- Email: [email protected]
Incorporating Sustainability and Continuous Quality Improvement Principles into a University Student-operated Restaurant
MONDAY, OCTOBER 23
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Glycemic Control with Different Foodservice Models: On Demand Room Service and Batch Set-time Models in an Urban Academic Medical Center Author(s): A. Bhow, D. Henroid, P. Booth, A. Boyle, L. Tabrizi, R. Badri, S. Blakenship, S. Burke, M. Fujii, S. Hu, S. Smith; University of California San Francisco Medical Center Learning Outcome: Gain an understanding of the impact of food service systems on management of hospitalized patients that need insulin therapy. Background: The foodservice process for room service on-demand dining and batch set-time models for patients on pre-meal insulin and its impact on glycemic control was studied in an urban academic multi-site medical center. Methods: Finger stick blood glucose measurements were collected for 56 patients needing pre-meal insulin for the study day. Control points were evaluated: 1) Accurate identification of patients with pre-meal insulin orders; 2) Tracking of meal trays at nonstandard times; 3) Meal orders at least three hours apart; 4) Foodservice notification to the nurse when meals ordered; 5) Foodservice assistant contacted nurse when meal delivered. Other factors that influence blood glucose levels were noted such as diet order, insulin orders for meal time correction, glucocorticoid therapy. Data points were gathered using nurse surveys, EMR and Computrition databases. Results: Fifty-six patients consisting of 41 room service and 15 on a batch settime model were observed. A total of 181 meals and nourishments were served for these patients. Eighteen of 41 patients on room service had hyperglycemia (>200 mg/dl) at meal time compared to 5 of 15 who had scheduled meal delivery. Six of those patients with room service had one hyperglycemic event. Foodservice team members notified nursing of meal delivery 84% of the time and spaced meals more than 3 hours 75% of the occurrences. Conclusions: A number of factors influence glycemic control in the hospital including food consumption. Limited data and lack of comparison group make it difficult to determine incidence of hyperglycemia between meal delivery models.
Influence of Local and Organic Products on a College Student’s Buying Decisions Author(s): T. Haselden, R. King, C. McCurry, V. Butler, W. Koszewski; Winthrop University Learning Outcome: Participants will identify how college students differentiate between local and organic foods and the factors that influence their decision making in consuming these foods. In addition, barriers will be discussed and nutrition education programming needs will be identified in order to develop appropriate programming for this target group. Background: Many influential factors assist an individual’s food consumption choices such as perceived benefits, taste, income, and several other considerations. Organic sales and local farmers markets have grown significantly over the past several years. The objective for this project was to identify characteristics and barriers of college students who consume local or organic products and determine if differences exist between off and on-campus students. Methods: Cross-sectional survey design was used. On-line Qualtrics Survey took 10 minute to complete. Questions included demographics, definition of organic and local, whether they consumed organic and local foods, frequency, and barriers. Survey was available to two weeks in the Fall of 2016. Project was approved by IRB as an exempt project for Human Subjects. Results: 115 students completed the survey (105 females; 10 males) with a good distribution of college year. 81 students were identified as off campus and 34 as on-campus. More students reported consuming organic and local foods compared to those who do not. The percent of commuter vs. oncampus students who consume organic products were similar (58.82%, 59.25%) as well as the percent who consume local products (64.71%, 67.9%). For both local and organic, off and on-campus students reported consuming these food products more often when purchased or prepared by others (n¼57, 49.57% organic and n¼40, 34.78% local). The biggest selected barrier for commuters and on-campus students when consuming organic was cost (82.35%, 82.73%), followed by lack of knowledge on the subject. Conclusion: More research and nutrition education needs to be done on how college students identify and consume local and organic foods.
