• 한국식품조리과학회지
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• 제29권1호
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• pp.63-71
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• 2013

The purpose of this study was to analyze the gap between importance and performance in perceived sanitation management for general hospital foodservice operations. Data were collected through surveys given to 168 hospital dietitians in the Seoul-Incheon, Gyeonggi-do, Daegu, and North Gyeongsang province. The 65 questionnaires from total questionnaires were usable and the response rate was 38.7%. All statistical analyses were conducted using the SPSS package program (version 20.0) for t-test, ANOVA, and importance-performance analysis (IPA). According to the importance and performance analysis for 26 items, the importance score was significantly higher than the performance score for 22 items. In addition, the results of IPA showed the following areas as improvement priorities: handling foods on working table and management of distribution temperature. In conclusion, the performance level of prerequisite programs applying to the hospital foodservice needs improvement, especially cross-contamination prevention and temperature control for distribution. Additionally dietitians should be educated about sanitation management items that perceived to be less important than the others.

• 대한지역사회영양학회지
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• 제13권2호
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• pp.244-252
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• 2008

The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, $x^2$-test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.

• Nutrition Research and Practice
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• 제4권2호
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• pp.163-172
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• 2010

The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.

• 한국식품조리과학회지
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• 제19권3호
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• pp.339-353
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• 2003

The rapid increase in food borne illness outbreaks in Korea has been one of the major threats to the Nation's Health. Foodservice establishments have been identified as the major place for these outbreaks, mainly due to the lack of sanitary management and sanitary facility management practices. The purposes of the study were to develop hospital foodservice facility evaluation tools, based on the general HACCP-based standards and guidelines, for hospital food service establishments, to ensure the safety of these foodservices and to reduce the risk of food home illness. The scope of this study included: 1) an assessment of the current foodservice sanitation practices and managements for 6 general hospitals, with more than 400 beds, and 3 general hospitals, with less than 400 beds; 2) the development of foodservice establishments sanitation evaluation tools and sanitation standards, based on the HACCP system. The survey data showed varied results between the hospitals surveyed. Most of the hospital foodservice operations had many problems with ventilation and the plumbing. The total dimensional mean scores for the hospitals with more than 400 beds and less than 400 beds were 31.5 and 27.0, respectively. The highest dimension scores were for the water supply facility and lighting, with the lowest for insect and rodent control and toxic materials management. The levels of the mean scores were very low, especially for the general hospitals with less than 400 beds. These low mean scores may have arisen from critical problems within the hospital foodservice operations. The most needed facility management items for improvement were: storage shelf should be spaced 6 inches from the floor and walls, the use of three compartment sinks, utility sinks and cleaning facilities, with a floor drain for cleaning mops or liquid wastes, a ventilation hood designed to prevent dripping onto food, cooking facilities should be disassembled for washing and sanitizing, a separated hand washing sink and a sanitized food board for each area should be provided, all toxic material must have warning labels attached, and be stored in an area away from food preparation under padlock. The evaluation tool consisted of 14 dimensions, with 65 check-off items. The results of this study will provide basic facilities' guidelines to regulators, or foodservice industry personnel, wishing to build, or expend, and establish an efficient flow of food. As a result, food borne illnesses will be effectively prevented, and the Nation's health will be promoted for the development of their own sanitation standards, with a checklist for the safe production of foods.

• 한국의료질향상학회지
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• 제7권2호
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• pp.244-261
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• 2000

Background : In order to cope with changes in the management environment at hospitals, increased interests are drawn in patient foodservice system on Continuous Quality Improvement Activity as the method of approaching a quality food service and effective management. Thus, as a part of this activity, this study was conducted to evaluate job flow improvement that was already performed and the results of that process at the dietetic department of a university hospital, focusing on improving management. Method : On February 15 of 1998. the dietetic department formed a job flow-improvement to decide on the priority of job flow improvement, and prepared specific action strategies and schedule of the priority: after a 5 month process period, job improvement achieved on June 15. 1998. Also, economic achievement of the task was evaluated through labor productivity analysis and cost-benefit analysis. Results : The patient food service system which was managed decentralized at the present hospital was centralized, some steps of the food service process were integrated, and quality of patient food was improved. Also, as a solution of the problems expected when conducting job flow improvement was made on food service equipments and utensils. The result of evaluating the job flow improvement that labor productivity improved by 18.2% compared to before the improvement and the result of the analysis of cost-benefit showed that Benefit-Cost (B/C) ratio was 2.22. showing financial merit on the investment. Conclusions : Continuous Quality Improvement Activity needs to be initiated and conducted in the future in various areas of hospital foodservice system in order to actively adopt to ever changing hospital management environment. In order to achieve this goal, many researches and more efforts need to be put in by people in charge of hospital food service management, and interests and support are needed from hospital policy makers.

