlight of their day, if a caretaker does not take the time or the consideration while feeding a resident, this joy to their day to day life can be diminished.
There are many reasons for a resident to need feeding; they can include Arthritis of joints that determines if a resident can hold utensils or glasses. If a resident has Multiple Sclerosis, a resident often needs to be fed due to the lack of limb control. Parkinson’s residents need to be fed a great deal of the time due to their tremors, they do not have the function to get the utensil from their plate to their mouth with all the food maintained on it. Stroke patients often have one side of their body paralyzed; this can lead to the necessity to be fed. Mentally challenged patients may not have the capacity or ability to feed themselves.
During my career I have been able to observe meal time at many different long term care facilities. I often find myself asking the below questions. These questions are a great starting point from nutrition and food service management point to the nursing and nursing aid staff when working together on menu planning, food items and diet therapy. Meal time observation should always be a part of the nutrition and food service manager when working in a long term care facility. This time allows you to interact with residents, nursing and observe how your product is being received.
From my observations of feeding times at long term care facilities I have drawn some general conclusions and suggestions for any facility to adapt.
Overall, the main suggestion I have for people that feed residents or are responsible for people that feed residents would be to sit back and take a couple extra minutes to feed these residents. An extra 5 minutes might make a huge difference in that resident’s day and quality of life.
The most significant learning experience from observing the feeding experience was to learn how by feeding a resident with care you could have a direct affect on the residents improved quality of life. This was an incredibly rewarding realization and made the importance of the issue very clear and worth working towards.
Go Lean!
February 23rd, 2010Health care foodservice departments today are under considerable pressure to do more with less. Management is challenged to find savings, create efficiencies, provide safe work environments and invest wisely in sustainable yet flexible technologies. As a company that’s been a part of the health care foodservice industry for 25 years Burlodge is able to leverage its worldwide experience to develop new technologies that meet today’s demands. An excellent example of this is one of our recent developments: B-Lean.
Launched in 2007, the B-Lean project was developed as an equipment solution for a number of worldwide clients aimed at helping them to implement a small sized tray line assembly work cell to meet space challenges. As the concept evolved, it became clear that it mirrored Toyota’s highly successful Lean Principle of production. In effect, this was a method of producing a finished product through the removal of waste while implementing flow, rather than relying on a batch and queue approach.
To Toyota, the main method of lean is the reduction of three types of waste: muda or “non-value-adding work”, muri or “overburden”, and mura or “unevenness”. By addressing these waste areas, tools can then be developed to work around different situations. It was important to develop the B-Lean with Lean Thinking in mind and provide more than equipment. It was vital that Burlodge provide a system.
Perfect Flow
In short, Lean implementation focuses on getting the right things to the right place at the right time, and doing so in the right quantity. The goal is to achieve perfect flow while minimizing waste, remaining flexible and adapting to change. As these systems were developed and implemented they have evolved, providing operators with a considerable number of options to choose from. Burlodge offers two B-Lean Equipment systems that are interchangeable. Apart from the creation of new and improved design features of the B-Lean equipment, Burlodge has also gleaned some key insights about implementing Lean System thinking in the kitchen.
The concept of Lean must be understood, appreciated, and embraced by employees as they will soon own the equipment and operate it, which means owning the process and delivering value. The cultural and managerial factors of Lean are just as important as—if not more important—than the actual tools or methods of production itself. Unsuccessful Lean tool implementation without sustained benefit is often blamed on a weak understanding of Lean within the organization. This is why Burlodge has developed B-Lean as a system so that our experts can help move the Lean concept forward through successful implementation.
An Adaptable Approach
Providing the necessary tools and support, The B-Lean System by Burlodge allows operators to abandon conventional tray line assembly of patient meals and establish a very effective new Lean world that can adapt to an operation’s everyday challenges. This Lean System uses a very flexible work cell design that can be configured into an array of work cell formats on the fly. The equipment system is comprised of components that can be used when needed and placed where it makes the most sense to maintain continuous flow based on circumstances or production patterns.
Increasingly, there are more locations trying to provide different models of meal delivery under one roof, whether it’s driven by client or patient need, and/or ability. Some locations wish to offer a room service system to one client group while at the same time provide pre-assembled trays to the balance of the hospital. Space as well as existing tray line placement and construction are major barriers to overcome in these situations. That’s why the B-Lean System equipment has been developed to be perfectly flexible so it can be implemented in all different spaces and for a variety of needs.
The Benefits of B-Lean
The B-Lean solution from Burlodge will provide the following benefits to an operation:
