RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report

Study Report: Continuous Quality Improvement of Patient Tray Costs Theresa Price The University of Southern Mississippi

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Introduction Foodservice managers and directors are constantly attempting to evaluate cost effectiveness (Burns & Gregory, 2007). The main ways foodservice operations determine cost effectiveness is to maintain profit margin, reduce food costs, and stay on budget. Healthcare foodservice is reforming and making it a goal to become more customer driven in order to have better patient satisfaction. The main concern for hospital foodservice facilities is to keep a balance between patient meal satisfaction and cost (Burns & Gregory, 2007). Many registered dietitians have been able to achieve both customer satisfaction while controlling costs (Boyce, 2011). Menu planning occurs in all foodservice operations and has a central idea for menu

engineering (Kivela, 2003). When a food item has poor sales and is not as popular as other items they may be evaluated for removal from the menu, typically a chef of director will make this type of decision in a foodservice operation, this is called a traditional menu planning approach. Menus are considered the most important aspect of a foodservice facility and can directly impact the demand, costs, and profits for a facility. Traditional menu planning allows for menus to be implemented and evaluated afterwards. New menu engineering technology is emerging and may help with future menu planning (Kivela, 2003; Raab, Hertzman, Mayer & Bell, 2006). Determining meal costs is an important factor within a foodservice operation (Raab, Hertzman, Mayer, & Bell, 2006). Managers running a foodservice operation constantly work to find a balance between menu costs and satisfying customers. Traditional costing systems are being replaced with a new costing system called an Activity-Based Costing (ABC). ABC systems allow for additional costs such as salaries, wages, and other costs to be included in menu pricing to provide a more accurate range of pricing. Different menu analysis strategies help

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report foodservice operations find more profitable menu items and increase profit margins (Annaraud, 2007). Literature Review Menu Engineering An experimental research study conducted by Kivela (2003) determined the major differences in traditional menu planning and menu planning with a newer approach called Menu Planning Qualitative Variables (MPQV). The MPQV approach for menu planning involves variables that effect the menu items, current and future marketing, customer needs, and specific

facility goals and objectives. The purpose of this study was to determine if planning a menu with MPQV was more useful than traditional menu planning. Out of 79 randomly selected hotels only 20 hotels participated, there were 80 foodservice staff members from the hotels who participated in the study. The 80 subjects were randomly selected to be placed in the experimental and control groups. The experimental group designed a menu using the MPQV approach while the control group designed a menu using the traditional approach. Both groups completed the menu planning activity and then were asked a series of five questions. The first question assessed was if details in the menu planning brief were useful to develop the menu, 60% in control group said yes but that it was no different than what was given in current facilities, 86% in the experimental group agreed the range of information was useful in menu planning. The second question assessed was if menu planning variables provided were helpful in planning the proposed menu, 23% of the control group stated variables were helpful and 76% of experimental group stated the variables were helpful. The third question assessed was if the range of information gave an advantage in how to approach the menu planning, 53% of control group disagreed that the range of information gave them an advantage, and 78% of

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report experimental group reported an advantage. The fourth question assessed was if the information

provided in the brief would be useful in their facilities, 86% of the experimental group stated the information would be applicable and useful in their current facility, 51% of the control group said it would be applicable and 30% stated it was not any different to what they already did in the facility. The last question assessed whether the participants would utilize the menu planning approach used during the study in their facilities, 41% of the control group and 83% of the experimental group stated they would use the menu planning approached used during the study in the current facilities. Researchers concluded the MPQV approach provided more information before menu planning, provided a wider range of variables for menu planning, and was more likely to be used in facilities after learning about the approach. This article recommended using the MPQV approach before menu planning and implementation due to pre-determining different variables and planning tasks (Kivela, 2003). An article written by Raab, Hertzman, Mayer, and Bell (2006) discussed the comparison of implementing a traditional costing approach, Contribution Margin (CM) and a newer approach, ABC system, to reveal a more accurate pricing system for menus and to see the profitability of menu items. The researchers looked at the dinner menu for one 200-seat restaurant in the Southwestern United States. The restaurant had a negative profit margin and was suspected to have a non-profitable dinner menu. The results from the CM Menu Engineering provided different results than ABC system Menu Engineering. According to CM, five pasta dishes were categorized as Dogs, which indicated low popularity and low profitability. Only one menu item, Pasta Marinara Shellfish, was a Puzzle, which means it is not popular but is profitable. Three menu items, Mushroom Chicken, Salmon,

