Patient Services Playbook 6/17

Patient Services Playbook 6/17

P L AY B O O K Patient Services

About This Guide • All information in this guide is for use by TouchPoint Support Services associates only. Because our processes and procedures are proprietary, broader distribution is strictly prohibited. This guide should never leave the work premises. • While these guides are printed and static, the online version is kept up-to-date. Please use the digital playbook on the TouchPoint intranet to print information for posting or training.

• To access this guide online, click on the “Associate Login” link on IAmTouchPoint.com

• In the text, you will see items highlighted in blue that reflect hyperlinks. The hyperlinks are functional only in the digital playbooks.

©2017 TOUCHPOINT SUPPORT SERVICES. ALL RIGHTS RESERVED; UPDATED JUNE, 2017

Strictly confidential; do not remove from premises or share outside of TouchPoint associates.

Essentials 1. All patients have a written diet order. Nothing is served to a patient until the diet order is in writing. Diet orders written in the medical record match those in the diet manual and on the patient menu.

2. Meal orders are taken as close to the meal service time as possible.

3. Temperatures are recorded at the start of meal service and then recorded again either at the mid-point or end of service.

4. Tray assembly starts on time and meals are delivered to patients on time.

5. Trays are assembled and checked to ensure tray accuracy before leaving the kitchen.

6. Meals served are safe for patients to eat. Trays for patients that have allergies or are on texture modified diets are double checked according to policy prior to leaving the kitchen.

7. Diet orders are verified as most current prior to serving the meal to the patient.

8. Associates serve meals to patients using proper hand hygiene, respectfully entering the patient’s room, using 2 patient identifiers to verify correct patient, and using key words and phrases in conversations.

9. Patient meals look and taste great and are served at the correct temperature. Test trays are done according to the test tray policy.

10. Patients receive a visit from a member of the TouchPoint management team at least one time during their stay.

11. Must follow all 10 essentials for culinary.

TABLE OF CONTENTS

THE FOUNDATION Objectives for Patient Meal Service. .................................... 6 Diet Order Process............................................................... 10 Meal Service Process........................................................... 12 The Menu: Appetizing and Nourishing............................. 14 Diet Orders and Other Patient Information....................... 18 Department Role in Menu Accuracy. ................................. 22 Meal Safety........................................................................... 26 Tray Assembly....................................................................... 30 Tray Delivery and Pick-Up.................................................... 34 Patient-Specific Nourishments............................................ 38 Nursing Unit Stock............................................................... 42 Branded Patient Services Programs................................... 46 PATIENT SATISFACTION Special Meal Services.......................................................... 50 Food for Patients Other than Tray Service......................... 54 Unity Rounds. ....................................................................... 58 Patient Surveys..................................................................... 62

2 | The Foundation

QUALITY MEASURES Mealtime Temperature Checks........................................... 66 Quality Checks. .................................................................... 70 Nurse Survey......................................................................... 74 Nutrition Focus Group......................................................... 76 OTHER Record Retention – Patient Services................................... 80 Training Patient Services Staff............................................. 82 Disaster Response................................................................ 84 CHAT..................................................................................... 86

THE FOU

DATION

Objectives for Patient Meal Service

Why this is important:

• The hospital hired us to provide quality service for their patients.

• Food and nutrition products are provided for each patient according to their care, treatment and services.

What to do: • Select meal service program based on types of patients treated. For example, if patients have treatments that require meals at specific times, a program where patients call when they want to eat doesn’t work as well.

• Have amount of supplies that you need to serve an appetizing-looking meal.

• Agree with nursing on times to serve meals on each patient unit.

• Make sure tray ticket includes necessary information, such as the patient’s name, room number, second identifier, diet order and allergies.

• Start and end tray service on time.

The Foundation | 7

• Ensure meal served is safe for the patient to eat. Double- check the trays for patients with food allergies and patients who have trouble chewing or swallowing. • Train associates on how to serve meals to patients, the proper elevators to use, coordination with nursing team, hand hygiene, and entering a patient’s room. Train on serving patients on isolation precautions, if food service enters these rooms.

• Train associates on how to pick up trays, hand hygiene, and speaking with patients.

The Foundation | 9

Diet Order Process

Process:

• Doctor decides on the diet order.

• Order entered into Electronic Medical Record.

• Order sent to FNS: either a printed copy or an update in FNS software (such as Horizon DOC).

• Nothing is served until diet order is in writing.

