sfgh fns quarterly report december 2015_cw
TRANSCRIPT
QUARTERLY REPORT FY 2015 This report is from the Director & Assistant Director, Food and Nutrition October – December 2015.
FOOD AND NUTRITION SERVICES
TABLE OF CONTENTS
Contents
Overview _________________________________________________________________________________________________ 1
Regulatory Compliance ________________________________________________________________________________ 2
BLDG 25 __________________________________________________________________________________________________ 3
Financial Stewardship _________________________________________________________________________________ 4
Developing People______________________________________________________________________________________ 5
Safety _____________________________________________________________________________________________________ 6
Quality and Care Experience__________________________________________________________________________ 7
Environment of Care – Cafeteria _____________________________________________________________________ 8
Contact Information ___________________________________________________________________________________ 9
OVERVIEW
Page 1
Overview
REGULATORY COMPLIANCE
SFGH FNS works actively to be regulatory compliant with Title 22, CMS (2014), Title 9 for BHC , Title 15 for Jail Services and CDPH – All Facilities Letters.
BLDG 25
San Francisco General Hospital Medical Center (SFGH) is developing a 284 bed new acute care hospital and Trauma Center tower
(Building 25) within the current medical center including a fully functional kitchen to support patient services.
FINANCIAL STEWARDSHIP
FNS is working to reduce labor and supply costs by increasing productivity, reducing OT, and by practicing good business and foodservice management practices for security of food and supplies.
DEVELOPING PEOPLE
FNS works to develop staff, improve staff satisfaction and develop staff as problem solvers.
SAFETY
FNS takes safety of our patients and staff very seriously and daily monitors all aspects.
QUALITY
FNS is working to improve the quality of both the food and service provided to patients and customers.
CARE EXPERIENCE
FNS is committed to improving the patient care experience in both hospital in-patient dining as well as cafeteria services.
Sylvia Shih, Director, Food and Nutrition Services
Corilee Watters, Assistant Director, Food and Nutrition Services
Steve Koneffklatt, Assistant Administrator
REGULATORY COMPLIANCE
Page 2
Regulatory Compliance
SURVEY PARTICIPATION
• Department of Public Health Environmental Health Inspection at BHC Nov 2/15 no findings. (SS)
REGULATORY REQUIREMENTS
CRITERIA REGULATORY DESCRIPTION STATUS
Organizational Chart
The responsibility and the accountability of the dietetic service to the medical staff and administration shall be defined. Director of Food and Dietetic Service must be qualified and have responsibility and authority for the direction of the food and dietary service. Registered dietitian shall be employed on a full-time basis, supervise nutritional aspects of
patient care.
Compliant.
Competency Ensure competency of Nutrition Services staff upon hire, and quarterly and annual review, Weekly Foodservice Education in services developed, Competency checklists developed.
Annual reviews ~90% complete
Policies and Procedures
Policies and procedures shall be developed and maintained in consultation with representatives of the medical staff, nursing staff and administration to govern the provision of dietetic services. Policies shall be approved by the medical staff, administration and governing body. Procedures shall be approved by the medical staff and administration.
Updated foodservice, submitted for review
Diet Manual A current diet manual approved by the dietitian and the medical staff shall be used as the basis for diet orders and for planning modified diets.
Compliant since July 2015
Disaster Plans CDPH AFL – Dec 14/2014, Detailed written plans to meet all emergencies and disasters.
Meals for All™ available for patients, Menu updated for Staff, and Visitors
compliant
Nutrition Adequacy Ensure the nutritional needs of the patient are met on regular and modified diets. Incorporated Blossom Foods™ nutritional information into pureed menu nutritional
analysis
Ethnic, Cultural,
Food Preferences Patient menus adequately meets the ethnic, cultural and religious needs of the populations that are served.
