Hospital Dietary Services

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Hospital Dietary Service

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Hospital Dietary Services

  1. 1. HOSPITAL DIETARY SERVICES DR.N.C.DAS
  2. 2. HOSPITAL DIETARY SERVICES <ul><li>The Dietary Service is one of the important supporting service of the hospital unlike any other supporting services. </li></ul><ul><li>- The objective of the diet services is to make provision for clean, hygienic and nutritious diet for the indoor patient as per their caloric requirement. </li></ul><ul><li>- The dietary service can be provided either by in house provision or by out sourcing. </li></ul>
  3. 3. DIETARY SERVICE The dietary division of a hospital has got three major components . DIETARY SERVICE PLANNING & MANAGEMENT OF HOSPITAL DIET DIET COUNSELLING TO PATIENTS DIETARY EDUCATION
  4. 4. DIET COUNSELLING DIET COUNSELLING WARD ROUND WITH CLINICAL FOR DIET COUNSELLING OF INDOOR PATIENTS FORMULATING CALORIC REQUIREMENT & NUTRITION CARE PLANNING <ul><li>RUNNING NUTRITIONAL CLINIC </li></ul><ul><li>CALORIC ADJUSTMENT </li></ul><ul><li>DIABETIC </li></ul><ul><li>NEPHROTIC </li></ul><ul><li>HIGH PROTEIN DIET </li></ul>
  5. 5. DIETARY EDUCATION DIETARY EDUCATION TEACHING OF HOSPITAL & KITCHEN STAFF. (Hygienic Cooking) TRAINING TO DIETATIC INTERNS DIETATIC RESEARCH <ul><li>Menu Planning </li></ul><ul><li>Preserving Nutritional Value </li></ul><ul><li>Storage of food items </li></ul><ul><li>Modern Methods of Cooking </li></ul>
  6. 6. DIET PLANNING AND MANAGEMENT DIETARY SERVICE PLANNING OF INFRASTRUCTURE DIET MONITORING & EVALUATION QUALITY CONTROL MANPOWER PLANNING (Organization & Staffing) DIET PLANNING DIET SERVICE MANAGEMENT
  7. 7. INFRASTRUCTURE PLANNING PLANNING LOCATION ADMINISTRATIVE AREA SIZE EQUIPMENTS PHYSICAL FACILITIES ENVIRONMENTAL ISSUES
  8. 8. LOCATION <ul><li>The dietary service area should ideally be in the ground floor. </li></ul><ul><li>Away from normal traffic flow. </li></ul><ul><li>Access to lorries coming for unloading supplies. </li></ul>SIZE The area requirement for kitchen varies as per the type and size of the hospital. Up to 200 beds - 20 sq ft/ bed 200-400 beds - 16 sq ft/ bed 500 and above - 15 sq ft/ bed
  9. 9. PHYSICAL FACILITIES The physical facilities can broadly be divided into two components. FACILITIES PERIPHERAL COMPONENT CENTRAL COMPONENT <ul><li>Collection of diet demand </li></ul><ul><li>Distribution of diet </li></ul><ul><li>Administrative Area </li></ul><ul><li>Cooking Area </li></ul><ul><li>Preparation area </li></ul><ul><li>Service Area </li></ul><ul><li>Receiving Area </li></ul><ul><li>Dry Ration Storage </li></ul><ul><li>Cold Rooms for perishable items </li></ul><ul><li>Garbage Collection Area </li></ul><ul><li>Toilets </li></ul><ul><li>Washing area </li></ul><ul><li>a) Dish Washing </li></ul><ul><li>b) Trolley Washing </li></ul>
  10. 10. ENVIRONMENTAL PLANNING ENVIRONMENT ADEQUATE VENTILATION GARBAGE DISPOSAL ENOUGH LIGHT GASPIPE LINE SOLID STAINLESS FLOORING STEAM SUPPLY WATER SUPPLY
  11. 11. ADMINISTRATIVE AREA <ul><li>Office of Chief Dietician </li></ul><ul><li>Office of Dieticians </li></ul><ul><li>Office Clerk </li></ul><ul><li>Steward Office </li></ul><ul><li>Staff Changing Rooms </li></ul><ul><li>Toilets </li></ul>
  12. 12. EQUIPMENTS EQUIPMENTS COOKING UTENSILS DISTRIBUTION TROLLEY COOKING OVENS CHAPATI MAKING MACHINE DISH CLEANING GRINDING WEIGHING CUTTING EQUIPMENTS MIXING MACHINES
  13. 13. MANPOWER PLANNING MANPOWER ORGANIZATION STAFFING FUNCTIONS
  14. 14. ORGANOGRAM MEDICAL SUPERINTENDENT ADDITIONAL MEDICAL SUPERINTENDENT CMO I/C KITCHEN CHIEF DIETICIAN SENIOR DIETICIAN DIETICIAN STEWARD STORE KEEPER CLERK HEAD COOK DIETICIAN HEAD COOK COOK ASSTT. COOK MASALCHI BEARER (Trolley) STORE ATTENDANT SAFAIWALA