Funding Disclosure: None Funding Disclosure: None
Incorporating Sustainability and Continuous Quality Improvement Principles into a University Student-operated Restaurant
Malnutrition Screening: An Underutilized Screening Tool for Outpatient Oncology Patients
Author(s): J. Taylor, D. Holben; The University of Mississippi, Department of Nutrition and Hospitality Management
Author(s): A. Shapiro1, E. Trujillo2, C. Taylor3, J. Mills4, S. Johnson5, C. Spees3; 1 University of Minnesota, 2National Cancer Institute, National Institutes of Health, 3The Ohio State University, 4Dartmouth Hitchcock Medical Center, 5 Regions Hospital
Learning Outcome: After the presentation, the participant will be state how sustainability and continuous quality improvement processes can be incorporated into a studentoperated restaurant laboratory. Background: According to ACEND standards, nutrition and dietetics education programs must ensure that graduates develop sustainability (SUS) and continuous quality improvement (CQI) processes-related knowledge and skills. Purpose Of The Program: To incorporate principles of SUS and CQI into a didactic program and an MS-level coordinated program in dietetics through a university studentoperated restaurant laboratory.
Methods and Outcomes: Utilizing the ACEND standards, areas for programmatic development related to SUS and CQI were identified. The Green Restaurant Association (GRA) certification process was accessed (http://dinegreen.com/restaurants/standards. asp). GRA goals in five distinct areas of the operation [Water Efficiency; Waste Reduction and Recycling; Sustainable Furnishings and Building Materials (not applicable to existing operations); Sustainable Food, Energy, Disposables; and Chemical and Pollution Reduction] were evaluated. In collaboration with laboratory faculty, staff, and students, a plan was established to secure a GRA two star certification, and operations were implemented. Changes to the restaurant laboratory included: 1) installation of energy-efficient lighting, foot-operated hand sinks, and water-efficient toilets; 2) usage of recyclable takeout containers and printing supplies; 3) increased usage of locally-sourced foods; and 4) institution of composting and recycling. Certification guidelines, programmatic plans, and operational outcomes will be presented with plans for continued improvement evaluations and strategies. Conclusions: A student-operated restaurant laboratory can be utilized to teach principles of SUS and CQI processes to dietetics students through operational audits, classroom lectures, and hands-on experiential learning.
Funding Disclosure: The University of Mississippi (UM), Department of Nutrition and Hospitality; UM Energy Fund; UM Office of Sustainability Green Fund Grant
A-46
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
Learning Outcome: After reading/listening to this abstract presentation, the reader will be able to describe a validated tool for malnutrition and rates of utilization in a comprehensive cancer center. Background: The provision of adequate nutritional care in outpatient cancer centers was the focus of a 2016 IOM Workshop, “Assessing Nutrition Care in Outpatient Oncology.” Here we report our internal project that evaluated the documentation of a malnutrition screening tool (MST) at a large Comprehensive Cancer Center (CCC). Methods: Screening scores from a validated 2 question MST scale were entered into the EMR. Questions prompt for: 1) unintentional weight loss; and 2) eating poorly because of a decreased appetite. A score of 2 indicated nutrition risk. De-identified oncology clinic visit data were examined for a 4-week period to assess MST utilization and scores for ambulatory oncology patients. Results: Nearly two-thirds (66%, n¼8505) of the 12,903 unique oncology patients that visited the CCC during the 4-week period had documented MST data. MST data were less likely to be completed by Heme Onc (54%, n¼1168), Surg Onc (7%, n¼153), and Chemo (7%, n¼148) services. Of those that had a valid MST score, 10% (n¼807) had MST scores that indicated nutritional risk. The majority of high MST’s (2) were associated with Med Onc (35.9%, n¼290), followed by Rad Onc (12.5%, n¼101) and Chemo (8.4%, n¼68). Conclusion: The MST is a valid malnutrition screening tool for outpatient oncology patients, yet this tool is not uniformly being utilized. Implementing the consistent use of the MST in the EMR and obtaining data on utilization, as initial steps, are needed to inform future RDN staffing patterns, cost/benefit analysis, and health outcomes for oncology patients. Funding Disclosure: None
