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Hospitals Should Look at Best Practices in Food Service Standards

Matt Phillion, for HealthLeaders Media, September 14, 2009

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.


Matt Phillion, CSHA, is senior managing editor of Briefings on The Joint Commission and senior editorial advisor for the Association for Healthcare Accreditation Professionals (AHAP).

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