• When new orders arrive between meals, they are served according to policy.

• Diet Census report prints at set times; used to offer menu and verify orders before meals.

• FNS software; diet order updates on menus; print menus just before tray assembly.

• Associate uses Diet Census sheet to “head” menus/BLD Tickets (patient name + room # + date of birth + diet order).

The Foundation | 11

Meal Served Process

Process:

• Associate “speaks” the menu to the patient; records the choices on the BLD ticket or in software.

• DOC: patient calls when ready to eat. Nutrition Operator enters order into software; meal ticket prints.

• Associate assembles tray according to choices on the BLD ticket/tray ticket.

• CTY: before serving trays, CA checks with nurses about recent diet changes, especially changes to NPO and food to liquids. • Associate asks patient to say their name and date of birth; verifies the same information on the tray ticket before tray is served.

• Meal served.

The Foundation | 13

THE MENU Appetizing and Nourishing

Why this is important: • Patients need to eat in order to get well. If the menu is not interesting and tasty, patients might not eat their meals. • Some patients have diet restrictions due to their medical conditions. The menu must be adapted to offer choices to these patients.

• The menu must meet the nutritional needs of the majority of our patients.

What to do: • Your CEC uploads available menus into your Webtrition account. Ask your Clinical Nutrition Manager or lead dietitian if there are diet menus needed that are not available. You and your team are responsible for adding them in Webtrition.

• The Clinical Nutrition Manager or lead dietitian contacts the Admissions Department to get information on the typical patient – average age and whether male or female.

• The Clinical Nutrition Manager or lead dietitian uses the Webtrition Menu Nutrient Analysis report to confirm that the menus meet the nutritional standard.

The Foundation | 15

The Dietary Reference Intakes (DRI) is the current standard. o Print a copy of the Menu Nutrient Analysis Summary Report. o Save a copy of the full Menu Nutrient Analysis Report on a shared drive where any manager can access it. • The Clinical Nutrition Manager or lead dietitian approves the master menu and diet menus. File a signed and dated copy of the menus and Menu Approval Form . Keep these files for three years.

• Provide menu spreadsheets for associates who offer the menu choices to the patients, those who serve food and those who deliver meals.

• Evaluate success of menu on a planned basis. Use information from patient visits, test trays and surveys.

• Additional details are in Section C of the P&P Manual (Patient Menu and Nutritional Adequacy of Menus/Menu Approval) C010 .

16 | The Foundation

The Foundation | 17

Diet Orders and Other Patient Information

Why this is important: • The patient’s diet is a part of their medical treatment. The diet order must be written before anything is served to the patient. • A patient could be harmed if served the wrong diet. This could happen if there is a delay in sending the information to Food and Nutrition Services, or if something is served without checking the current diet order. • Information about a patient’s needs, preferences, and cultural or religious beliefs that affect food choices is also entered into the medical record. This information prints on the diet census report.

• The hospital determines which medical professionals can order diets, based on state law and hospital protocol.

What to do:

• The Clinical Nutrition Manager or lead dietitian works with medical services to develop the list of diet orders.

• The Clinical Nutrition Manager or lead dietitian works with IT to develop a diet census report that has all of the required information, and is available at the times needed.

o Required information: Name, room number, second identifier (usually birthdate), diet order, food allergies,

The Foundation | 19

and additional information needed to provide the diet as intended.

o As available information: Food preferences, cultural and religious beliefs affecting food choices.

o Diet orders often print immediately after being written. Arrange for a report with all patient’s diet and food allergy information to print just before each meal.

• Whenever a diet order is changed, the entire diet order must be rewritten.

• The diet orders in the medical record system should match those in the diet manual and on the patient menu. If not, Clinical Nutrition Manager or lead dietitian develops a reference for Food and Nutrition Services to use. • Food and Nutrition Services associates update current diet census report until a new report prints. Use diet census report to select correct menu for patient and for information to write on the tray ticket. • If the hospital system is off-line, ask nursing to update and sign most recent diet census report. File signed reports for 90 days.

• Keep a Telephone Message Sheet next to any phone used to accept messages about patients. File them for 30 days.

• A patient can refuse the diet ordered but there is a process to follow. Continue to serve the diet (even if the patient says they do not want it) until the order changes. In the meantime, offer the patient other foods that are allowed

20 | The Foundation

on the current diet.

