Waltick Memorial Hospital

-Nutrition SolutionsDietetic Consultants:

Dawn Frick, RD, LDN
Samantha Walters, RD, LDN

Nutrition Solutions
Who

are we?
Our Goals
Our Mission = Waltick Memorial Mission
Consulting Tasks

Waltick Memorial Hospital

400

bed community hospital

Medical/Surgical, GI, Cardiology, Oncology
Recently opened outpatient clinics:

Open Monday-Friday (7-3p)

Diabetes
Eating disorders

Nutrition Solution Proposals

Patient

Meal Delivery System

Improved Menus and Menu Cost
RD Staffing Resolution
Equipment
Sustainability

Patient Meal Delivery System

Meal Delivery System

Current

problems include:

Inaccurate

patient meals
Poor patient satisfaction
Patient complaints

Proposed
Budget

solutions must consider:

restrictions
Choices available
Patient satisfaction

Meal Delivery Options

Room

Service Style

At

Your Request (AYR)

Needs Menus, customer service (diet office staff), production

staff, tray line, runners

Expressly

For You (EFY)

Needs Menus, production staff, tray line, runners, with the

addition of a dietitian or diet tech in patient rooms to receive
orders

Room Service Solution

Advantages
Patient decides meal
Variety of selections available
Flexibility with time and selections
Financial

Food
Length of stay

Disadvantages
Decrease in speed and efficiency
Time limits
Increase in employees production, runners, diet office

Meal Delivery Options

Commissary

Style

Centralized
Distributed
Positive

to satellite centers

feedback from current users

Availability

food preparation

in the area

Ten miles away Meade Hospital

Commissary Solution
Advantages
Fewer

employees in food service

Lowered food and supply costs
Lowered needs for new equipment and maintenance
Increased flexibility

Disadvantages
Some

new equipment needed freezers, warmers

Transportation costs
Food safety and HACCP regulations
Food quality and patient satisfaction

Meal Delivery Options

Ready-Prepared
Foods

prepared on site
Foods stored in freezers until use

Foods

2 weeks to 3 months

heated as needed

Convection oven, microwave, or infrared oven

Ready-Prepared Solution
Advantages
Flexibility

in food preparation and employee schedules

Fewer employees decrease cost

Disadvantages
New

equipment needed
New menu items required

Food

Many current menu items wont freeze well

quality
Patient satisfaction new foods and perception

Meal Delivery Options

Assembly

Serve

Convenience

Offer

foods

Frozen, refrigerated, room temperature

foods that require minimal preparation

Caf settings

Assembly Serve Solution

Advantages
Less

equipment
Less employees

Disadvantages
Limited

variety
Patient satisfaction
Rise in food cost
Limited ability to modify diets and snacks

Waltick Memorial Solution

Room

Service Option

Patient

Oriented

Taste preferences
Willingness to eat
Recovery time
Scheduled around medications and procedures

Retail

Sales
Patient Satisfaction
Budget Friendly

Improved Menus and Menu Cost

Diet Specific Menus

New

diet and menu plans needed

AYR service
Equipment dependent
Budget
Menu cycle

General Diet Breakfast Proposal

Breakfast

Sunday

Monday

Tuesday

Orange Juice
Oatmeal
Scrambled Eggs
Sausage
Apple Spice Muffin
Margarine
Low Fat Milk
Coffee
Non-Dairy
Creamer
Sugar
Salt and Pepper

Orange Juice
Cream of Wheat
Scrambled Eggs
Pancakes
Syrup
Margarine
Low Fat Milk
Coffee
Non-Diary
Creamer
Sugar
Salt and Pepper

Orange Juice
Rice Krispies
Scrambled Eggs
Bacon
Blueberry Muffin
Margarine
Low Fat Milk
Coffee
Non-Diary
Creamer
Sugar
Salt and Pepper