  15. 15. STAFFING Staffing differs as per the size of the hospital . 10 to 30% extra for offs and leave reserve. S.NO TYPE OF STAFF 300 BEDS 500 BEDS 750 BEDS & ABOVE 1. Chief Dietician - - 1 2. Senior Dietician - - 1 3. Dietician 1 1 1 4. Asstt. Dietician 3 5 7 5. Steward 1 1 1 6. Diet Clerk - 1 1 7. Head Cook 1 1 1 8. Therapeutic Cooks 2 2 3 9. Cooks 8 10 16 10. Asst. Cooks 6 8 10 11. Masalchi 6 8 10 12. Store Attendant 1 2 2 13. Trolley Bearer 8 10 16 14. Safaiwala 2 2 3
  16. 16. FUNCTIONS 1. CHIEF AND SR. DIETICIANS <ul><li>(i) Making Policies regarding indents, standardization, quality control, </li></ul><ul><li>receipt, issue and disposal. </li></ul><ul><li>(ii) Supervisory record keeping, stock verification. </li></ul><ul><li>(iii) Menu Planning, Budget Planning, Cost Accounting. </li></ul><ul><li>(iii) Diet Counselling, Training </li></ul><ul><li>(iv) House keeping and Sanitation </li></ul><ul><li>(v) Personal Management </li></ul><ul><li>FOOD SERVICE </li></ul><ul><li>Uniforms, Work Schedule, timing for service food. </li></ul><ul><li>Personal hygiene of staff, cleanliness of cooking and serving area. </li></ul><ul><li>CLINICAL FUNCTIONS </li></ul><ul><li>Menu Planning, Preparation of therapeutic diets. </li></ul><ul><li>Diet Counselling, Diet Charts, Education and Training. </li></ul>
  17. 17. 2. STEWARD <ul><li>Over all supervision and control of kitchen. </li></ul><ul><li>Preparation of diet demands. </li></ul><ul><li>Collection of ration from store for cooking. </li></ul><ul><li>Supervision of food distribution in wards. </li></ul><ul><li>General sanitation, hygiene of kitchen. </li></ul>3. STORE KEEPER <ul><li>Indent and receipt of dry and wet rations. </li></ul><ul><li>Proper storing of ration and perishable item is cold room. </li></ul><ul><li>Accounting, issue and records. </li></ul><ul><li>Pest Control </li></ul>4. HEAD COOK <ul><li>Over all supervision of cooks. </li></ul><ul><li>Kitchen hygiene and food quality. </li></ul><ul><li>Checks pilferage </li></ul><ul><li>Receipt of fresh supplies, vegetables, eggs, milk, bread </li></ul><ul><li>Kitchen Discipline </li></ul>
  18. 18. 5. ASSISTANT COOK/ KIDMATGAR <ul><li>Distribution of food to different places. </li></ul><ul><li>Assists in preparation and cooking. (Cutting, Peeling, Grinding) </li></ul><ul><li>Assists in cleaning and drying utensils. </li></ul>6. MASALCHI <ul><li>- Maintenance of cleaning in kitchen area. </li></ul><ul><li>Washing of utensils. </li></ul><ul><li>Proper Disposal of Waste. </li></ul>7. COOKS <ul><li>Preparation of various diets. </li></ul><ul><li>Preparation and cooking of General Diet. </li></ul>
  19. 19. DIETARY SERVICE MANAGEMENT MANAGEMENT DIET/ MENU PLANNING QUALITY CONTROL FINANCIAL MANAGEMENT EQUIPMENT MANAGEMENT PERSONAL MANAGEMENT AREA MANAGEMENT RAW MATERIAL MANAGEMENT FOOD MANAGEMENT
  20. 20. MENU PLANNING DIET GENERAL FULL DIET DISTRIBUTION TIME (7AM,8:30 AM,12 NOON, 7 PM) HIGH PROTEIN DIET LIQUID DIET DIABETIC DIET NEPHROTIC DIET SOFT DIET HIGH CALORIE DIET
  21. 21. MATERIAL MANAGEMENT DEMAND ESTIMATION & INDENTING STORAGE ISSUE TO KITCHEN ON DAILY BASIS MATERIAL MANAGEMENT (Monthly/ Daily) <ul><li>The daily ration is estimated based on previous day census. </li></ul><ul><li>The list is collected every day morning and no. of diets of various types are calculated. </li></ul><ul><li>Accordingly ration is drawn from the store for a day. 50% cooked in the morning and 50% </li></ul><ul><li>in the evening. </li></ul><ul><li>The dry ration is procured on monthly basis and perishable items in the daily basis from </li></ul><ul><li>the contractor. </li></ul>Maintenance of all equipments, cold room on daily and though AMC. Maintenance of various area of services.