• Additional details are in Section C of the P&P Manual (Diet Orders; Communication of Patient Information and Requests; and Kosher Meal Service).

The Foundation | 21

Department Role in Menu Accuracy

Why this is important: • Meals are an important part of a patient’s day – something they understand. Patients expect to get the food they ordered.

• Doctors expect that their patients be served according to the written orders.

What to do:

• Diet orders change constantly, so the diet census list is never “finished”.

• The goal with menu selection is to offer menu as close to the time meal is served as possible. This limits time available for diet orders to change. •  Printed Menu : FNS associate edits menu before presenting to patient to remove choices not allowed on a combination diet. Menus are checked just before assembly. •  Spoken Menu : FNS associate prints a diet census report before offering menu to patients. Before meals are served, FNS associate either asks nursing to confirm diet orders, or prints a new report for a check of trays.

• Serve a “non-select” meal if patient isn’t available to select meal.

The Foundation | 23

• Diet order changes during meal assembly: if patient’s unit hasn’t been served, insert new ticket with others for the unit. Otherwise, assemble tray at the end. • Use menu or tray ticket to identify tray. Ticket should include patient’s name, room number, second identifier (usually birthdate), diet order and allergies.

• Culinary decides which foods need to be counted before meal service, and what time the count is needed.

• Culinary needs tohave food available to serve as scheduled so that tray assembly starts on time.

• Associates who plate and serve meals need to be in assembly station on time, so that meals are served as scheduled. • Additional details are in Section C of the P&P Manual (Menu Preparedness (Heading) Process; Menu Distribution/Collection; Menu Selections Made by Food and Nutrition Services; Special Food Requests; Menu Editing; Forecasting the Amount to Prepare).

24 | The Foundation

The Foundation | 25

Meal Safety

Why this is important:

• Every meal that we serve needs to be safe for the patient to eat.

What to do: • “High Risk Trays” are those served to patients with food allergies, or those that require textured food (chopped, ground or pureed) and/or thickened liquids. In some cases, other types of diet orders are included. These trays must be double-checked before they leave the kitchen. • Food allergies must be recorded in the medical record. If a patient tells FNS associate about a food allergy, FNS associate reports it to the nurse. • The chef maintains a list of patient food allergies, so that production associates know which menu items are affected. • The supervisor uses diet census report to write/verify list of trays to be double-checked. At some hospitals, IT develops a report to provide information before each meal. • Trays that need to be double-checked on each unit are assembled first. Alert associates to trays with food allergy orders through red BLD tickets or other color-coding system. The associate calls supervisor to double-check

The Foundation | 27

tray. The supervisor confirms that everything on tray is allowed. The supervisor’s confirmation of tray means that no foods contain food patient is allergic to, and texture of food and thickness of liquids are correct. The supervisor initials form. Before cart leaves kitchen, supervisor checks list to make sure all were double-checked. At the end of the day, the manager signs and dates form and files it. • Webtrition Menu Allergen-Intolerance Report must be near assembly station for reference. Supervisor/manager must also refer to product labels to confirm that allergen is not present in food. • All managers and supervisors are trained on food allergies, using Webtrition report and reading product labels. Someone is available during each tray assembly period to answer questions about menu items and food allergies.

• Involve Speech Therapist if there are questions about textures or liquid thicknesses.

• Train all patient service associates on food allergies and modified diets.

• Additional details are in Section C of the P&P Manual (Avoiding Adverse Events).

28 | The Foundation

Tray Assembly

Why this is important: • Patients should receive the correct diet, served on time and at the correct temperature. In order to achieve this, the tray assembly process must be organized and well run.

What to do:

• Both culinary and patient services need to work to the time that meal assembly is scheduled to start.

• Be aware of amount of time that it takes plates to heat. If that amount of time isn’t available between the end of dishwashing and beginning of next meal, buy more plates. • Plan on two turns for dessert plates and dishes, as one will be in service/being washed, while other will be in cold production for next meal.

• A plan for meal delivery times on each nursing station is set; nursing has schedule.

• Supervisor is responsible for ensuring that tray assembly area is ready to start on time. Taste Temperature Record includes a list of reminders. List utensils needed to serve meal on this form.

The Foundation | 31

• Temperatures are recorded according to type of patient services program in place.

