- Email: [email protected]
Finding Efficiencies and Reducing Waste
MONDAY, OCTOBER 21
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Call Center Employee Adherence to Customer Service Scripting Author(s): C.D. Weiss, D.M. Brown, J. Whaley; Nutrition and Food Systems, Univ. of Southern Mississippi, Hattiesburg, MS Learning Outcome: After reading the abstract presentation, the participants should be able to describe factors affecting customer service in a room service style hospital food service system.
Price Analysis of Maid Rite Formed Puree Products Versus Facility Made Pureed Food Author(s): D. Korb1, J.R. Bodzio2, L. Harrison2, M. Golden1; 1Marywood Univ., Scranton, PA, 2Nutriton and Dietetics, Marywood Univ., Scranton, PA Learning Outcome: The learner will be able to distinguish cost and quality discrepancies between formed puree and traditionally prepared puree dishes.
Room service style dining in hospitals is aimed to increase patient satisfaction. Accurate and timely recording of patient requests is essential to ensure successful room service operations. This pilot study evaluated the patient meal ordering process in a small hospital offering room service dining based upon a pre-established protocol. Call center processes were observed to determine areas of deviation from established procedures and scripting using a standardized checklist. One evaluator directly observed calls and noted each step in the call process. A total of 41 calls over 3 days were evaluated. Patients were greeted according the script 100% of the time. Name and room number were verified for 73% of calls. Patients on therapeutic diets exceeded nutrient thresholds during the ordering process 61% of the time. Alternative foods were offered according to the script on only two occasions while the requested items were allowed 53% of the time resulting in nutrient thresholds being exceeded. Patients were informed when to expect the delivery of the meal according to the script 41% of the time. Only five of the 41 calls observed were completely free of scripting errors. Established procedures and scripting were not consistently followed. Hospitality associates need ongoing training, encouragement, and management oversight to ensure patient requests meet patient expectations and dietary constraints. Training hospitality associates to adhere to the established scripts when interacting with patients could contribute to accuracy of orders, compliance with patient care protocols and, increased patient satisfaction.
The economic burden of health care costs within the US is a pivotal concern with the incoming tide of aging Americans. Research aimed at exploring ways to dampen the economic effect of this demographic is valuable. This study explored the opportunity to decrease the cost of treatment for patients suffering from dysphagia, which is prevalent among the elderly. The purpose of this study was to determine the acceptability differences and the cost incurred to long-term care facilities whose employees prepare their own puree proteins in comparison to purchased formed purees. Facility employees used a hedonic scaled scorecard to assess the texture, appearance, and taste of five facility-made and formed pureed protein products. These same pureed foods were examined to determine differences in costs incurred in the purchase and preparation of the products accounting for ingredients and employee compensation. The formed puree products were perceived as more acceptable receiving more desirable mean scores in almost all acceptability categories. The formed purees were $.59 less on average in comparison to the facility made purees. A savings of $.59 per protein portion, per meal could equate to a $646.00 annual savings per person consuming a pureed diet and can translate into a significant reduction in overall healthcare costs. The results of this study determined that formed purees were superior in both acceptability and price. Future research should explore an acceptance comparison using participants who consume a pureed diet and a cost analysis of a larger, more varied sample of pureed foods.
Funding Disclosure: None
Funding Disclosure: None
Improved Labor Cost across Organizations through Use of Lean Six Sigma Tools
Finding Efficiencies and Reducing Waste
Author: L.E. Trombley; Morrison Management Specialists, Inc., Torrance, CA
Author(s): A. Farrell, L. Hess; Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Learning Outcome: The participant will demonstrate understanding of the benefit of Lean Six Sigma methodology training in decreasing labor costs in a healthcare foodservice setting. Department leaders are constantly seeking ways to control costs, including working with shrinking labor budgets. Labor cost exceeded budget in 3 targeted hospital foodservice operations last year by a combined total of $287,378 (5.5% over budget). The budget for the upcoming year was cut by 1.5%, posing a significant challenge for the directors. To decrease the gap between budgeted and actual labor dollars, Lean Six Sigma (L6S) tools were introduced. White belt training was conducted for the foodservice directors, including: Define Phase: Project charter, SIPOC (Suppliers/Inputs/Process/Outputs/ Customers) analysis, Voice of the Customer Measure Phase: Pareto chart, Fishbone Diagram Improve Phase: Risk Prioritization Matrix, Failure Mode and Effects Analysis Control Phase: Plan Do Check Act These tools guided directors to systematically focus on three priority areas: overtime, turnover, and limited staffing availability. Individual hospital results were reviewed for trends between facilities at each step to share challenges and best practices. Annualized combined labor savings after 3 months is $259,262 based on an improvement in the budget gap to $28,116 (0.5% over budget). Improvements were seen in each target area, with turnover decreasing from 4.08% prior to this study to 1.53% last month (goal: less than 2%), overtime decreasing from 2.32% to 1.78% of payroll dollars (goal: less than 2%), and use of part-time associates increased from 15.27% to 15.47% (goal: over 15%). Use of L6S tools across 3 organizations resulted in significant cost savings. More training is planned for other hospital directors facing similar challenges.
