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    Dietary Services in Hospitals

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    Manish Jain
    Hospital dietary services involve multiple functions like diet planning, food purchasing, production, and distribution. The main objectives are maintaining patient nutritional status and meeting metabolic demands. Diet provided must consider patient culture, tastes, requirements, and palatability. Proper coordination between medical staff and dietary services is needed. Dietary services contribute to patient recovery through prepared diets and education on nutrition. Key functions include administrative duties like menu development and record keeping, clinical duties like diet prescription, and education functions like patient and staff nutrition counseling. Planning considerations include number of beds/specialties, meals served, and staff/visitor catering needs. Facilities require areas for receiving, preparing, cooking, serving, cleaning, and storing food with proper ventilation and

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    Dietary Services in Hospitals

    Uploaded by

    Manish Jain
    3K views5 pages
    Hospital dietary services involve multiple functions like diet planning, food purchasing, production, and distribution. The main objectives are maintaining patient nutritional status and meeting metabolic demands. Diet provided must consider patient culture, tastes, requirements, and palatability. Proper coordination between medical staff and dietary services is needed. Dietary services contribute to patient recovery through prepared diets and education on nutrition. Key functions include administrative duties like menu development and record keeping, clinical duties like diet prescription, and education functions like patient and staff nutrition counseling. Planning considerations include number of beds/specialties, meals served, and staff/visitor catering needs. Facilities require areas for receiving, preparing, cooking, serving, cleaning, and storing food with proper ventilation and

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    Hospital dietary services involve multiple functions like diet planning, food purchasing, production, and distribution. The main objectives are maintaining patient nutritional status and meeting metabolic demands. Diet provided must consider patient culture, tastes, requirements, and palatability. Proper coordination between medical staff and dietary services is needed. Dietary services contribute to patient recovery through prepared diets and education on nutrition. Key functions include administrative duties like menu development and record keeping, clinical duties like diet prescription, and education functions like patient and staff nutrition counseling. Planning considerations include number of beds/specialties, meals served, and staff/visitor catering needs. Facilities require areas for receiving, preparing, cooking, serving, cleaning, and storing food with proper ventilation and

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    3K views5 pages

    Dietary Services in Hospitals

    Uploaded by

    Manish Jain
    Hospital dietary services involve multiple functions like diet planning, food purchasing, production, and distribution. The main objectives are maintaining patient nutritional status and meeting metabolic demands. Diet provided must consider patient culture, tastes, requirements, and palatability. Proper coordination between medical staff and dietary services is needed. Dietary services contribute to patient recovery through prepared diets and education on nutrition. Key functions include administrative duties like menu development and record keeping, clinical duties like diet prescription, and education functions like patient and staff nutrition counseling. Planning considerations include number of beds/specialties, meals served, and staff/visitor catering needs. Facilities require areas for receiving, preparing, cooking, serving, cleaning, and storing food with proper ventilation and

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    Dietary/Food services in hospital management

    As the name suggest a hospital food service involves a multiple functional activities in a
    hospital dietary such as diet planning, food purchasing, food production, management of
    human resources in the processes of diet setting and distribution system, updating of food
    service technology and organization of food service. No matter what ever be the disease
    conditions, maintenance of nutritional status and rising up to the nutritional challenges in
    response to the metabolic demands is the prime objectives of any hospital food service. Food
    given to an in – patient cannot solely be regarded as something that is prescribed by a
    dietitian, their social culture, food likes and dislikes, metabolic requirements, and palatability
    must be given due importance. Therefore a hospital meal should be provided in a proper
    environment, having choices by a co-ordinated effort of a physician, dietitian, nurse and
    hospital food service personals.
    Hospitals these days receive patients of varying nature, with different cultural background,
    with varied food habits and with different diseases. The clinicians and dieticians have not
    only to meet the requirements of patients as per their nature of diseases, their nutritional
    status and to tackle any problems related to underlying pathological conditions. In fact the
    doctors and the dieticians have to coordinate their activities in the best interest of patient care.
    Dietary service is one of the most important hospital supportive services contributing to the
    recovery of health, through scientifically prepared diets, educating the patients attending the
    hospitals for treatment regarding use and utility of different foods and balanced diets.
    HOSPITAL DIETARY SERVICE FUNCTIONS:
    Broadly 3 major functions:
    Administrative functions:
     Establishment of policies and standards
     Development of food menu
     Purchase and receipt of foods
     Production and service of safe, nutritious and palatable food
     Effective utilization of personnel, layout and equipment, maintenance of records and
    reports.
    Clinical functions:
     Providing and promoting high quality nutritional care.
     Diet prescription and implementation of diet orders.
    Education functions:
     Education of patients, attendants, hospital personnel and paramedic groups regarding
    importance of diet.
     Individual and group counselling of patients.
    Also the functions of a hospital dietary services can be grouped under four headings:
    1) Inpatient Catering
    2) Diet Counselling
    3) Commercial catering
    4) Education, Training and research
    1) Inpatient Catering: It pertains to provision of meals to the patients admitted in the
    hospital. It should be a balanced diet providing adequate calories, taking into account the type
    of underlying illness, any extra nutritional requirements and the general food habits of
    patients.
    2) Diet Counselling: This service can be provided as out-patient diet clinics where patients
    are referred by clinicians to the dieticians for calculating their dietary requirements
    considering the body weight, height, underlying disease, food, habits availability and
    acceptability of different foods locally depending upon the economic condition of each
    patient. Patients are usually given a diet chart to be followed by them along with certain
    foods either to be avoided or to be preferred. Admitted patients in the hospitals especially
    with certain diseases like diabetes, hypertension, heart ailments, anaemias etc. are advised
    during admission and the time of discharge regarding food intake.
    3) Commercial Catering: the service caters to the needs of staff members who are on duty in
    various shifts by way of provision of meals, tea, snacks, cold drinks etc. The service usually
    takes the shape in the form of staff canteens open from early morning till late evenings and
    the food provided works out to be cheaper to the employees when compared to the costs run
    by private parties. Moreover, the administration can control the quality of food services. This
    type of service call be extended to the attendants of visitors of the patient who are usually
    desperate to find a good quality of food at a reasonable price and at a convenient place with
    in the hospital. The hospitals can provide this facility in a separate place other than staff
    canteen.
    4) Education, Training and Research: This forms an integral component of any department.
    The staff of the hospital like Nurses, Residents, Nursing aids, Technicians, Cooks etc. could
    be educated regarding types of foods, their caloric value, balanced diet etc.