• Put milk in freezer thirty minutes before start of tray assembly. Remove milk one case at a time. Be sure to remove any that remains from freezer at end of service. • Hold a daily line up meeting once a shift. This is an opportunity to review department events, current issues and quick in-service topics. Guides for these meetings are posted on MyCompass on the TSS Go Beyond page. File agenda and attendance records for 3 months. • Post meal spreadsheets at tray assembly station. These outline items served for major diets when a patient has not selected the meal. • Monitor time of assembly and scheduled delivery time on nursing units. Record start and end times for each nursing unit. Notify nursing units if trays will leave kitchen more than ten minutes late. • Diet changes may print during tray assembly time. If diet change is for a patient on a nursing unit not yet served, insert tray ticket into pack so that patient is served on time. • Several types of quality checks are expected. They include daily test trays, double-check of high risk trays, random tray accuracy and assembly rate checks. • Additional details are in Section C of the P&P Manual (Tray Assembly Procedures and Daily Meeting; Trayline Taste/ Temperature Record; Tray Service Quality Assessment; and Test Tray Evaluation).

32 | The Foundation

The Foundation | 33

TRAY DELIVERY AND PICK-UP Mealtime and Between Meals

Why this is important: • Nursing units expect trays to be delivered on time. Nurses plan their work such as medication pass and breaks around times that meals are expected to be delivered.

• Patients expect their meals on time.

• There are regulations that specify the number of hours allowed between dinner one day and breakfast the next.

• There are regulations that require that patients are fed who were unable to eat at the scheduled times.

What to do:

MEET WITH NURSING TO DISCUSS THE FOLLOWING:

• Time meals will be delivered.

• Nursing assistance with patients being ready to eat their meals.

• Action needed when a patient’s diet order changes.

• Department that will serve meals to patients on isolation precautions.

• Department that will record patient meal intake.

The Foundation | 35

TRAIN FOOD AND NUTRITION SERVICES ASSOCIATES WHO DELIVER MEALS, TO INCLUDE:

• Elevator etiquette: where to position cart and protecting patient information.

• Hand hygiene during service.

• Respectful room entry, including use of “key words” and check of two identifiers.

• Information to report to nursing.

• Extra supplies to have available and what to do if patient requests something not available on nursing unit.

• Types of assistance that can be provided to patient during service.

• What to do if Food and Nutrition Services serves patients on isolation precautions and/or records meal intake.

DAILY SERVICE:

• Make sure service is on time. If trays will arrive more than 10 minutes late, call nursing unit.

• Do not accept verbal diet orders; they must be in writing.

• Check for diet changes during meal service; it might be possible to serve meal with the rest of the trays for nursing unit.

36 | The Foundation

• Trays requested between scheduled meal times are called “NOW” trays. They must be served within 30 minutes of request. • Pick-up trays 45-60 minutes after meal service. Follow procedures for disposal of tray tickets and disposable trays.

• Check pantry for dirty trays to be returned to kitchen.

Patient-Specific Nourishments

Why this is important:

• Between-meal nourishments are a part of the treatment plan for certain patients.

• They are either listed on the Diet Census Report, or are an understood part of the diet order. For example, if the diet order is for six small meals, the patient will have three meals and three snacks.

What to do: • Food and Nutrition Services works with Nursing to agree whenandhownourishmentswill bedelivered. For example, Food and Nutrition Services delivers nourishments during the day and Nursing delivers the bedtime nourishments. • Director determines how to serve nourishments, based on foods typically used. Make food look as appetizing as possible because patients who have orders for nourishments often have poor appetites. • Develop a system to know which patients have orders for nourishments. Check for diet changes before nourishments are prepared. Check again before nourishments are served.

The Foundation | 39

• Develop a system for labels needed for nourishments. The requirements are the same as for tray tickets.

• Additional details are in Section C of the P&P Manual (Nourishments, Patient Specific).

40 | The Foundation

The Foundation | 41

Nursing Unit Stock

Why this is important:

• Patients need access to food at times other than the scheduled meal times.

• Nurses need to be able to meet simple needs for food to serve to patients.

What to do: • Agree with nursing on types and amounts of food to stock on each nursing unit. Specific nursing units may have different needs. • Set the schedule for restocking each pantry. Track amounts stocked in each pantry. A nurse signs to “accept” the delivery. In some cases, the cost of nursing unit stock is transferred to nursing. • Do not deliver products in corrugated cardboard. Transfer product to zip-lock bags or plastic containers. Label and date products delivered to pantries. • Only patient food can be stored in pantry refrigerator. This means no nursing staff food, specimens or medications can be placed in pantry refrigerator.