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report and Shrimp and Scallops, were Plow Horses, which means they are popular but not profitable. Five items were Stars, which indicated the items were both popular and profitable, including Pork, Paella, Sea Bass, Steak, and Filet Mignon. ABC system agreed the same five pasta dishes and the ravioli were Dogs and did not provide a profit and were not popular. No items were considered a Puzzle. Five menu items were Plow Horses including the Mushroom Chicken, Salmon, Shrimp and Scallops, Pork and Steak. Only three items were considered Stars, which provided the most profit, and were the most popular, these items included Sea Bass, Paella, and Filet Mignon. Researchers concluded the ABC system resulted in more accurate analyzing of menus compared to traditional menu analyzing approaches. The ABC system revealed more accuracy on profit margins and menu engineering than CM approaches. ABC systems may also be more useful than CM systems in determining the total costs of menus due to the ability to incorporate more than just food costs (Raab, Hertzman, Mayer, Bell, 2006). A main goal of foodservice operations is to maintain profitability among menu items. During menu analysis the food item

costs, ingredients, taste, presentation, nutritional value, quality are all evaluated. There is a menu analysis tool with an index method to determine if there are changes in the profit margin, as well as amount of foods sold. It also states that this tool could be used to enhance current menu analysis techniques (Annaraud, 2007). Patient Satisfaction and Controlling Costs A longitudinal study conducted by Burns and Gregory (2007), collected data from Veteran Administration healthcare facilities from 2003, 2004, and 2005 were compared with regression analysis to determine how patients rated the quality of food and nutrition services during the hospital stay. The researchers gathered information from primary studies and used

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report

previous years of information to determine if patients were satisfied within the healthcare setting while remaining in budget. The patient satisfaction survey was a five-point Likert scale with five being the most positive and one being the most negative. In 2003 the overall satisfaction was an average of 3.76, in 2004 the overall satisfaction was an average of 3.4, and in 2005 the overall satisfaction was an average of 3.92. The food costs were $0.19 lower for 2004 than 2003 and the food costs were 20% lower in 2005 than in 2004. The researchers concluded several strategies in order to continue running a foodservice operation with patient satisfaction and keeping menu costs low. The strategies included developing a patient satisfaction survey to determine the foodservice satisfaction and rank the most important service attributes, provide kitchen staff with training on cooking methods and how to impact patient satisfaction, provide delivery staff with service training and how proper service impacts patient satisfaction, sharing patient satisfaction ratings and cots with employees to see the facilities progress, and develop a way for employees to provide suggestions to improve patient satisfaction and alternatives to lower food and labor costs (Burns & Gregory, 2007). The literature suggests satisfied customers improved customer service and reduced costs. There are ways to be more cost efficient and to improve customer service for the business of dietetics to provide advice to dietetic professionals on how to satisfy customers and lower costs within foodservice operations. Such strategies include getting to know the customers, promoting achievements and staff credentials, design menu with customers in mind, host interactive web site with menu, pricing, and nutrition, involve community through programs, host customer focus groups to sample products, gather customer feedback through surveys, and educate the

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report consumer to recognize the value provided from the operation. More satisfied customers lead to more opportunities to reduce costs among foodservice facilities (Boyce, 2011).

The literature reviewed concluded a MPQV system should be the first step in developing a menu and in order to achieve customer satisfaction. MPQV systems use a wide range of variables that are looked at before the menu has been developed and implemented in order to decrease the amount of menu items that will be removed or rearranged on the menu. Other menu analysis tools are available and it is recommended to use more than one analysis to determine menu engineering categories and profit margin of the menu. The literature also suggests evaluating costs and volume with ABC menu engineering are the best way to determine acceptability of patient trays. Research suggests patient satisfaction of meals and meal costs can be balanced within the foodservice facilities by keeping the customer in mind when creating menus and listening to customer feedback. Satisfied customers may increase customer service and may reduce costs within foodservice operations. Overall, it is important to evaluate menu costs regularly to remain competitive and continue to increase profitability. Background Every year, a hospital in Southern Mississippi conducts an overall pricing of for the menu in order to determine current food costs and analyze the current menu to determine ways to provide cost effectiveness. The foodservice director mentioned wanting to decrease tray costs by using bulk items and pre-portioning in order to save money in the area of food costs. Since the most recent overall pricing there have not been any continuous quality improvement measures conducted to determine individual meal prices for patient trays. The purchasing supervisor generally purchases the lowest priced food item for each menu item when placing orders, which keeps tray costs lower but the tray costs may fluctuate between each purchase.