• 대한영양사협회학술지
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• 제6권2호
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• pp.136-147
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• 2000

The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.

• 대한영양사협회학술지
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• 제10권2호
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• pp.184-189
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• 2004

The purposes of this study were to evaluate the quality of hospital food services in view of patients in orthopedic wards and accomplish the quality improvement in hospital foodservice operations. Quantitative questionnaires for patients containing foodservice satisfaction and demographic information were developed. A survey of 8 general hospitals was undertaken and detailed information was collected from 290 patients in orthopedic wards. The collected data were processed using the SAS PC 6.12 for descriptive analysis, t-test. In demographic information of patients, 32.6% was over 50 years old and 31% was hospitalized over 30 days. 80% of patients was taking normal diet. 47.7% and 47.9% of patients showed moderate appetite and moderate pain respectively. The overall satisfaction score for patients was 3.24 out of 5, showing slightly higher level than the average score(3.00). According to foodservice involvement scores of patients, they were divided into two groups which were high involved group and low involved group. Two groups showed significant differences in taste of meals, variety of menu, punctuality of meal times, temperature of meals and portion size. The foodservice involvement factor which affected significantly patient foodservice satisfaction was 'kindness of foodservice staff'.

• Journal of Nutrition and Health
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• 제38권2호
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• pp.173-179
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• 2005

The study estimated employee satisfaction to apply TQM system to hospital foodservice management. A survey was mailed to foodservice employees of five general hospitals with more than 300 beds, three of them were independent and two of them were contract foodservice management. A total of 129 questionnaires were returned and analyzed for statistical analysis. Statistical analysis was completed using SPSS for chi-square test, t-test and Pearson's correlation. The results of this study showed that employees of contract foodservice presented higher scores than independent foodservice in interests, affection, importance of works. And achievement of work was significantly different between contract and independent foodservice employees (p < 0.05). The satisfaction of payment adequacy was lower for contract foodservice employees (p < 0.05). The employees of both contract and independent foodservice were satisfied with attitude of foodservice managers toward employee. Attitude scores of foodservice employees toward co-worker were higher in independent foodservice. Employees of independent foodservice showed higher scores for the attitude toward institution represented satisfaction. (Korean J Nutrition 38(2): 173～179, 2005)

• Journal of Nutrition and Health
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• 제33권4호
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• pp.464-476
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• 2000

The purpose of this study was to measure patient satisfaction with hosptial foodservices, and thereby identify areas for improvement and provides basic data for the introduction of total quality management into hospital foodservice in the Taegu·Kyungpook area. This survey was carried out on 676 hospitalized patients in 11 hospitals with over 200 beds to determine the quality satisfaction with foodservices. The subjects were 62.4% male and 37.6% female. Sixty-two percent of the subjects were over age 40, 46.7% were only educated to middle school or below, 41.8% were hospitalized for 1 - 10 days. Eighty-seven precent of the subjects did not receive any nutrition education. The expectation and perception grid showed that the high expectation to the low perception items were the seasoning of the meals, taste of the meals, and prompt dealings with meal complaints. The quality satisfaction values of all the attributes indicated a minus. The unsatisfied quality attributes were the opportunity to meet with a dietitian, seasoning of the meals, taste of the meals, explanation of the meals, and prompt dealings with meal complaints. Among the demographic characteristics, age, education, length of admission, and experience with nutrition education produced significant differences in the quality satisfaction scores. In conclusion, it would seem to be desirable that hospital foodservice department introduce selective menus, hygiene education for foodservice employees, standard recipes, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.

• 대한영양사협회학술지
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• 제11권4호
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• pp.381-392
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• 2005

This study compared he importance of food service, views to the performance, management objectives, and recognition gap about the contract contents towards the dietetic departments of hospitals that manage the patients' food service and managers of contract managed companies, and dieticians. It conducted questionnaires and survey towards the vice director and dieticians of 17 hospitals, over 500 beds, and the persons responsible for contract managed companies and dietitians who were in charge of food service. The hospitals showed significantly(p<0.05) higher the importance scores in menu planning, the distribution of meal, sanitation management, and leadership than those of the contract managed companies. In the difference of hospitals and contract managed companies about performance, it appeared high in the contract managed companies. In the importance of the foodservice management objective, the hospital had significantly(p<0.05) higher scores in the management of client's satisfaction and quality improvement element through management innovation than those of the contract managed companies. In the importance of contract term, the contract method, expense, and payment condition of commission fee were significantly(p<0.05) high scores in the contract managed companies, compared to the hospital.