Hospitals Should Look at Best Practices in Food Service Standards

When was the last time your facility looked at tracers in the dietetic and food service areas?

"There have been a number of updates published in recent months on the topic, so it's a good time to take a look at best practices on the topic," says Elizabeth Di Giacomo-Geffers, RN, MPH, CSHA, a healthcare consultant in Trabuco Canyon, CA, and former Joint Commission surveyor.

In terms of Joint Commission standards, the following chapters have the most bearing on dietetic services:

• Emergency Management


• Environment of Care


• Human Resources


• Infection Control


• Patient Care, Treatment, and Services


• Record of Care, Treatment, and Services

Specific EPs to review include: PC.02.02.03, HR.01.04.01, and HR. 01.05.03.

Now let's take a look at CMS' Conditions of Participation (CoP). The CoPs require that a hospital have organized dietary services directed and staffed by adequate personnel. (Note: If your facility has a contract with an outside food management company, keep Joint Commission leadership standards in mind as well.)

What policies are required? Your facility should have and follow a minimum of the following policies and procedures, according to the CMS CoPs:

• Availability of a diet manual and therapeutic diet menus to meet patients' nutritional needs


• Frequency of meals served


• A system for diet ordering and patient trays delivery


• Accommodation of non-routine occurrences—e.g., parenteral nutrition (tube feeding), total parenteral nutrition, peripheral parenteral nutrition, change in diet orders, early/late trays, nutritional supplements, etc.


• Integration of the food and dietetic service into the hospital-wide Quality Assessment and Performance Improvement and Infection Control programs


• Guidelines for acceptable hygiene practices of food service personnel


• Guidelines for kitchen sanitation

All of these policies apply whether the food services are provided by the hospital alone or through a contracted vendor.