(See Chapter 7, “Food Security and Protection”)
Food service at a hospital is similar to food service at extremely large complex facilities housing potentially thousands of people on a daily basis. In hospitals, food has to be provided 24 hours a day to patients with special diets, debilitated people, staff, and visitors. Hospitals in addition to sheer numbers of people, typically have numerous other problems including: improper storage and handling of incoming foods and improper timing and refrigeration of perishables; improper defrosting of chickens and turkeys and other meats outside of refrigeration; improper cleaning and decontamination of a variety of surfaces because of the constant use of the kitchen facilities by workers who may only stay for short periods of time and need constant training and supervision; inadequate lighting in a variety of areas especially the ware washing rooms; sick food handlers who continue to process and serve food; inadequate supply of hand-washing sinks; improper breaking down of the equipment and thorough cleaning procedures; reusing disposable water carafes and glasses; improper cleaning and temperature control, both refrigeration and heat in food carts that go on to the various floors; delaying service of food to patients and thereby compromising temperature controls; potentially serious insect and rodent control problems based on the distribution of substantial amounts of food in various parts of the facility; improper handling and removal of food from isolation units; etc.
Best Practices for Food Preparation, Handling, and Disposal (See Chapter 7, “Food Security and
- • Develop and utilize a self-inspection concept for food service operations. See the Food Service Inspection Report on pages 526-527 of Handbook of Environmental Health— Biological, Chemical and Physical Agents of Environmentally Related Disease, Volume 1 (CRC Press, Boca Raton, FL, 2003). (See endnote 61.)
- • Develop a food service self-inspection program for a 19-week, 2-hour a week training program for food service supervisors and managers. This program should include the following: Session 1: introduction of course and administrative personnel of hospital; Sessions 2-3: discussion of injuries, infections, and proper hospital practices; Sessions 4-5: discussion of Hazard Analysis and Critical Control Points (HACCP) principles and practices; Session 6: the self-inspection form and how and why to use it; Sessions 7-8: field experience within the institution in use of the form (make actual inspections under supervision); Sessions 9-10: review of actual food service department problems within the institution and start using the inspection form on a weekly basis; Sessions 11-12: discuss general housekeeping principles and practices and results of weekly self-inspections and how to make appropriate corrections; Session 13: discuss general food service equipment and ware washing techniques and continue the discussion of the weekly inspections; Session 14: microbiology and spread of foodborne and waterborne disease as well as hospital infections; Session 15: food preparation, storage, serving, transportation, and disposal as well as results of weekly inspections; Session 16: insect and rodent control as well as results of weekly inspections; Session 17: supervisory problems; Session 18: supervisory techniques; and Session 19: final examination covering the entire course.