Learning Outcome: To describe the use of quality improvement tools in a formula room to reduce waste and cost. Saving money and increasing workflow efficiency is of utmost importance in healthcare today. As this large pediatric medical center grew, the complexity of formula recipes paralleled the patients’ medical complexity. Formula Room hours were unchanged for over 15 years. Observations of the Formula Room work flow indicated formula preparation prior to medical rounds ending. After rounds, many formulas changed which resulted in duplicate preparations and wastage. The project objective was to streamline processes and save money by reducing formula orders prepared and wasted from 13.3% to 6.8% on a defined unit. Baseline data was collected prior to testing interventions, and quality improvement tools were used to determine the causes of formula wastage. A Plan-Do-Study-Act model was used by a diverse project team. On the defined unit, waste was reduced from 13.3% to 3.9%, thus exceeding the initial goal. The changes were spread to the entire hospital using an extensive communication plan, which has resulted in a decrease in waste from 7.8% (baseline) to 3.0% overall. This equated to a 41% cost savings. These results indicate the importance of continually seeking efficiencies and reducing waste in the field of dietetics. Funding Disclosure: None
Funding Disclosure: None
September 2013 Suppl 3—Abstracts Volume 113 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-53
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Call Center Employee Adherence to Customer Service Scripting Author(s): C.D. Weiss, D.M. Brown, J. Whaley; Nutrition and Food Systems, Univ. of Southern Mississippi, Hattiesburg, MS Learning Outcome: After reading the abstract presentation, the participants should be able to describe factors affecting customer service in a room service style hospital food service system.
Price Analysis of Maid Rite Formed Puree Products Versus Facility Made Pureed Food Author(s): D. Korb1, J.R. Bodzio2, L. Harrison2, M. Golden1; 1Marywood Univ., Scranton, PA, 2Nutriton and Dietetics, Marywood Univ., Scranton, PA Learning Outcome: The learner will be able to distinguish cost and quality discrepancies between formed puree and traditionally prepared puree dishes.
Room service style dining in hospitals is aimed to increase patient satisfaction. Accurate and timely recording of patient requests is essential to ensure successful room service operations. This pilot study evaluated the patient meal ordering process in a small hospital offering room service dining based upon a pre-established protocol. Call center processes were observed to determine areas of deviation from established procedures and scripting using a standardized checklist. One evaluator directly observed calls and noted each step in the call process. A total of 41 calls over 3 days were evaluated. Patients were greeted according the script 100% of the time. Name and room number were verified for 73% of calls. Patients on therapeutic diets exceeded nutrient thresholds during the ordering process 61% of the time. Alternative foods were offered according to the script on only two occasions while the requested items were allowed 53% of the time resulting in nutrient thresholds being exceeded. Patients were informed when to expect the delivery of the meal according to the script 41% of the time. Only five of the 41 calls observed were completely free of scripting errors. Established procedures and scripting were not consistently followed. Hospitality associates need ongoing training, encouragement, and management oversight to ensure patient requests meet patient expectations and dietary constraints. Training hospitality associates to adhere to the established scripts when interacting with patients could contribute to accuracy of orders, compliance with patient care protocols and, increased patient satisfaction.