• Food and Nutrition Services rotates foods when new product is delivered and discards expired foods.

The Foundation | 43

• Often, there is a designated place where boxed meals are stored, accessible by nurses from any nursing unit. Boxed meals may be used for after-hours service. • Meet with nursing, infection control and environmental services to determine each department’s role, if any, in monitoring the temperatures in refrigerators (temperature log) and cleaning pantries. During an inspection, Food and Nutrition Services is most often cited if temperatures aren’t recorded, even if another department is responsible. There is a process in place to notify Food and Nutrition Services if temperatures are out of range. • There is a process in place to provide additional items needed by nursing between scheduled deliveries. Record amounts delivered daily in order to track cost. • Nurses offer items from pantry to patients who request them. Nurses need to be aware of patient’s diet and food allergies when items are offered. Food and Nutrition Services provides a reference for nurses on pantry stock that can be offered to patients on modified diets. • Nursing is responsible for security of pantry.

• Nurses label/date products when opened.

• Additional details are in Section C 034 of the P&P Manual (Nursing Unit Stock; Guidelines for Distribution of Pantry Stock to Patients).

44 | Quality Measures

Quality Measures | 45

Branded Patient Services Programs

Why this is important:

• Catering to You (CTY) and Dining on Call (DOC) are the branded patient services programs available.

• There are specific service expectations connected to each of them. The client expects that they will be implemented as described during the approval process.

What to do: • Learn everything you can about the program you will use. Contact the Customer Experience Team for support materials. • Manager training is available through the TouchPoint Dining Technology course. Go to www.compassmylms. com for details and dates. • Connect with the Customer Experience team who assists with program implementation. That team will guide you in writing an implementation plan with a timeline. • Talk with your RDO to find local accounts using the same branded program. Network with those managers. Visit to observe, if possible.

• Section C of the P&P Manual has been adapted for CTY and DOC.

The Foundation | 47

PAT SATISF

ENT CTION

Special Meal Services

Why this is important:

• A “one size fits all” approach rarely works in today’s “instant access” world.

• Most patients don’t want to be in the hospital. We can make their stay more enjoyable by providing some special services to brighten their day.

What to do: • Connect with other hospital departments to make sure there is no duplication in providing extra patient services. For example, volunteers might already be delivering newspapers. • Connect with maternity services to see if there is interest in celebrating births through a meal or a gift. The usual time that a new mother is in the hospital will affect the choices offered.

• Connect with IT to see if a message can be printed to alert you about patient birthdays. Decide what to offer.

• Connect with nursing to see if guest trays should be available. Determine a process and cost for guest trays that can be purchased. There may be situations where the guest tray is free.

Patient Satisfaction | 51

• There may be need for kosher foods. Frozen, sealed meals are available for purchase.

• Holiday placemats and napkins are available from the approved placemat vendor.

• Additional details are in Section C of the P&P Manual (Guest Trays; Kosher Meal Service; Special Food Requests; Special Patient Meals and Services).

52 | Patient Satisfaction

Patient Satisfaction | 53

Food for Patients Other than Tray Service

Why this is important:

• A patient’s preferred foods might not be available through the planned menu or “always available” choices.

• Family members may bring food to a patient as a way of showing concern for the patient.

• Rehab patients and others with extended stays who are on regular diets may tire of the menu choices and ask for items from the retail menu.

What to do: • Some facilities do not allow patients to have food other than what is available from Food and Nutrition Services.

IF THEY DO:

• The nurse must verify food is appropriate for patient (diet, texture, allergies, etc.) if food from outside is allowed.

• Consult dietitian if patient is on a modified diet.

• Label and date foods that must be refrigerated. Place them in refrigerator in unit pantry. Discard foods after 24 hours.

Patient Satisfaction | 55

• Reheat foods in microwave on nursing unit, or in customer area of retail.

• Rehab patients and others with extended stays, who are on regular diets, may be able to choose items from retail. Sometimes patients visit retail to select items, and sometimes the items are served on patient’s tray. This is at no cost to patient. • Additional details are in Section C of the P&P Manual (Food Brought in to Patients from the Outside; Patient Retail Policy).

56 | Patient Satisfaction

Patient Satisfaction | 57

Unity Rounds

Why this is important: • Learn first-hand what patients think about their meals and our support services. You can’t fix something if you don’t know it’s broken. By identifying opportunities early, we can provide immediate service recovery.

