title: Assessment of foodservice quality and identification of improvement strategies using hospital foodservice quality model.
abstract: The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.
authors.affiliation: Department of Food and Nutrition, Seoul Women's University, 623 Hwarangro, Nowon-gu, Seoul 139-774, Korea.
authors.forename: Kyungjoo
authors.initials: K
authors.lastname: Kim
authors.forename: Minyoung
authors.initials: M
authors.lastname: Kim
authors.forename: Kyung-Eun
authors.initials: KE
authors.lastname: Lee
references.citation: Clin Nutr. 2003 Apr;22(2):115-23
references.pmid: 12706127
references.citation: J Healthc Qual. 2002 Mar-Apr;24(2):30-4
references.pmid: 11942155
references.citation: Am J Clin Nutr. 2002 Feb;75(2):308-13
references.pmid: 11815323
references.citation: J Am Diet Assoc. 2006 Oct;106(10):1663-6
references.pmid: 17000200
references.citation: J Am Diet Assoc. 1999 Sep;99(9):1112-4
references.pmid: 10491685
references.citation: J Am Diet Assoc. 2002 Apr;102(4):546-8
references.pmid: 11985414
references.citation: J Am Diet Assoc. 1987 May;87(5):635-7
references.pmid: 3571783
references.citation: Nurs Manage. 1993 Feb;24(2):70-2
references.pmid: 8429980
references.citation: J Am Diet Assoc. 1998 Nov;98(11):1303-7
references.pmid: 9813587
references.citation: J Nurs Care Qual. 2003 Jan-Mar;18(1):27-37
references.pmid: 12518836
references.citation: J Am Geriatr Soc. 1991 Nov;39(11):1089-92
references.pmid: 1753047
references.citation: J Am Diet Assoc. 1997 Apr;97(4):401-5
references.pmid: 9120194
references.citation: J Am Diet Assoc. 1977 Sep;71(3):253-7
references.pmid: 886128
references.citation: J Am Diet Assoc. 2006 Apr;106(4):581-6
references.pmid: 16567154
references.citation: J Am Diet Assoc. 2003 Oct;103(10):1347-9
references.pmid: 14520255