HospitalInspections.org

Based on dietetic services observations, dietary document review and dietary and administrative staff interview, the hospital failed to ensure measurable improvements and timely interventions for patient food temperatures that were not within acceptable hospital developed parameters.

Findings:

During meal distribution observation and concurrent interview with Dietary Staff (DS) Q, on 3/21/16 beginning at 12 p.m. a test tray was conducted. DS Q stated that she was the person responsible for completing weekly test trays. DS Q selected a different unit each week and evaluated meals for temperature, palatability and appearance as well as several other elements. The tray was evaluated at the time the last patient received their meal. She stated that since the hospitals' dishwasher was non-functional maintaining food temperatures problematic. DS Q described that the hospital changed to plastic plates from Styrofoam several weeks earlier; however after the change temperature regulation seemed to be more problematic. There was no current plan to go back to the Styrofoam despite better results.

In an interview on 3/24/16 beginning at 9 a.m., with Administrative Staffs (AS) A and H they were aware that the change to plastic plates did not maintain temperatures. While they were in the process of developing a proposal for administrative staff to place an external dishwashing trailer on the hospital campus, the document was still in the formulation and approval stages, it would require an unspecified timeframe for approvals and implementation. There were no intermittent plans developed. Administrative Staffs A and H also stated education was provided to nursing staff to ensure patient readiness prior to meal service; however there was no monitoring for the effectiveness of this intervention and whether or not patient readiness was a contributing factor of suboptimal food temperatures.

Weekly facility documents titled "Patient/Resident Tray Assessment" from 2/28 to 3/21/16 revealed that 8 of 8 meal evaluations did not meet expected parameters with relationship to food temperatures. Each tray had the possibility of receiving a maximum of 18 points. The results of the temperature evaluation ranged from 0 to 7 points, with the majority of the meal trays receiving 2-5 points.

Review of hospital document titled "Performance Improvement/Risk Management/Patient Safety Plan 2016" noted that the scope of the plan is organization wide and applies to all departments to provide a framework of optimal patient care.

Review of facility document titled "Statement of Deficiencies" dated 12/30/15 noted that hospitals' program will "...measure, analyze and track quality indicators for Food and Nutrition Services ...Such data will be reviewed on a routine basis ...implement appropriate corrective and improvement activities ..."