September 2017 Suppl 1—Abstracts Volume 117 Number 9
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Glycemic Control with Different Foodservice Models: On Demand Room Service and Batch Set-time Models in an Urban Academic Medical Center Author(s): A. Bhow, D. Henroid, P. Booth, A. Boyle, L. Tabrizi, R. Badri, S. Blakenship, S. Burke, M. Fujii, S. Hu, S. Smith; University of California San Francisco Medical Center Learning Outcome: Gain an understanding of the impact of food service systems on management of hospitalized patients that need insulin therapy. Background: The foodservice process for room service on-demand dining and batch set-time models for patients on pre-meal insulin and its impact on glycemic control was studied in an urban academic multi-site medical center. Methods: Finger stick blood glucose measurements were collected for 56 patients needing pre-meal insulin for the study day. Control points were evaluated: 1) Accurate identification of patients with pre-meal insulin orders; 2) Tracking of meal trays at nonstandard times; 3) Meal orders at least three hours apart; 4) Foodservice notification to the nurse when meals ordered; 5) Foodservice assistant contacted nurse when meal delivered. Other factors that influence blood glucose levels were noted such as diet order, insulin orders for meal time correction, glucocorticoid therapy. Data points were gathered using nurse surveys, EMR and Computrition databases. Results: Fifty-six patients consisting of 41 room service and 15 on a batch settime model were observed. A total of 181 meals and nourishments were served for these patients. Eighteen of 41 patients on room service had hyperglycemia (>200 mg/dl) at meal time compared to 5 of 15 who had scheduled meal delivery. Six of those patients with room service had one hyperglycemic event. Foodservice team members notified nursing of meal delivery 84% of the time and spaced meals more than 3 hours 75% of the occurrences. Conclusions: A number of factors influence glycemic control in the hospital including food consumption. Limited data and lack of comparison group make it difficult to determine incidence of hyperglycemia between meal delivery models.
Influence of Local and Organic Products on a College Student’s Buying Decisions Author(s): T. Haselden, R. King, C. McCurry, V. Butler, W. Koszewski; Winthrop University Learning Outcome: Participants will identify how college students differentiate between local and organic foods and the factors that influence their decision making in consuming these foods. In addition, barriers will be discussed and nutrition education programming needs will be identified in order to develop appropriate programming for this target group. Background: Many influential factors assist an individual’s food consumption choices such as perceived benefits, taste, income, and several other considerations. Organic sales and local farmers markets have grown significantly over the past several years. The objective for this project was to identify characteristics and barriers of college students who consume local or organic products and determine if differences exist between off and on-campus students. Methods: Cross-sectional survey design was used. On-line Qualtrics Survey took 10 minute to complete. Questions included demographics, definition of organic and local, whether they consumed organic and local foods, frequency, and barriers. Survey was available to two weeks in the Fall of 2016. Project was approved by IRB as an exempt project for Human Subjects. Results: 115 students completed the survey (105 females; 10 males) with a good distribution of college year. 81 students were identified as off campus and 34 as on-campus. More students reported consuming organic and local foods compared to those who do not. The percent of commuter vs. oncampus students who consume organic products were similar (58.82%, 59.25%) as well as the percent who consume local products (64.71%, 67.9%). For both local and organic, off and on-campus students reported consuming these food products more often when purchased or prepared by others (n¼57, 49.57% organic and n¼40, 34.78% local). The biggest selected barrier for commuters and on-campus students when consuming organic was cost (82.35%, 82.73%), followed by lack of knowledge on the subject. Conclusion: More research and nutrition education needs to be done on how college students identify and consume local and organic foods.