• Daily visits are essential to address patient, resident and guest needs.

• Visiting with patients can set the expectations of their experience with our hospitality team.

• We can gather and trend information from our visits in order to continuously improve the service we provide.

What to do: • All managers are expected to participate, as well as trained hospitality ambassadors and supervisors. These include Directors, Assistant Directors, Clinical Nutrition Managers, Operations Managers, Patient Service Managers, Retail Managers, Patient Experience Managers, Chefs, and Clinical Dietitians.

• Unity round on every patient at least once during their stay.

Patient Satisfaction | 59

• Managers should use the Unity Rounding Form found in TeamCoach to get well-rounded feedback from each visit. It includes nine questions, covering FNS, EVS, Patient Transport (if applicable) and the overall impression of the hospitality team.

• Rounders should gather before and after rounding to share observations.

• Each rounder should visit nurse’s station before and after rounding.

• Immediately address issues that are within your scope and record corrective actions.

• Input issues into TeamCoach; a director should review by the following day to consider need for additional follow- up.

• Engage clinicians, maintenance, and other departments, as appropriate.

• Work together with other service lines on service recovery and continuous improvement efforts.

• Issues, trends, and actions should be discussed at joint management meetings on a weekly or biweekly basis.

• Share success stories to positively reinforce valued behaviors.

• Additional details can be found in the Unity Rounding Fact Sheet .

60 | Patient Satisfaction

Patient Satisfaction | 61

Patient Surveys

Why this is important: • Hospitals usually hire a company to survey their patients after they are discharged. These surveys often include at least one question about meal service. Ascension Health has selected PRC (Professional Research Consultants) to be the primary third party surveyor responsible for conducting all its hospital’s surveys system-wide. Non- Ascension Health hospitals may contract with a different third party surveyor. • The federal government’s questions on the survey (HCAHPS questions) do not include a specific question about meal service. However, there are questions that our services might impact, such as communication and responsiveness.

What to do:

• Know what surveys are in place and the questions on the survey.

• Arrange to gain access to survey company’s website.

• Know your Operational Excellence Goals. Monthly scores (overall and per unit) should be posted in a prominent location in kitchen/department for all associates to see.

• Additional details are in Section C of the P&P Manual (Patient Survey).

Patient Satisfaction | 63

QUALITY

EASURES

Mealtime Temperature Checks

Why this is important:

• Meal satisfaction is affected when the food served isn’t at the expected temperatures.

• Food safety is affected when food isn’t held at safe temperatures.

• The time that passes between plating and service of food affects the temperature, as well. “Optimal” holding temperatures are listed on the Taste Temperature Record to address this.

What to do: • Use the TouchPoint Webtrition Taste Temperature Record. The report lists Optimal Temperatures and other important mealtime checklists.

o As an alternate, type a full cycle of Taste Temperature forms. Be sure to fill in all columns of the form.

• Test temperatures of hot and cold foods.

• Taste hot and cold foods to ensure food quality standards are met.

• Use separate set of forms for each workstation.

Quality Measures | 67

• Temperatures are recorded at the start of service. Temperatures are recorded again, at either mid-point or end of service.

• Take temperature of replacement pans of hot food to check food is at expected temperatures.

• Additional details are in Section C of the P&P Manual (Trayline Taste Temperature Record).

68 | Quality Measures

Quality Measures | 69

Quality Checks

Why this is important:

• Patient meals should look and taste great, and be served at the right temperature.

• Invite a variety of people to test patient meals. Use their feedback to identify opportunities for improvement. When hospital staff has a food experience with a patient meal, they are supportive of Food and Nutrition Services when talking with patients.

What to do:

• Manager/floor owners schedule a test tray weekly on their unit. Invite nurses to participate in test.

• Use the Test Tray form (found in the P&P Manual) while still in the kitchen. Record temperatures of hot and cold foods as tray is prepared. • Be sure to have enough utensils, plates and plastic condiment cups so that each person can taste each item on tray. • On the unit, wait the normal amount of time that it takes a patient to be served before starting test. This is usually 30-45 minutes from assembly to delivery.

Quality Measures | 71

• If a majority of the patients on a unit receive the same type of diet – for example, a cardiac diet – serve that diet occasionally to let nurses taste what the patients are served.

• Complete process according to instructions on form and guidance in the P&P Manual.

• Take corrective action for items resulting in a score of less than 90%.

