Improving the Patient Dining Experience - Annotated Bibliography Example

Business Plan Report Cover Page: The POD Squad Company Logo Table of Contents: Include each major section and page numbers Mission ment: Our mission: to provide an exceptional food service experience to satisfy patients, to maximize efficiencies of the innovative POD system, and to optimize patient care through provision of quality nutrition. Executive Summary: What business are you in? Who is on the team? Where will you locate and why? What is your product/service? How much capital will be needed? Why we should invest in your company? The Business Team: Who are the managers? What is their area of responsibility? Who are the owners? Market Summary The POD system was created to improve the patient dining experience and overall patient satisfaction while staying at North Shore University Hospital. The POD system was implemented 2 years ago with the idea that it would minimize the amount of late trays, provide more efficient service, and familiarize patients with their dining associate for a more personalized food service experience. The Press Ganey scores prior to POD service implementation were extremely low. Since implementation, scores have risen. However, we believe that with small improvements, the survey scores on the POD service floors have the potential to increase dramatically. Imagine this, you are lying in a hospital bed in pain and are unable to ambulate. All of a sudden, you hear a knock on the door, “Nutrition and dining services, may I enter your room?” You respond- “yes”. You are greeted by a smile and warm “Hello Mr. Kiley, right?”you respond “yes, that’s me”, “I just need to confirm your date of birth” “05/22/87”,  “Thank you, how are you doing today?, my name is Angelica, I will be your personal dining associate for this afternoon. I am here to go over your menu selections for today. I see you haven’t filled out your menu and I wanted to make sure your lunch is exactly what you would wanted. Today’s specials for lunch include veal parmesan and meatloaf with mushroom gravy. Veal parmesan is a lightly breaded veal cutlet topped with marinara sauce & mozzarella cheese served with a side of al dente rotini pasta and sliced zucchini. The second option is savory meatloaf topped with mushroom gravy, a warm baked potato and fresh cut green beans. If you are not interested in the specials, we also offer menu alternatives.” You place your order but before the dining associate leaves the room, she says “here is my card, with my name and the nutrition and dining services number, if you need anything during your stay, please do not hesitate to call.” Before you know it, your lunch is right in front of you with exactly what you ordered. “Here is your lunch for today, is there anything else I can get for you? Do you need any help setting up your tray?” You may be asking yourself right now “how can customer service like this be implemented at North Shore University Hospital?” or maybe “why isn’t this sort of customer service being provided now?.” Well look no further. After conducting extensive research, we have found the perfect solution to improve the POD system. Our strategy is to make various improvements within the existing POD system. These improvements include: Providing dining associates with a menu alternative list as a reference they can use to offer menu items to fit the food preferences and dietary needs of the patient. Creating food descriptions of menu items as a way to make the special hot entrees for lunch and dinner sound more appetizing.   Conducting briefs before shifts as a quick way for supervisors to motivate and communicate important information to staff. Providing a hospitality cart on the floors using the POD system after meals are served as a fast way to provide patients with items that were missing from their tray, replenish beverages and condiments. Place a “Sorry I missed you card” at the bedside of a patient who was not present in the room when the associate was going to review their meal selections. This card will be a reminder to the patient to call nutrition and dining services to place an order. Provide each patient with an introduction card that states the name of their dining associate and the number to the nutrition and dining services. Improving and expanding the dining associate training program highlighting emphasis on the deficiencies observed during job performance. Competition The three floors at North Shore University Hospital (NSUH) that the Point of Distribution (POD) system serves includes 3DSU, 4 DSU and 7 Tower.  Each of these floors has approximately forty patients on it at any given time.  3DSU is composed of mostly cardiac patients, 4DSU is composed mostly of general medicine patients and 7 Tower is composed mostly of bariatric and gastrointestinal surgery patients.  These patients are usually between the ages of forty to eighty years old and live in the Long Island or Metropolitan area.  The majority of these patients has been to NSUH before at least once before and has stayed at other short-term facilities as well.   Considering that these patients are in an inpatient facility, many of them are either in pain, feeling ill, immobilized or lacking interaction with others.  The highlight of their day arises from the comfort of food that is being served at breakfast, lunch and dinner.  Consequently, the quality, quantity, portion size, temperature, mode of delivery and patient etiquette all play a critical role in patient satisfaction with the food service. According to the Journal of Health Management, in the health care setting, patients tend to rely on functional attributes (e.g. facilities, cleanliness, quality of hospital food, hospital personnel’s attitudes etc.,) rather than technical attributes (e.g. medical diagnoses and procedures etc.,) when evaluating the service quality because they are unable to evaluate the technical quality due to lack of expertise (Marti, Deshpande, &Srivastava, 2013). Quality in health care is currently at the forefront of professional, political and managerial attention.  This is mainly because it is being seen as a means for achieving increased patronage, a competitive advantage and long-term profitability. It is ultimately seen as an approach to achieving better health outcomes for consumers (Marti, Deshpande, &Srivastava, 2013). Several other health care facilities have implemented the POD system with great success.  WakeMed hospital in Raleigh, NC was featured in Foodservice Director Magazine for maintaining the POD system for almost 13 years. The production manager, Sandra Ray reports that they moved to PODs because they were looking for a way to prepare and deliver patient trays that improved patient satisfaction.  They also wanted to shorten the amount of time that it took to run their tray line.  