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report

The foodservice director conducted the most recent menu analysis and was a comparison of the total costs of breakfast for Saturday and Sunday compared to the newly proposed breakfast for Saturday and Sunday. The original two breakfast menus combined cost $3.77 and were reduced to $2.98. The purpose of this study was to conduct a continuous quality improvement study to determine if searching for lower priced food items could reduce menu prices and if replacing already packaged containers with bulk items that needed to be portioned into disposable containers would reduce food costs as well. The objectives for this study included determining the most current patient tray cost, identifying items that could be replaced with lower costs similar items, and determining if portioning bulk items into disposable containers was more cost effective than current contained food and beverage items. Process Reviewed The process for conducting the Continuous Quality Improvement (CQI) project can be found in Appendix A by following the flow chart. The flow chart provides a set of procedures that can be followed to determine the raw cost of patient trays and how to further collect data for the CQI project. Once a year a staff person such as the manager should identify tray costs for a non-select patient menu. The manager will retrieve the patient meals that are pre-selected for room service no patients. Room-service no patients have either opted out of selecting their own patient trays or they are unable to select their own meal. The room service no patient meals have been pre-selected by the Registered Dietitian and can be retrieved from the Dietitian. After the menu has been received the next step is to identify raw food costs for each item that goes on the patient tray and determine the cost of each item per patient tray. The items that are included on the patient tray are the food items, beverages, condiments, disposable utensils, food containers, and tray liners. The next step is to add all the raw food costs. After the allotted days have been

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report evaluated the next step is to ask if any items can be replaced with a less expensive item or removed to reduce food costs. If there are items that can be replaced the manager should

highlight which items will be replaced or removed. If no replacements or removals are available for the menu then the process ends. The factors that affect the costs of patient trays can be found in Appendix A by looking at the fishbone diagram. The causes of patient tray costs to increase and decrease include storage factors, staff, comparative factors, inventory management, kitchen patient trays, and production. Under each factor there are additional causes that branch off each other and lead back to the central issue, of increasing costs of patient trays. The aspects under comparative factors include food cost, labor costs, and food quality. The factors under staff include handling from procurement to production, Serv Safe knowledge, general food handling, food safety practices, no incorrect tray items, and proper cooking preparation. The extensions under storage include room for food to be stored, inadequate turnover or loss due to handling, flow of food, temperatures, and proper sealing of storage units. Within inventory management there are things such as underlying price, intrinsic value, committed manufacturer agreement, expiration dates, and supply and demand that can impact the patient tray costs. Things like amount of heating, correct containers, need for food security in summer and warmer months, outside temperatures, and preventative maintenance can cause patient tray costs to be increased. Lastly, within production there are factors that can impact the patient tray costs including proper food costing and comparing, routine maintenance, determining critical control points, Serv Safe training, and proper education or certification.

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Methods The CQI project involved determining the current patient tray costs on Monday and

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Tuesday for Breakfast, Lunch, and Dinner. Since the facility utilizes room service and patients who select to be a room service yes patient are allowed to place their own orders. Patients who are a room service no receive a pre-determined tray. The trays are the same each week and two of the days were evaluated as part of this project. The full menus were retrieved for Monday and Tuesday and analyzed by determining the raw cost for each food item, beverage, condiment, container, and utensil. Once each items cost was determined for an individual tray the prices were totaled. After both days were totaled the patient tray costs were multiplied by the average percentage of room service no patients, which is 31.2%. The number calculated is then multiplied by 12, which is how many Monday and Tuesdays are in a three month time span. This number then provides the total costs of patient meals for three months for Monday and Tuesday. Data Collection Data collection included going through each item on the current menu and search for less expensive prices for the same foods in order to lessen the patient tray costs. For some items such as juice, it was less expensive to purchase a bulk amount of juice and the following step was to determine if the bulk juice and disposable containers was more cost efficient than purchasing individual juice cups. After every item on the patient tray was thoroughly checked for an alternative, the items were then added together to determine potential savings. The individual tray cost then went through the same process as the current tray costs to determine a three-month total. The proposed menu total was subtracted from the current menu to determine potential total savings for an individual meal and for three months. More information on the data collection