General Diet Lunch Proposal

Lunch

Sunday

Monday

Tuesday

Iced Tea
Chicken Noodle
Soup
Crackers
Hamburger on a
bun
Lettuce/Tomato/
Onion
Cole Slaw
Fresh Fruit - Apple
Ketchup
Mustard
Salt and Pepper

Iced Tea
Grilled Chicken
Sandwich
Lettuce/Tomato
Glazed carrots
Fruit Cocktail
Mayonnaise
Salt
Pepper

Iced Tea
Tomato Soup
Crackers
Turkey Sandwich
Lettuce/Tomato
French Fries
Fresh Fruit Banana
Mayonnaise
Salt and Pepper

General Diet Dinner Proposal

Dinner

Sunday

Monday

Tuesday

Grilled Chicken
Breast
Mashed Potatoes
Gravy
Green Beans
Dinner Roll
Margarine
Low Fat Milk
Coffee
Non-Dairy
Creamer
Sugar
Salt
Pepper

Cream of Mushroom
Soup
Crackers
Roast Beef
Gravy
Baked Potato
Broccoli
Chocolate Cake
Dinner Roll
Margarine
Low Fat Milk
Coffee
Non-Dairy
Sugar
Salt
Pepper

Tossed Salad
Italian Dressing
Spaghetti and
Meatballs
Green Beans
Breadstick
Pineapple
Margarine
Low Fat Milk
Coffee
Non-Dairy Creamer
Sugar
Salt and Pepper

Reducing Meal Cost

Patient

satisfaction
Budget concerns

Current meal cost

$7.50

New cost limit

$5.85

New Cost Breakfast Day One

Menu Item
Orange Juice
Oatmeal
French Toast
Syrup
Margarine
Low Fat Milk
Coffee
Non-Dairy Creamer
Sugar
Salt
Pepper

Serving Size

Cost

4 fl. oz.
4 oz. ladle
2 slices
1 oz.
1 pat
8 fl. oz.
6 fl. oz.
1
1 packet
1 packet
1 packet

$0.18
$0.12
$0.20
$0.16
$0.02
$0.23
$0.10
$0.05
$0.00
$0.00
$0.00

Total: $1.06

New Cost Lunch Day One

Menu Item

Serving
Size

Cost

Chicken Noodle Soup

Crackers
Chicken Salad Sandwich
Potato Salad
Chocolate Chip Cookies
Salt
Pepper
Iced Tea

4 oz.
1 pkg.
#12 scoop/1 slice
#12 scoop
2
1 packet
1 packet
8 fl. oz.

$0.48
$0.03
$0.83
$0.05
$0.15
$0.00
$0.00
$0.01

Total: $1.55

New Cost Dinner Day One

Menu Item
Roast Turkey
Gravy
Dressing
Broccoli
Dinner Roll
Margarine
Low Fat Milk
Coffee
Non-Dairy Creamer
Sugar
Salt
Pepper

Serving
Size
3 oz.
2 oz. ladle
#12 scoop
2 spears
1 roll
1 pat
8 fl. oz.
6 fl. oz.
1
1 packet
1 packet
1 packet
Total: $2.04

Cost
$0.97
$0.04
$0.18
$0.33
$0.12
$0.02
$0.23
$0.10
$0.05
$0.00
$0.00
$0.00

New Meal Cost Summary

Day 1

Day 2

Day 3

Previous
Cost

$ 7.50

$7.50

$7.50

New
Cost

$4.65

$5.12

$5.46

Savings

$2.85

$2.38

$2.04

Menu Cycle
7

day cycle
Average length of stay
Weekday and weekend

Cost

effective
Patient satisfaction
Food service implications

HS Snack Rotation
Available

overnight for in-patient diabetics

Contain 15-20g carbohydrates and about 1
serving of protein
7 day fixed snack schedule
Average cost per snack: $0.70

HS Snack Rotation
Day

HS Snack

Carbohydrate
Count (g)