    PLANNING CONSIDERATION
    Inpatient catering is the major activity of the dietary department and proper planning leads to
    the economy of operation and adds to the efficiency of the service. While planning we have
    to consider:
    1) Location and site.
    2) Number of hospital beds and the specialities existing.
    3) Number of meals served per day and type of foods to be served considering the local food
    habits of the people.
    4) Catering to staff members of the hospital and number of employees.
    5)' Extension of facilities to attendants of the patient.
    6) Centralised vs. decentralised service.
    7) Type of equipment available.

    PHYSICAL FACILITIES AND LAYOUT


    Space requirement: food production is the core activity of the service and the design should
    follow the function to minimise the labour and reduce space needs. The area and shape of the
    floor space will influence equipment arrangement and work flow patterns.
    Location: it should be located on the ground floor, nearer to service lifts, having easy access
    with the roads of the hospital for receipt of supplies and should be as far as possible nearer to
    inpatient area. It will be preferable that the main hospital kitchen is planned within the service
    area of the hospital and if the equipment is running on steam boilers, the distance from the
    location of steam boilers should be less as far as possible, if such service is centrally placed
    and feeding to other areas of the hospital especially so in big hospital. In smaller hospital
    small steam generators could be used within the patient kitchen itself.
    Layout: it has to be arranged in such a manner that different functions are carried out
    systematically. Facilities required are:
     Receipt and storage area
     Day store
     Preparation area
     Cooking area
     Service area
     Dish washing and pot washing area
     Record room
     Staff room
     Store area for dead stock and unserviceable items.
    Other facilities: the area should be properly ventilated and have good lighting arrangement.
    Adequate number of exhaust fans should be fixed to let out any steam and fumes. In addition
    we should have LPG cylinder bank, steam supply and electrical points for utilising different
    equipments. Flooring with tiles/kota stones for easy washing and cleaning is needed. A
    seminar room in a large teaching hospitals is needed for training student nurses and dieticians
    and other staff members.
    Staffing:
    It may not be possible to generalize the requirement of staff according to the size of the
    hospital. It will vary from hospital to hospital due to the differences in the type of foods
    served, physical facilities, equipment, type of service. Following type of organisational
    structure is recommended for large hospitals of 500 beds and above.
    The department should be headed preferably by a person who possess a degree in hotel
    Management/Catering, Dietetics and Nutrition and having experience of working in a
    hospital setting. The other supervisory staff should also be trained and experienced.

    MANAGERIAL ISSUES
    The department should be concerned with supply of proper diets at fixed timings maintaining
    good hygiene. The quality of preparation and cooking of different meals should be strictly
    monitored. The feedback from the patients/staff to whom the food is served acts as a control
    mechanism for improving the service. Regular feedback from the staff working in the wards
    regarding the diets served to the patients is equally important. The officer in charge should
    ensure:
    1. Regular cleanliness of the food preparation area.
    2. Regular maintenance of equipments and proper day to day cleaning of utensils,
    crockery, cutlery etc.
    3. Periodical health check-up of staff working in the department is essential. Proper
    health record of each employee should be maintained.
    4. The employees should be given 2-3 sets of uniforms and ensure they wear it.
    5. On the job training of new employees who join the department should be done.
    6. Food prepared should be checked by the dieticians before serving.
    7. The menu should be displayed.
    8. Dieticians and officer in-charge should make regular visits towards and enquire from
    the staff and the patients about any observations in the diets served.
    9. Budgetary provisions act as a regulatory mechanism to control costs. Working out
    food costs regularly, helps in guiding the department.
    10. Proper maintenance of records in the department regarding materials received, daily
    issue, number of diets served, etc.

    CONTROL AND EVALUATION MECHANISM


     Proper committee for inspection
     Supervisory posts at every level
     Control of petty thefts and pilferages
     Limited accessibility to the stores and locking mechanism
     Cost control measures
     Daily checking and feed back from the patients and staff.

    Quality Control in Foodservice


    Quality is a value that must be consistently maintained in a food product to meet the aesthetic
    expectations of the consumer. To maintain consistent quality in foodservice, standards must
    be established and control systems designed to monitor and compare the quality of the
    foodservice with the established standards. Routine evaluation may identify areas that do not
    meet the established standards. It is the responsibility of management personnel to establish
    ·and maintain standards. Quality control in foodservice areas is difficult to establish and
    maintain because there is much variability in production and highly perishable products are
    involved. The purpose of quality control is to maintain established standards for a product
    during all stages of storage, processing, preparation and service with continual corrective
    action. Quality is controlled when the actual quality of the product is compared with the
    established standards and changes are made to correct any deficiency. Maximum benefits can
    be derived when a total quality control program is established at all levels in the operation.
    Control of food quality in critical areas must be consistently maintained to provide a safe
    food product that meets the aesthetic expectations of the consumer. A frequently used method
    to evaluate the quality of the food and service is to obtain the opinion of the consumer.

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