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report tool is in Appendix B and more information on the data collected can be viewed in the data collection graphs or Appendix C. Data Collection Graphs and Tables

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Graph 1 Comparison Between Current and Proposed Prices for Monday Breakfast, Lunch, and Dinner

Proposed Current

Graph 2 Comparison Between Current and Proposed Prices for Tuesday Breakfast, Lunch, and Dinner

Proposed Current

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report

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Graph 3 Comparison Between Current and Proposed Prices for Monday and Tuesday Total

Current Proposed

Graph 4 Comparison Between Current and Proposed Prices for Monday and Tuesday Three Month Total

Current Proposed

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Table 1 Cost Comparison Between Monday and Tuesday for Each Meal Monday Current Per Tray Proposed Per Tray Savings Per Tray Current 3 Month Proposed 3 Month Savings Per 3 Month Savings Per Year $7.04 $5.31 $1.73 $2,635.78 $1,988.06 $647.72 $2,590.88 Tuesday $7.62 $6.14 $1.48 $2,852.00 $2,298.82 $553.18 $2,212.72

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Results The total cost for Monday, which included breakfast, lunch, and dinner, was $7.04. The current price for Monday would equal $2,635.78 for three months. There were several changes made to each meal to reduce costs. Breakfast reduced by changing the premade biscuits to biscuit mix that requires water only, changing the premade fruit cups to using fresh cantaloupe, honeydew melon, and grapes cut up in the facility and serving them in four ounce disposable containers, and changing the prepackaged grape juice to a larger bulk grape juice and pouring them into four ounce disposable containers. Lunch was reduced by finding less expensive English peas, brownie mix, and premade dinner rolls. The facility currently makes homemade dinner rolls; however, during data collection the premade dinner rolls were four cents cheaper. Finding less expensive chicken tenders, macaroni and cheese, honey mustard, and premade dinner rolls reduced dinner costs. The total proposed cost for Monday, which included breakfast,

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report

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lunch, and dinner was $5.31, which was a savings of $1.73 per tray. The proposed cost for three months for Monday would now be $1,988.06, which is a $647.72 savings for three months. Throughout a 12-month cycle there would be a total of $2,590.88 saved just from adjustments made for Monday. The total cost for Tuesday, which included breakfast, lunch, and dinner, was $7.62. The current price for Tuesday would equal $2,852.00 for three months. There were changes involved to reduce the costs of patient trays. Obtaining lower priced pancake mix and patty sausage reduced breakfast costs. The prepackaged apple juice was also replaced with a larger bulk apple juice carton and serving them in four ounce disposable containers. Finding lower cost mashed potatoes, hamburger steak, and premade dinner rolls reduced lunch costs. Lunch was also reduced in price by purchasing a larger bulk item of orange sherbet and serving them in fourounce disposable containers. Finding a less expensive premade dinner roll and peach cobbler reduced dinner prices. The total proposed cost for Tuesday was reduced to $6.14, which was a savings of $1.48 per tray. The proposed costs for three months for Tuesday after revision would be $2,298.82, which is a potential $553.18 three-month savings. Throughout a 12-month cycle there would be a total of $2,212.72 saved by adjusting Tuesday meals. All trays included the removal of the condiment tray liner, which lowered the cost by $0.30, $0.15 for both Monday and Tuesday. The highest savings was for Mondays dinner meal, the original meal cost $2.87 and the proposed meal cost $2.01, which saved $0.86 and 30% savings. The second highest savings was for Tuesday lunch, the original meal cost $3.24 and the proposed meal cost $2.43, which saved $0.81 and 25% savings. Tuesday lunch was the highest costing meal and Tuesday breakfast was