Total Cost per HS

Snack

Monday

3 graham cracker squares

and 8 oz. skim milk

18 g

$0.64

Tuesday

1 slice whole wheat bread

and 1oz. sliced turkey

15 g

$1.03

Wednesday

6 whole grain crackers

and and 1oz. low-fat
cheese

15 g

$0.63

Thursday

2/3c. Nonfat sugar-free

yogurt with 3 graham
cracker squares

18 g

$0.88

Friday

Small apple and 1/2 cup

low-fat cottage cheese

17 g

$0.75

Saturday

6 whole grain crackers

and 2 Tbsp. peanut butter

16 g

$0.48

Sunday

1 slice whole wheat bread

and 1 oz. sliced ham

15 g

$0.52

RD Staffing Resolution

RD Staffing Breakdown
The

Team

2 Experienced Full-time RDs

2 Entry-level Full-time RDs
1 Entry-level Part-time RD
1 Full-time Diet Tech
1 Part-time Diet Tech

Part-time

employees strictly work outpatient

All full-time RDs rotate Saturday shifts

Week 1 Master Cycle Schedule

Monday

Tuesday

RD1 (7-3)
RD2 (8-4)
RD3 (8-4)
RD4 (8-4)
DT1 (9-5)
OPD:
RD5 (8-12)
DT2 (8-12)

RD1 (7-3)
RD2 (8-4)
RD3 (8-4)
RD4 (8-4)
DT1 (9-5)
OPD:
RD5 (8-12)
DT2 (8-12)

Wednesday

Thursday

RD1 (7-3)
RD2 (8-4)
RD3 (8-4)
RD4 (8-4)
DT1 (9-5)
OPD:
RD5 (8-12)
DT2 (8-12)

RD1 (7-3)
RD2 (8-4)
RD3 (8-4)
RD4 (8-4)
DT1 (9-5)
OPD:
RD5 (812) DT2
(8-12)

Friday
RD2 (8-4)
RD4 (8-4)
RD3 (8-4)
DT1 (9-5)

Saturday
RD1 (8-4)

OPD:
RD5 (8-12)
DT2 (8-12)

-RDs only available in outpatient from 8-12p Monday-Friday

-One RD available, on Saturdays, and none on Sundays

Equipment

Equipment Purchases
$40,000

budget
Wish-list
Improved retail area

Patient satisfaction
Sustainable practices
Energy-efficient

equipment
Removal of disposables

More variety
Retail sales

Equipment Purchasing List

Major Purchases
(at least $2,000
per item)
Dish Machine
Plate Lowerator
Refrigerator/Freezer
Grill

Minor Purchases
(< $2,000 per item)
China Plates
China Bowls
Tablespoons
Knives
Forks
Trays
Food Warmer
Steam Table
Steam Pans
Toaster Oven
Robot Coupe
Coffee Condiment Holder
Coffee Maker
Coffee Mugs

Equipment Purchasing Overview

Totals

$29,469.88 in major purchases

$9,939.50 in minor purchases

$590.62

leftover
1 year parts and labor warrantee
Lifetime edge chip limited warrantee

Our Vision
Improved

More variety and convenience for customers

Help yourselves
Feel at home
Increased sales

Improved

retail area

quality of food

More equipment
More storage

Sustainability

Organic and Non-Organic Waste

Food

waste

The Digester
Cooking Oil
Stop Wasting Food initiative

Eliminate

disposable dishes
Recycling program

Sourcing Local, Seasonal, and

Sustainably Grown and Raised
Products
Environmental

impact
Less nutrients lost
Fishing
Farming

Safe farming practices

Supporting local economy

Water Intensity
Flow

restrictions, regulators, and pressurelimiting valves

Water taps in food service
Energy-saving/water-saving kitchen
equipment

Questions

References
http://www.webstaurantstore.com/viewcart.cfm.
FoodManagementSystems.com
Johns Hopkins Hospitals Daily Menu Cycles and Specialized Diets
St. Joseph Medical Centers Daily Menu Cycles and Specialized Diets
Sodexonet.com
https://www.flickr.com/photos/8004703@N05/