25% of menus Hispanic/Asian
Nutrition Care Screen, Timely, MD Acknowledgement, Accurate Weight, Ins & Outs 90-100% compliant
Wt compliance increased from 87 % to 95%
Pantry Updated Nourishment centers to provide individual PC, 6 month expiry April and September
BLDG 25
Page 3
BLDG 25
REGULATORY APPROVAL City and County of San Francisco Department of Public Health Environmental Health inspection completed Building
Permit approved for the Kitchen (Sep 2015) California CDPH consultancy review of Food and Nutrition Services (Nov 12, 2015) FDI consultancy review of Food and Nutrition Services (Dec 9 2015)
NOURISHMENT CENTER STANDARDS
Reviewed specifications for Nourishment Centers refrigerator, ice machine, microwave and freezer (Nov, 2015)
TRAINING
Corilee Watters, PhD RD Asst. Director with Super-users Heather Waldorf, RD and Elaine Tang, MS, RD
SF City Fire Inspection Dec 22/15
FINANCIAL STEWARDSHIP
Page 4
Financial Stewardship
1.1 Reducing Over-time
Overtime pay @ 1.5 has been by 41% reduction in 6 months -- From an average of 220 hours per pay period in FY ’14-’15 (Jan-July2015) to 131 hours (July – Nov) per pay period in FY ’15-16 a savings of ~$4303 pp
1.2 Security of Food and Supplies Video cameras installed throughout Food production /Storage and Cafeteria area (SS)
1.3 Reducing Waste in Food Purchasing and Supplies
Increase use of re-useable containers vs disposables for patient foodservice, utilizing compostable cutlery Dec 2015
1.4 Increasing revenue from Novation Provider agreement July to September 2015 77% compliance with Novation purchasing from U.S. Foods
1.5 Increasing Productivity
Tracking Daily Productivity of Clinical Dietitians and DTRs (CW) Increased Productivity by 13% from average of 6 pts seen/day (May, June 2015) to 6.8 pts/day (Dec 2015)
Clinical Dietitians have provided nutrition care for ~7,484 patients this year which is ~47% of admitted inpatients congruent with the proportion on therapeutic and texture modified diets , and have completed over 777 clinical chart audits to monitor regulatory compliance with nutrition care. (CW)
Submitted IT request for Diet Order interface to reduce staff time entering diet orders and paper waste (CW)
paper waste generated each month resulting from no Diet Order Interface
1.6 Malnutrition Coding
1326 of 16, 765 inpatients admitted from 10/1/2014 until 9/30/2015 had a MCC or CC relating to malnutrition. A prevalence rate of 8% is comparable to that reported by West Virginia University Medical Center a trauma center, but below ~10% reported by New York Presbyterian Hospital. Malnutrition coding significantly impacts reimbursement rates which reflects the increased length of stay and healthcare resource utilization. (CW)
DEVELOPING PEOPLE
Page 5
Developing People
1.1 Monthly Clinical Nutrition Rounds
Nutrition co-chaired SFGH Medical Grand Rounds on Oct 13, 2015 (CW) Drs. Critchfield, Watters and Stollman Medical Grand Rounds Dr. Stollman presented on Medical Management of C. Diff.
1.2 Audit Education competency relating to Weekly Foodservice Topics (CW)
*based on observation, verbal explanation or demonstration with individual employees (Oct 2015)
1.3 Staff Recognition
1.4
Healthcare Foodservice Workers week October - Foodservice staff newsletter highlighting staff roles and
accomplishments (CW)
- Daily events for staff including pumpkin decorations, ice cream social, pizza, and employee photo board (CW,SS)
Thanksgiving meal for Foodservice Staff (SS)
70
75
80
85
90
95
100
FSW 2604(n=20/60)
Sr FSW 2606(n=4/6)
Cook 2654(n=5/11)
Audit Education Competency Assessment*
SAFETY
Page 6
Safety
1.1 Patient Food Safety New Test Tray Evaluation form developed Oct 22/15 (RC) which indicated that the New Follett Trayline Refrigerators for milk, salads and soups introduced Nov 12/15 improved temperature.
1.2 Patient Nutrition Safety
Christine Struble, RD, CNSC led an update of Pediatric TPN order form
2. Staff Safety Injury Reporting Binder and Log developed April 2015 (CW), Number of days injury free tracked daily on Huddles
70%
75%
80%
85%
90%
95%
100%
Test Tray Temperature Compliance
Oct Nov
QUALITY AND CARE EXPERIENCE
Page 7
Quality and Care Experience
2.1 Tracking HCAHPS monthly scores and comments Response to survey question “During this hospital stay, how often did the staff who brought you your food treat you with courtesy and respect“ reached national average score results.
2.2 Patient satisfaction rounding with written meal survey cards and interviews (RC, CW)
2.3 Improving Food Quality Replacing disposable salad containers with reusable Dinex containers on patient trays (Oct RC, CW
ENVIRONMENT OF CARE
Page 8
Environment of Care
SELLING HEALTHY FOOD
Beginning in October, freshly prepared entrée salads were established in the cafeteria on a daily basis. Sales data indicated that entrée salads increased the overall number and amount of transactions, shifted customers away from meat entrees, grill and outsourced packaged Grab N’Go.
Donna Harrison Serving Taco Salad
Starting in December, freshly prepared in house Grab N’ Go items are made including fresh fruit, fresh vegetables, yogurt and banana pudding parfait, cheese, crackers and grapes. (CW)
Sept, NonSalad Days
Sept, SaladDays
October November
Veg Entrée 5.30% 3.79% 3.88% 3.79%
Meat Entrée 8.50% 8.06% 6.85% 7.23%
Salad 9.24% 9.74% 8.82%
Grab n Go Items 18.60% 15.50% 15.35% 10.76%
Grill 6.90% 4.80% 3.75% 5.04%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%
18.00%
20.00%
Percent Daily Average Cafeteria Sales
CONTACT INFORMATION
Page 9
Contact Information
SYLVIA SHIH, CDM DIRECTOR
CORLEE WATTERS, PHD,RD ASST. DIRECTOR
STEVE KONEFFKLATT, MBA ASST. ADMINISTRATOR
Tel :206-6288
Tel :206-4539
Tel 206-6286
Steve. [email protected]