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report the lowest costing meal originally and after revisions. The potential total yearling savings of both Monday and Tuesday could be $4,803.60. Conclusion/Recommendations During the data collection the most recent inventory sheets were used to determine the cost of the current patient tray costs. To determine the costs of the proposed patient trays the U.S. Foods catalogue was utilized to obtain the least expensive items. The policies and procedures used during purchasing allow the supervisor to purchase similar items that are at a lower cost, which was part of the data collection for the proposed menu costs. The main items

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changed that could not be done by only browsing the purchasing catalogue were the grape juice, apple juice, fruit cup, and orange sherbet, all of these items were viewed in a larger bulk container and would be portioned in four ounce disposable containers for patients. The biscuits were chosen due to being less expensive but would require the bakery to mix the biscuit mix and water together and bake the biscuits for production. Since the proposed menu suggests removing the homemade dinner rolls for cost effectiveness the bakers should be able to bake biscuits instead to save time and money. A recommendation would be to asses patient satisfaction of the homemade dinner rolls to see how well liked the rolls are and if replacing them would be beneficial or detrimental to the patient satisfaction. Even though replacing the rolls with premade dinner rolls is more cost efficient it is most important to satisfy the customer and the difference is not significant. It is recommended to remove the patient tray liners to reduce patient tray costs by $0.05 per tray, which can be seen as unnecessary spending. It is also recommended to purchase juices, sherbet, and fruit, in larger bulk and pre-portioning the items into four-ounce disposable containers to be more cost efficient.

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report References Annaraud, K. (2007). Restaurant menu analysis: Can we go further? Journal of Foodservice Business Research, 10, 25-37. doi: 10.1300/J369v10n04-03 Boyce, B. (2011). Satisfying customers and lowering costs in foodservice: Can both be accomplished simultaneously? The Journal of the American Dietetic Association, 111, 1458-1466. doi: 10.1016/j.jada.2011.08.026 Burns, J. & Gregory, S. (2007). Changing foodservice systems: A balancing act between patient satisfaction and cost. Journal of Foodservice Business Research, 10, 63-78. doi: 10.1300J369v10n05_05 Kivela, J. (2003). Results of a qualitative approach to menu planning using control and experimental groups. Journal of Foodservice Business Research, 6, 43-65. doi: 10.1300/J369v06n04_03

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Raab, C., Hertzman, J., Mayer, K., & Bell, D. (2006). Activity-based costing menu engineering: A new and more accurate way to maximize profits from your restaurant menu. Journal of Foodservice Business Research, 9, 77-96. doi: 10.1300/J369v09n01-06

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Appendix A Flow Chart: Patient Tray Analysis

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RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report

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RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Fishbone Diagram: Factors Affecting Patient Tray Costs

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RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Appendix B Final Data Collection Tool
Monday Breakfast Tuesday Breakfast

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Food Cost

0 Food Cost

Paper Cost
Total Tray Cost

0 Paper Cost
Total Tray 0 Cost

0
0

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Appendix C CQI Data Collected Current Breakfast
Monday Breakfast
Ham & Cheese Omelet Biscuit .08+.07+.18 27.77/216 19.02/640o= 0.2per OZ*4 18.43/36 20.32/96 .02 per OZ 6*.02 16.28/600 8.65/200 58.50/200 30.94/1000*2 0.33 0.13

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Tuesday Breakfast
Scrambled Egg Pancake Patty Sausage Apple Juice 2%milk Coffee Syrup Margarine Creamer (2) Sugar (2) 30.35/480oz= 0.06perOZ*2 23.08/480oz=0.05perOZ*2 24.98/160oz= 0.15perOZ*2 19.07/96 58.50/200 .02 per OZ 6*.02 7.55/100 16.28/600 30.94/1000*2 0.12 0.09

Grits Fruit Cup Grape Juice Coffee Margarine Strawberry Jelly 2% Milk Creamer (2) Sugar (2)