  22. 22. PROCUREMENT AND STORAGE <ul><li>Procurement is done through approved contractors. </li></ul><ul><li>Dry ration on monthly basis and perishable items like vegetables, fruits, milk, egg and breads buffer on daily basis. </li></ul><ul><li>Non perishable items are kept in racks, poly packs, in ventilated room. </li></ul><ul><li>The perishable items like milk, cheese, butter, egg, milk, vegetables, fruits are kept in cold room. </li></ul><ul><li>Adequate buffer stock of dry ration is maintained. </li></ul><ul><li>Daily ration is issued on indent to the kitchen. </li></ul>
  23. 23. QUALITY CONTROL QUALITY CONTROL RAW MATERIALS EQUIPMENTS KITCHEN SANITATION FOOD COOKED
  24. 24. RAW MATERIAL <ul><li>There should be a policy of checking raw materials. </li></ul><ul><li>Should be procured from Govt. or co-operative stores. </li></ul><ul><li>Dry rations are procured from Kendriya Bhandar. </li></ul><ul><li>Milk, Butter, Bread from Mother Diary, Nafed etc. </li></ul><ul><li>There should be kitchen Advisory Committee to prepare SOP and advise </li></ul><ul><li>for continuous improvement and quality control. </li></ul><ul><li>The committee comprises of:- </li></ul><ul><li>Additional Medical Superintendent - Chairman </li></ul><ul><li>Sr. Dietician - Member Secretary </li></ul><ul><li>CMO I/c Kitchen - Member </li></ul><ul><li>Physician - Member </li></ul><ul><li>Nephrologist - Member </li></ul><ul><li>Administrative Officer - Member </li></ul>Proper record keeping of receipts, indents and accounting.
  25. 25. QUALITY CONTROL OF FOOD <ul><li>It is very important to maintain quality of food. </li></ul><ul><li>Standardization of cooking methods. </li></ul><ul><li>Regular Health Check –up of Kitchen Staff. </li></ul><ul><li>Regular training in handling food. </li></ul><ul><li>Surprise testing of cooked food by senior officials. </li></ul>QUALITY CONTROL OF AREA <ul><li>Schedule of cleaning of kitchen. </li></ul><ul><li>Maintenance and calibration of equipments. </li></ul><ul><li>Monitoring of cold room temperature, deep freezers. </li></ul><ul><li>Method of disposal of waste. </li></ul><ul><li>Proper ventilation and smoke exhaust. </li></ul>
  26. 26. EVALUATION The various indicators used for evaluation are- <ul><li>No. of complaints on food received. </li></ul><ul><li>No. of cases of food poisoning. </li></ul><ul><li>Instances of false diet distribution. </li></ul><ul><li>Non serving/ inadequate serving complains. </li></ul><ul><li>Wastages/ pilferage incidences. </li></ul><ul><li>Pests and rodents </li></ul><ul><li>Feed back proforma/ interview at discharge. </li></ul>DR.N.C.DAS
  27. 27. Hospital Administration Made Easy http//hospiad.blogspot.com An effort solely to help students and aspirants in their attempt to become a successful Hospital Administrator. hospi ad DR. N. C. DAS

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