Ray stated that the time to assemble trays for one meal period was shortened by 45 minutes when they moved to the POD system. However, due to the fact that the hospital has continued to grow, the time is now similar to what it was on the initial tray line. Nevertheless, a fourth POD is in the works to accommodate for the increase in volume, which Ray hopes will once again decrease assembly time as it proved to do in the past (Schilling, 2009). Another reason WakeMed decided to go with a POD system was to give patients a personal touch in their meal service. “One of the best ways to improve customer satisfaction is with a personal piece,” Ray says.  In addition to assembling and delivering trays, the host/hostess visits patients after breakfast to get lunch orders and once again after lunch to get dinner orders and the next day’s breakfast.  Since the patient’s orders are being taken right before the meal is served, this should ensure the correct food items are being served to the patient, and will minimize the need for late trays or additional items being brought up to the patient. Shands Hospital at the University of Florida in Gainesville has had the POD system since 2006.  Each host/hostess is responsible for getting the patient’s order, assembling the tray, delivering the tray, picking up the tray and getting the order for the next meal.  They try to keep a maximum of 30 patients for every host/hostess.  The hospital has found that since starting the POD system, patient satisfaction has increased from the 60th percentile to the 80th percentile (Schilling, 2009). Moreover, a research article in Appetite Journal examined the provision of hospital meals from the patients’ viewpoint, with the aim of improving hospital food service. The study found that some patients regard food as part of the responsibility they take for their own recovery. They not only commented about the quantity of food versus exercise, but also the availability of salads and vegetables. These patients used appetite as a gauge of recovery: “as you get hungrier you know you’re getting better,” a patient stated.  Respondents praised the food service staff that were “superb/kind,” “helpful,” “happy/cheerful,” “polite,” and “friendly”. Service staff provided “someone non-medical to talk to” (Johns, Hartwell, & Morgan, 2009). Service quality can be managed and improved in much the same way as food quality. Managers must realize that food service and the service staff help patients cope with the foreignness of the hospital environment.  In this study, food, choice and staff were mentioned most (FOR WHAT?).  Patients’ perceptions of meals compared favorably with their expectations, but the latter were not high and the meals compared unfavorably with home. At best, the food and service staff offered a moment of ‘‘normality’’ in the foreign hospital environment.  In contrast, service staff offered a chance to conduct a normal conversation with someone who was not directly involved in medical care (Johns, Hartwell, & Morgan, 2009). A number of management consequences were identified from this study. Managing of menus, ordering system, service styles and timing can improve expectations. Many of these aspects are also dependent upon attitudes, so service staff tend to have a greater impact on patients’ experience of eating in hospital than the food itself.  The service staff needs to appreciate the value of customer service. Their training should emphasize the importance of food to patients’ well being and recovery and seek to maximize beneficial interaction between staff and patients (Johns, Hartwell, & Morgan, 2009). According to Foodservice Director Magazine, Regina Toomey Bueno became the foodservice director in 2007 at NYU Langone Medical Center in New York City.  She suggested changing to a  POD system to improve customer satisfaction and as a way to switch to cook-serve from cook-chill, which the hospital was currently doing (Schilling, 2009). Last June, the Medical Center piloted one POD. Once the entire hospital is converted to the POD system, only bulk items like soups and sauces will be done cook-chill, and the rest of the items will be cook-serve. In addition to patient satisfaction going up, Toomey Bueno says employee morale has also increased (Schilling, 2009). Opportunity Press Ganey Scores 600+ Bed Group 3 DSU Mean Mean Rank/Percentile Temperature of the food 72.2 77.6 5 Quality of the food 75.0 73.7 63 Courtesy of person served food 81.3 88.6 1 Overall Performance 76.2 79.8 1 4 DSU Temperature of the food 78.6 77.6 65 Quality of the food 82.1 73.7 98 Courtesy of person served food 85.7 88.6 12 Overall Performance 82.1 79.8 79 7 Tower Temperature of the food 75.0 77.6 21 Quality of the food 75.0 73.7 63 Courtesy of person served food 88.5 88.6 45 Overall Performance 79.5 79.8 49 When compared to the 600+ Bed Group within the Press Ganey database, NSUH has 7/12 scores at the bottom percentiles (red zone/below median) and 5/12 scores at the top percentiles (blue zone/above median). 3 DSU is 5th percentile in temperature, 63rd percentile in quality, and 1st percentile in courtesy. Therefore, 3 DSU should focus on improving temperature of the food and courtesy of the person serving the food. 4 DSU is 65th percentile in temperature, 98th percentile in quality, and 12th percentile in courtesy. Therefore, 4 DSU should focus on improving courtesy of the person serving the food. 7 Tower is 21st percentile in temperature, 63rd in quality, and 45th in courtesy. Therefore, 7 Tower should focus on improving the temperature of the food and the courtesy of the person serving the food. There is a significant discrepancy in overall performance between the three floors. 4 DSU is scoring high above the other two with a 79th percentile; 7 Tower is 49th percentile, while 3 DSU is much lower at the 1st percentile. Overall, courtesy of the person served has the highest mean score among all three floors, while temperature of the food has the lowest. Therefore, improvements should be focused on temperature control on all floors and overall enhancement of 3 DSU. Moreover, each floor should work to amend their specific deficiencies. Patient Survey 3 DSU 4 DSU 7 Tower Are you familiar with your dining server? Y: 69% N: 31% Y: 86% N: 14% Y: 64% N: 36% Are you satisfied with their service? Y: 85% N: 8% Sometimes: 8% Y: 86% N: 0% Sometimes: 14% Y: 82% N: 0% Sometimes: 18% Does this server review the menu with you before the meal is delivered? Y: 46% N: 38% Sometimes: 15% Y: 64% N: 21% Sometimes: 14% Y: 45% N: 55% Was everything on your tray exactly what you asked for? Y: 77% N: 23% Y: 86% N: 0% Sometimes: 14% Y: 64% N: 9% Sometimes: 27% Have you needed to call down for a second tray at meals? How often? Y: 15% N: 85% Y: 14% N: 86% Y: 36% N: 64% How much time did it take for the second tray to arrive? 1.5 hours: 1 Read More