0.12 0.51 0.21 0.12 0.03 0.04 0.29 0.06 0.01

0.31 0.19 0.29 0.12 0.07 0.03 0.06 0.01

12.28/2000*2

12.28/2000*2
62.00/200 54.40/1009

Food Cost
Diet Pack Condiment Tray Coffee Lid

1.85 Food Cost

0.31 0.05 0.03 Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

1.29 0.31 0.05 0.03

30.60/1000

30.60/1000

Paper Cost
Total Tray Cost

0.39 Paper Cost

Total Tray 2.24 Cost

0.39
1.68

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Current Lunch
Monday Lunch
Turkey Breast Cornbread Dressing Poultry Gravy Cranberry Sauce English Peas Dinner Roll Brownie 4.33/256=0.016*4 29.03/288=0.10*4 24.49/960= 0.025 per OZ 15.43/200 20.35/320=0.06*4 26.80/250 56.59/576=0.09*2 32.25/640= 0.05 per OZ*8oz 16.28/600 25.59/6000*2 0.06 0.4 0.025 0.07 0.25 0.1 0.19

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Tuesday Lunch
Mashed Potatoes Garden Side Salad Hamburger Steak Beef Gravy Broccoli Dinner Roll Orange Sherbet 36.69/260= 0.14 per OZ * 4 .20+.075+.075 42.95/53 20.95/960= 0.02 per OZ*1 20.35/384=0.05*4 26.80/250 11.66/48 32.25/640= 0.05 per OZ*8oz 16.28/600 12.18/100 25.59/6000*2 0.56 0.35 0.81 0.02 0.21 0.1 0.24

Tea Margarine Salt Pepper

0.4 0.03 0.008 0.004

Tea Margarine Ranch Dressing Salt

0.4 0.03 0.12 0.008 0.004 2.852 0.31 0.05 0.03

11.94/6000*2

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

1.537 Pepper Food Cost

0.31 0.05 0.03 Diet Pack Condiment Tray Coffee Lid

11.94/6000*2
62.00/200 54.40/1009

78.00/2000

78.00/2000

Paper Cost
Total Tray Cost

0.39 Paper Cost 1.927 Total Tray Cost

0.39
3.242

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Current Dinner
Monday Dinner
Chicken Tenders Mac & Cheese Green Beans Dinner Roll Almond Delight Cake Sweet & Sour Sauce Honey Mustard 29.34/160=0.18*4 29.75/304= .09*4 25.33/90 26.80/250 19.84/100 10.42/100 17.68/100 32.25/640= 0.05 per OZ*8oz 16.28/600 25.59/6000*2 0.73 0.39 0.28 0.1 0.27 0.1 0.17

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Tuesday Dinner
Grilled Chicken Breast Rice Poultry Gravy Baby Carrots Dinner Roll Peach Cobbler Tea 33.12/160=.20*4 29.95/800=0.03*4 24.49/960= 0.025 per OZ 23.08/384=0.06*4 26.80/250 16.76/160=0.10per OZ *4 32.25/640=0.05 per OZ*8oz 0.82 0.15 0.025 0.24 0.1 0.41 0.4

Tea Margarine Salt Pepper

0.4 0.03 0.008 0.004 2.482 0.31 0.05 0.03

Margarine Ranch Dressing Salt Pepper

16.28/600 12.18/100 25.59/6000*2

0.03 0.12 0.008 0.004 2.307 0.31 0.05 0.03

11.94/6000*2

11.94/6000*2

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

78.00/2000

78.00/2000

Paper Cost
Total Tray Cost

0.39 Paper Cost 2.87 Total Tray Cost

0.39
2.697

Monday Breakfast Monday Lunch Monday Dinner Total Price for Monday Tuesday Breakfast Tuesday Lunch Tuesday Dinner Total Price for Tuesday

2.24 1.93 2.87 7.04

1.68
3.24 2.7 7.62

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Proposed Breakfast
Monday Breakfast
Ham & Cheese Omelet Southern Style Buttermilk Buscuit Mix (add water)

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Tuesday Breakfast
Scrambled Egg 30.35/480oz= 0.06perOZ*2

.08+.07+.18

0.33

0.12

27.31/9,540 total servings

0.002

Pancake

16.71/480oz=0.03perOZ*2

0.06

Grits Fruit Cup Grape Juice Coffee Margarine Strawberry Jelly 2% Milk Creamer (2) Sugar (2)

19.02/640o= 0.2per OZ*4 22.52/48 25/138 .02 per OZ 6*.02 16.28/600 8.65/200 58.50/200 30.94/1000*2

