Dietetic professionals integrate knowledge and expertise in food, nutrition, management and people and apply their skills in a variety of settings. As the changing scene in health care has necessitated enhanced management of resources, the clinical nutrition manager (CNM) has emerged as a dietetic professional in hospitals applying sound management practices to the area of clinical nutrition services. The purpose of this study was to provide information about the position of clinical nutrition manager and about the professional development strategies used by incumbents. The research design had two phases. The purpose of the first phase was to develop a job description for the position of clinical nutrition manager, including duties/activities and job specifications for education, experience and professional credentialing. The purpose of the second phase was to verify the accuracy of the job description, determine educational and experiential resources used to develop the required skills and knowledge for performing the duties/activities, and collect other descriptive data about the position. The result was a job description for a Clinical Nutrition Manager with 46 duties/activities assigned to the position and job specifications for work experience and academic preparation. Chi square analysis was used to test the association of the performance of a duty/activity with amount of time allotted to the position; number of personnel supervised; and type of personnel supervised. Results indicated that type of personnel supervised had the most significant association. One sample chi square analysis indicated that entry-level education and entry-level experience were the less likely resources to be used for development of skills and knowledge. For more than 50% of the duties/activities, the number of resources used was significantly related to the perceived level of importance. There was no significant finding for an association between timing of career decision to become a CNM and career development strategies intentionally selected. Findings also indicated that perceived competence improves with increasing number of years in the position and is not affected by having an advanced degree. / Graduation date: 1992

Nutritional support for bone marrow transplant recipients is recognized as vital, yet little research has occured to determine the best method. This study was designed to survey existing food and nutrition services in bone marrow transplant centers in the U.S. in order to determine similarities in the services provided among centers from which a model protocol could be established for such centers. A survey instrument was developed and sent to all chief dietitians associated with BMT centers in the U.S, listed the International Bone Marrow registry, 1982. Items on the questionnaire included: background information on size and organization, nature of foodservice, and nutrition support services. The research suggested that there was a trend away from sterile food service. Problems encountered in establishing the food and nutrition services included: availability of single-serve sterile foods, standardization of recipes, and palatability of autoclaved foods. Four centers switched from sterile diets to either low bacteria diets or modified house diets at some point in their operation. Patient related services of the registered dietitian were most concentrated on admission and during critical care monitoring. Near all respondents indicated a desire to form a network for developing standards for services provided. Many differences between centers still remain which prevent the development of a model center.

Every hospital, private or public, profit or nonprofit, no matter the size, has the task of feeding its patients three times a day plus nourishments. The meals must be served during a short period of time to patients in their rooms which are spread throughout the hospital. The meals must be therapeutically balanced, attractive, the hot foods hot and the cold foods cold, and they must be nutritious. The meals in a hospital differ from those served in restaurants in that all of the courses are served at one time which means that there is greater importance placed on temperature maintenance. Considering that most hospitals offer a selective menu, the task is quite unique and challenging. Hospitals, profit or non-profit are conscious of cost, efficiency, and patient satisfaction. Therefore, the selection of a system to assemble and deliver meals to the patient is of the utmost importance. The purpose of this study is to identify and compare assembly and temperature maintenance and delivery systems currently available; in order to make available information for those who are planning systems and for those who are learning about these systems.

The U.S.D.A. Model which compares food service systems was tested to determine its reliability and validity. The Model lists the costs and needs of each type of food service system for different hospital bed sizes and demonstrates how two systems can be compared. The Model concludes that the ready foods system is the least-costly food service system. The U.S.D.A. Model was tested using data from eleven hospitals which use the ready foods system. Labor, material and overhead costs were compared. A description of the cost analyses is included. A significant difference was found between the actual cost data from the elven ready foods hospitals and the costs the U.S.D.A. Model predicts these hospitals should have anticipated. The major area of difference was in the area of labor costs. The Model predicted that the man-hours required for each operation are much less than what actually occurred in the eleven hospitals tested. The U.S.D.A. Model was based on data from six conventional and six ready foods hospitals. The U.S.D.A did not look at these twelve hospitals in terms of complete systems, but rather looked at the dishroom from one and the tray delivery system from another. This research looked at eleven ready foods systems in detail as complete systems. This may help explain the significant difference between the actual costs from eleven hospitals with the same system and the U.S.D.A. Model which was based on calculated costs from twelve hospitals only six of which used the ready foods system. It is concluded that the U.S.D.A. Model is neither a reliable nor a valid tool for a food service manager to use in determining the type of food service system to integrate into his operation. It is further recommended that this Model not be used in determining the costs of a food service system because it may give an inaccurate measurement and cause a hospital to spend more money than planned. / Master of Science

