Dietetic Internship Week 10: Management

The management rotation is meant to familiarize students with the role of the food service manager in hospitals and residential care facilities. I’m paired up with another intern for this 4-week stint in Eagle Ridge Hospital (ERH), a ~100 bed community hospital located in Port Moody, BC. ERH has an attached residential facility (Eagle Ridge Manor), which has ~40 beds. The food service manager (my preceptor) is responsible for overseeing the meals for patients in both the acute and the residential areas.

There are many different models of institutional food service. Some places bring in frozen, prepared entrees and heat them up on meal trays. Others cook then freeze their own entrees for later use. ERH uses a hot plating system where entrees are prepared on site just prior to mealtime and served immediately. Each of these systems bring a unique set of challenges for the food service workers, supervisors, and managers.

Being a relatively small facility that prepares its own food, the dietitian who works as the food service manager has a bit more leeway in experimenting with the menu. ERH is also in the final stages of its own Extreme Menu Makeover, with the intention that other care facilities in the Fraser Health region will adopt many of the new recipes developed here.

One project we interns worked on this week was testing a meal soup, a hearty dish comparable to a traditional entree. On days where a meal soup is served, instead of receiving a salad, side soup, entree (starch, protein, vegetable), drink, and dessert, residents would receive a salad, meal soup, (bun), drink, and dessert. Since various types of soups are associated with nourishment and strength across cultures, it may help increase patients’ food acceptance while in hospital. The recipe we tried and modified (3 times in 4 days!) was chicken corn chowder. Last Friday, we served it to ~20 residents in the Manor and received overall positive feedback. The next step is to try it as the main entree in the entire hospital and audit its acceptance by patients. Each recipe usually goes through several iterations of feedback and modification before it makes it to the menu (if it does at all).

Compared with clinical dietetics, management is definitely very different. Workload is more project-based, the conversations with co-workers changed (I no longer ask about a person’s oral intakes or leave notes asking for vitamin supplementation), and the problems that need to be solved revolve around food production rather than malnutrition. I also feel like there are a lot more meetings to attend and to hold as a food service manager than a clinical dietitian.

Chicken Corn Chowder: 2% milk, chicken, corn, onion, celery, carrots, margarine, flour, red pepper, chicken stock base, thyme, and black pepper.
Chicken Corn Chowder: 2% milk, chicken, corn, onion, celery, carrots, margarine, flour, red pepper, chicken stock base, thyme, and black pepper.

Important things I learned this week:

  • Food needs to be eaten by patients if we want them to receive the nutrition needed during periods of illness, no point making food that patients won’t eat
  • Hospital population ≠ general population. People in hospital are usually older and may have altered appetites due to their illnesses. Need to take these factors into consideration when designing the menu
  • Food service managers can make a difference in patients’ food experiences in hospital
  • Trial and error: trying a recipe repeatedly is the only way to know if it will or will not be successful as a menu item
  • Communication is key to success: talk to as many people about your plan ahead of time as possible (such great advice, applicable to so many different situations)

My goals for next week:

  • Have a concrete plan for events / various projects: try to anticipate potential problems and discuss these with fellow intern/ preceptor/ food service supervisors
  • Follow recipes: this is important for the sake of product consistency
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