• Additional details are in Section C of the P&P Manual (Test Tray Evaluation).

72 | Quality Measures

Quality Measures | 73

Nurse Survey

Why this is important: • Nurses spend their days with the patients. A nurse’s opinion of the food can influence the patient’s opinion of our services.

• The responses to questions on the survey tells you what they believe needs to be improved.

What to do:

• Meet with Director of Nursing to ask permission to offer a survey.

• Decide if survey is on paper or computerized. Set a date to offer survey.

• Involve nurse leaders in promoting survey. This may increase number of returns.

• When survey is closed, analyze results and develop an action plan.

• Share action plan with nursing to ensure that your plan will solve the problems identified.

• Implement the action plan.

• A sample survey is in P&P Manual.

• Additional details are in Section C of the P&P Manual (Nurse Survey).

Quality Measures | 75

Nutrition Focus Group

Why this is important: • Associates from other departments can influence how patients feel about their meals. It is important that we know what they think about our services.

• This setting also allows us to share information about how our department works.

What to do:

• Invite 3-7 facility associates who provide patient care. Include hourly associates and managers.

• Schedule meetings every other month or as appropriate. Plan date in advance so people can arrange to attend.

• Plan an agenda and send it out before meeting. Possible topics include NOW trays, floor stock, patient menu selection and food quality. • Take notes during meeting and send out to participants after meeting. Make sure you follow up on issues identified during meeting. • Consider scheduling meeting at mealtime so you can allow participants to choose from patient menu. Ask them to complete Tray Service Quality Assessment after meal.

• Additional details are in Section C of the P&P Manual (Nutrition Focus Group; Tray Service Quality Assessment).

Quality Measures | 77

OT

ER

Record Retention

Why this is important:

• You need records to confirm that your processes are in place and that food is being handled safely.

• You need records to prove to inspectors that you are meeting the regulations.

What to do:

Keep records for the lengths of time listed in this chart:

TYPE OF RECORD

TIME

Daily Meeting Attendance

3 months

Results of Daily Patient Attendance

3 months

Nurse Survey Results

6 months

High Risk Tray Logs

1 year

Taste Temperature Records

1 year

Tray Accuracy Assessments

1 year

Menus, with Dietitian’s approval signature and date

3 years

Other | 81

Training Patient Services Staff

Why this is important: • Continuous training keeps our associates engaged and growing their careers. This helps you improve the talent on your team.

What to do:

• Encourage patient services team to participate in training opportunities as often as they can.

• Train on required Patient Program Competencies every year.

• Use the eLearning TrainingManuals for frontline associates working in locations with CTY and DOC.

• Make sure supervisors/managers complete required training:

o Food Allergen Training o P&P Manual Training

o Mandatory trainings from Compass, such as “wage and hour” and “preventing workplace harassment” training which will be required via email campaign. • Recommended training for Patient Services Managers. (See MyLMS for dates and locations of these instructor- led sessions.) o Dining Technology Training • There are spot trainings happening all year long at various times. Your patient services staff should participate in all of these that pertain to patient services.

Other | 83

Disaster Response

Why this is important:

• Disasters can strike at any time. Those who are on-site when the disaster hits need to know what to do.

• The facility’s expectations for the response from Food and Nutrition Services are included in the department’s plan.

What to do: • Food and Nutrition Services Director develops department’s disaster plan. The department’s plan is coordinated with facility’s plan. • The department’s disaster plan needs to be in writing, and in an area that is available whenever department is open. That means the plan can’t be locked in the Director’s office on weekends and other times when Director may not be in department.

• Department managers and supervisors need to know where the plan is and what to do.

• Refer to Section H of the TouchPoint FNS Policy and Procedure Manual for guidance on development of your specific Disaster Plan.

Other | 85

CHAT

Why this is important: • Continuous training helps your associates grow in their roles. The monthly CHAT session is a regular part of training that is available.

• Over the year, the CHATS include topics that are required by regulation.

What to do:

• Know when CHAT materials are published. Schedule a set day each month to present CHAT.

• Type a sign-in sheet with names of all associates. Associates sign by their name when they attend CHAT. This makes it easy to see at a glance who did/did not attend.

• Offer a second session for those who couldn’t attend on day CHAT was presented.

• Have a plan to catch up with all remaining associates. The expectation is that 90% of associates attend each month.

• The CHAT calendar is posted on MyCompass, so you know what to expect.

Other | 87