0.12 0.46 0.18 0.12 0.03 0.04 0.29 0.06 0.01

Patty Sausage Apple Juice 2%milk Coffee Syrup Margarine Creamer (2) Sugar (2)

20/192oz= 0.10perOZ*2 16,94/138 58.50/200 .02 per OZ 6*.02 7.55/100 16.28/600 30.94/1000*2

0.2 0.12 0.29 0.12 0.07 0.03 0.06 0.01

12.28/2000*2

12.28/2000*2

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

1.642 Food Cost

0.31 0.05 0.03 Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

1.08 0.31 0.05 0.03

30.60/1000

30.60/1000

Paper Cost
Total Tray Cost

0.39 Paper Cost

Total Tray 2.032 Cost

0.39
1.47

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Proposed Lunch
Monday Lunch
Turkey Breast Cornbread Dressing Poultry Gravy Cranberry Sauce English Peas Dinner Roll Brownie 4.33/256=0.016*4 29.03/288=0.10*4 24.49/960= 0.025 per OZ 15.43/200 32.29/318 servings 16.19/240 25.32/480=0.05*2 32.25/640= 0.05 per OZ*8oz 16.28/600 25.59/6000*2 0.06 0.4

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Tuesday Lunch
Mashed Potatoes Garden Side Salad Hamburger Steak Beef Gravy Broccoli Dinner Roll Orange Sherbet 19.07/384= 0.04 per OZ * 4 .20+.075+.075 40.28/276=0.14 per OZ*4 20.95/960= 0.02 per OZ*1 20.35/384=0.05*4 16.19/240 10.11/96 32.25/640= 0.05 per OZ*8oz 16.28/600 12.18/100 25.59/6000*2 0.19 0.35

0.025 0.07 0.1 0.06 0.1

0.58 0.02 0.21 0.06 0.1

Tea Margarine Salt Pepper

0.4 0.03 0.008 0.004

Tea Margarine Ranch Dressing Salt

0.4 0.03 0.12 0.008 0.004 2.072 0.31 0.05 0.03

11.94/6000*2

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

1.257 Pepper Food Cost

0.31 0.05 0.03 Diet Pack Condiment Tray Coffee Lid

11.94/6000*2
62.00/200 54.40/1009

78.00/2000

78.00/2000

Paper Cost
Total Tray Cost

0.39 Paper Cost Total Tray 1.647 Cost

0.39
3.242

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report Proposed Dinner
Monday Dinner
Chicken Tenders Mac & Cheese Green Beans Dinner Roll Almond Delight Cake Sweet & Sour Sauce Honey Mustard 12.86/160= 0.08per OZ*4 26.83/384= 0.06perOZ *4 19.49/90 16.19/240 19.84/100 13.68/200 (.75oz) 7.54/100 32.25/640= 0.05 per OZ*8oz 16.28/600 25.59/6000*2

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Tuesday Dinner
Grilled Chicken Breast

0.32

27.26/48 (3oz)

0.56

0.24 0.21 0.06 0.27 0.06 0.07

Rice Poultry Gravy Baby Carrots Dinner Roll Peach Cobbler Tea

29.95/800=0.03*4 24.49/960= 0.025 per OZ 23.08/384=0.06*4 16.19/240 31.91/96 32.25/640=0.05 per OZ*8oz

0.15 0.025 0.24 0.06 0.33 0.4

Tea Margarine Salt Pepper

0.4 0.03 0.008 0.004 1.672 0.31 0.05 0.03

Margarine Ranch Dressing Salt Pepper

16.28/600 12.18/100 25.59/6000*2

0.03 0.12 0.008 0.004 1.927 0.31 0.05 0.03

11.94/6000*2

11.94/6000*2

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

Food Cost
Diet Pack Condiment Tray Coffee Lid 62.00/200 54.40/1009

78.00/2000

78.00/2000

Paper Cost
Total Tray Cost

0.39 Paper Cost Total Tray 2.062 Cost

0.39
2.317

RUNNING HEAD: Continuous Quality Improvement of Patient Tray Costs Study Report
Monday Breakfast Monday Lunch Monday Dinner Total Price for Monday

27

1.65 2.06 3.71

Tuesday Breakfast Tuesday Lunch Tuesday Dinner Total Price for Tuesday

2.32 2.32