The economic burden of health care costs within the US is a pivotal concern with the incoming tide of aging Americans. Research aimed at exploring ways to dampen the economic effect of this demographic is valuable. This study explored the opportunity to decrease the cost of treatment for patients suffering from dysphagia, which is prevalent among the elderly. The purpose of this study was to determine the acceptability differences and the cost incurred to long-term care facilities whose employees prepare their own puree proteins in comparison to purchased formed purees. Facility employees used a hedonic scaled scorecard to assess the texture, appearance, and taste of five facility-made and formed pureed protein products. These same pureed foods were examined to determine differences in costs incurred in the purchase and preparation of the products accounting for ingredients and employee compensation. The formed puree products were perceived as more acceptable receiving more desirable mean scores in almost all acceptability categories. The formed purees were $.59 less on average in comparison to the facility made purees. A savings of $.59 per protein portion, per meal could equate to a $646.00 annual savings per person consuming a pureed diet and can translate into a significant reduction in overall healthcare costs. The results of this study determined that formed purees were superior in both acceptability and price. Future research should explore an acceptance comparison using participants who consume a pureed diet and a cost analysis of a larger, more varied sample of pureed foods.
Funding Disclosure: None
Funding Disclosure: None
Improved Labor Cost across Organizations through Use of Lean Six Sigma Tools
Finding Efficiencies and Reducing Waste
Author: L.E. Trombley; Morrison Management Specialists, Inc., Torrance, CA
Author(s): A. Farrell, L. Hess; Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Learning Outcome: The participant will demonstrate understanding of the benefit of Lean Six Sigma methodology training in decreasing labor costs in a healthcare foodservice setting. Department leaders are constantly seeking ways to control costs, including working with shrinking labor budgets. Labor cost exceeded budget in 3 targeted hospital foodservice operations last year by a combined total of $287,378 (5.5% over budget). The budget for the upcoming year was cut by 1.5%, posing a significant challenge for the directors. To decrease the gap between budgeted and actual labor dollars, Lean Six Sigma (L6S) tools were introduced. White belt training was conducted for the foodservice directors, including: Define Phase: Project charter, SIPOC (Suppliers/Inputs/Process/Outputs/ Customers) analysis, Voice of the Customer Measure Phase: Pareto chart, Fishbone Diagram Improve Phase: Risk Prioritization Matrix, Failure Mode and Effects Analysis Control Phase: Plan Do Check Act These tools guided directors to systematically focus on three priority areas: overtime, turnover, and limited staffing availability. Individual hospital results were reviewed for trends between facilities at each step to share challenges and best practices. Annualized combined labor savings after 3 months is $259,262 based on an improvement in the budget gap to $28,116 (0.5% over budget). Improvements were seen in each target area, with turnover decreasing from 4.08% prior to this study to 1.53% last month (goal: less than 2%), overtime decreasing from 2.32% to 1.78% of payroll dollars (goal: less than 2%), and use of part-time associates increased from 15.27% to 15.47% (goal: over 15%). Use of L6S tools across 3 organizations resulted in significant cost savings. More training is planned for other hospital directors facing similar challenges.
Learning Outcome: To describe the use of quality improvement tools in a formula room to reduce waste and cost. Saving money and increasing workflow efficiency is of utmost importance in healthcare today. As this large pediatric medical center grew, the complexity of formula recipes paralleled the patients’ medical complexity. Formula Room hours were unchanged for over 15 years. Observations of the Formula Room work flow indicated formula preparation prior to medical rounds ending. After rounds, many formulas changed which resulted in duplicate preparations and wastage. The project objective was to streamline processes and save money by reducing formula orders prepared and wasted from 13.3% to 6.8% on a defined unit. Baseline data was collected prior to testing interventions, and quality improvement tools were used to determine the causes of formula wastage. A Plan-Do-Study-Act model was used by a diverse project team. On the defined unit, waste was reduced from 13.3% to 3.9%, thus exceeding the initial goal. The changes were spread to the entire hospital using an extensive communication plan, which has resulted in a decrease in waste from 7.8% (baseline) to 3.0% overall. This equated to a 41% cost savings. These results indicate the importance of continually seeking efficiencies and reducing waste in the field of dietetics. Funding Disclosure: None
Funding Disclosure: None
September 2013 Suppl 3—Abstracts Volume 113 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-53