Approximately 20% of all hospitals in the United States utilize management contracts for the food service operation, and other hospital administrators are contemplating their use. Despite the rapid growth of contracting within hospital food service, very little is known about the performance of contractors. This research was designed to produce new information about food service contracting in hospitals. A comparative content analysis of proposals from three food service management companies was conducted. It revealed that all proposals included the same basic categories of information, but the extent of detail provided in proposals varied. A survey was sent to 909 hospital administrators that had been identified as utilizing food service contracts. Responses to the survey provided descriptive data about the hospitals and their food service contracts. Responses also measured the levels of satisfaction/dissatisfaction and importance/unimportance experienced by hospital administrators with their food service contracts. Eight independent variables were tested to determine their influence on satisfaction and importance. They were: 1.) location of the hospital 2.) size 3.) length of present contract 4.) number of years using present contractor 5.) name of contractor 6.) length of previous contracts 7.) number of previous contractors 8.) total number of years contracted out One parameter of size caused significant differences in the levels of satisfaction and importance. The other variables did not cause significant differences in satisfaction or importance. / Master of Science

Call number: LD2668 .T4 1979 S52 / Master of Science

A mail questionnaire surveyed Arizona hospital dietary departments to reveal the most frequently initiated changes in dietary practice since the implementation of Diagnostic Related Groups (DRGs). The most frequently initiated change was remodeling the service/cafeteria areas to increase consumer appeal and subsequent sales. Fee-for-service nutrition was the tenth most frequently initiated change. Non-subsidized employee feeding was the second least frequently initiated change since DRGs. Hospital size was found to correlate significantly (alpha ≥ 05) with innovative management, development of DRG avenues of recovery, purchase of computers, development of clearly defined treatment plans, utilization of time studies and staffing, and the implementation of corporate wellness programs. Only a few hospitals have determined costs for DRG dietary treatments, or know standard length of stay for each DRG. The number of dietitians documenting services and patient outcome must increase or their cost effectiveness may never be known.

Thesis (DTech: Food and Beverage Management)--Tshwane University of Technology, 2012. / Aims to develop a framework to assess the quality of food service in public hospitals. It also looks at ways of improving the quality of food that is provided by public hospitals.

Five areas of hospital foodservice management, including; Inpatient Services, Cafeteria Services, Special Foodservices, Out-of-Hospital Services and Consolidation of Services, were studied to determine the impact of the 1983 Medicare Prospective Payment System. Ten Kentucky hospital foodservice directors were surveyed by phone. The Prospective Payment System had an impact on all areas of foodservice management, especially in the Inpatient Services. Foodservice directors developed cost containment and revenue generating programs in response to the DRG's. Note: The author has requested that her vita be removed from this Electronic Theses and Dissertation. / Master of Science

A three-day food intake was recorded for 100 elderly patients who were subsequently interviewed to determine the relationship of income level, educational level completed, and sex of the person with the nutrient intakes of these patients. Three-day caloric and nutrient intakes were recorded and compared to the 1974 Reconmended Daily Allowances (RDA). Mean intake for a three-day period of seven nutrients showed patient averages met at least 100 percent of the RDA for all nutrients except calcium. The females had a mean intake of ninety-six percent of the RDA for calcium. The patients with the lower incomes had dietary patterns that were less adequate than the patterns for those with higher incomes, and these patients ate more carbohydrate and less protein than did the patients with higher income. Nutrient intake was increased for the patients as their level of education increased. There were no significant differences in the nutrient intakes between sexes. The males had a higher nutrient intake and had a higher percentage of protein in their diets than did the females, however, the differences were slight. It was concluded from the above results that certain beneficial changes in the study menu could be made. Especially important areas such as calcium and fat intake may need modification at some time in the future as more light is shed on these areas. / Master of Science