Funding Disclosure: None Funding Disclosure: None
Incorporating Sustainability and Continuous Quality Improvement Principles into a University Student-operated Restaurant
Malnutrition Screening: An Underutilized Screening Tool for Outpatient Oncology Patients
Author(s): J. Taylor, D. Holben; The University of Mississippi, Department of Nutrition and Hospitality Management
Author(s): A. Shapiro1, E. Trujillo2, C. Taylor3, J. Mills4, S. Johnson5, C. Spees3; 1 University of Minnesota, 2National Cancer Institute, National Institutes of Health, 3The Ohio State University, 4Dartmouth Hitchcock Medical Center, 5 Regions Hospital
Learning Outcome: After the presentation, the participant will be state how sustainability and continuous quality improvement processes can be incorporated into a studentoperated restaurant laboratory. Background: According to ACEND standards, nutrition and dietetics education programs must ensure that graduates develop sustainability (SUS) and continuous quality improvement (CQI) processes-related knowledge and skills. Purpose Of The Program: To incorporate principles of SUS and CQI into a didactic program and an MS-level coordinated program in dietetics through a university studentoperated restaurant laboratory.
Methods and Outcomes: Utilizing the ACEND standards, areas for programmatic development related to SUS and CQI were identified. The Green Restaurant Association (GRA) certification process was accessed (http://dinegreen.com/restaurants/standards. asp). GRA goals in five distinct areas of the operation [Water Efficiency; Waste Reduction and Recycling; Sustainable Furnishings and Building Materials (not applicable to existing operations); Sustainable Food, Energy, Disposables; and Chemical and Pollution Reduction] were evaluated. In collaboration with laboratory faculty, staff, and students, a plan was established to secure a GRA two star certification, and operations were implemented. Changes to the restaurant laboratory included: 1) installation of energy-efficient lighting, foot-operated hand sinks, and water-efficient toilets; 2) usage of recyclable takeout containers and printing supplies; 3) increased usage of locally-sourced foods; and 4) institution of composting and recycling. Certification guidelines, programmatic plans, and operational outcomes will be presented with plans for continued improvement evaluations and strategies. Conclusions: A student-operated restaurant laboratory can be utilized to teach principles of SUS and CQI processes to dietetics students through operational audits, classroom lectures, and hands-on experiential learning.
Funding Disclosure: The University of Mississippi (UM), Department of Nutrition and Hospitality; UM Energy Fund; UM Office of Sustainability Green Fund Grant
A-46
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
Learning Outcome: After reading/listening to this abstract presentation, the reader will be able to describe a validated tool for malnutrition and rates of utilization in a comprehensive cancer center. Background: The provision of adequate nutritional care in outpatient cancer centers was the focus of a 2016 IOM Workshop, “Assessing Nutrition Care in Outpatient Oncology.” Here we report our internal project that evaluated the documentation of a malnutrition screening tool (MST) at a large Comprehensive Cancer Center (CCC). Methods: Screening scores from a validated 2 question MST scale were entered into the EMR. Questions prompt for: 1) unintentional weight loss; and 2) eating poorly because of a decreased appetite. A score of 2 indicated nutrition risk. De-identified oncology clinic visit data were examined for a 4-week period to assess MST utilization and scores for ambulatory oncology patients. Results: Nearly two-thirds (66%, n¼8505) of the 12,903 unique oncology patients that visited the CCC during the 4-week period had documented MST data. MST data were less likely to be completed by Heme Onc (54%, n¼1168), Surg Onc (7%, n¼153), and Chemo (7%, n¼148) services. Of those that had a valid MST score, 10% (n¼807) had MST scores that indicated nutritional risk. The majority of high MST’s (2) were associated with Med Onc (35.9%, n¼290), followed by Rad Onc (12.5%, n¼101) and Chemo (8.4%, n¼68). Conclusion: The MST is a valid malnutrition screening tool for outpatient oncology patients, yet this tool is not uniformly being utilized. Implementing the consistent use of the MST in the EMR and obtaining data on utilization, as initial steps, are needed to inform future RDN staffing patterns, cost/benefit analysis, and health outcomes for oncology patients. Funding Disclosure: None
September 2017 Suppl 1—Abstracts Volume 117 Number 9