Behind the Scenes of a Hospital Kitchen

By: Jennifer Pilut

Have you ever wondered what role food service workers play in the healing and recovery of hospital patients? Prior to my rotation at Ascension Saint Agnes Hospital, I was unaware of the steps and attention to detail that goes into making patient trays. Over the five weeks I was in the kitchen of St. Agnes, there were three parts of the food service system that stood out. The first, and most important, was that executives were passionate, hands-on and willing to lead by example. The second part involved the attention to detail by the staff. And finally, receiving consistent feedback from leadership and hospital patients helped the food service team improve their systems within the hospital. I observed and participated in all aspects of the food service department and believe that these three pillars of administration provide the best food service experience for patients. 

The standard regarding employees’ determination to get things right starts with lead-by-example leadership. As a future dietitian, it was clear to me the impact upper-level leadership has on the overall environment and mindset of the cafeteria assistants. Sarah Epling, the assistant director of the food and nutrition branch, demonstrated this when she said in her office “I am always the walking example of what I need my staff to mirror. If I don’t abide by the food service work attire, how can I expect them to do the same.” As she says this, she points to her shoes, earring selection, and business casual attire. This direct quote illuminates an environment that empowers employees to go the extra mile for their patients and for themselves. Jessica Rinn, the patient service manager who oversees the cafeteria assistants (CA), also stepped up when one of her supervisors was unable to come in. Although many tasks needed to be completed, Jessica put her patients first and stepped in to help. The attitude of the leadership is what sets the standard for other staff members and encourages them to work hard for their patients. 

Picture 1: Serving the Tray Line

Saint Agnes’ food service team is energetic, hard-working, and detail-oriented. Paying attention to detail is especially crucial for food service staff. Hundreds of patients require specific diets that need to be met accurately and safely. Throughout my time observing the CAs complete tray orders rarely did a mistake occur. With only one to one-and-a-half minutes to complete each tray, it is necessary for each CA to stay diligent and focused. The on-deck supervisor is the third and final check-off on the patient tray. This supervisor checks for accuracy and identifies anything that might be missing. During my time at St. Agnes, I had the opportunity to complete a tray accuracy evaluation and practice building the individual trays (picture 1). The most difficult part of both jobs was identifying the specific needs for each diet. From dysphagia patients to renal patients the tray was always changing. This made building and checking trays much more difficult and highlights the importance of ensuring all staff pay attention to detail. 

Another example of a crucial food safety step, taken by the staff at St. Agnes was the chef checking food temperatures. Throughout every conversation I had with a CA, chef, or leadership, they were constantly discussing the temperatures of the food to ensure the food was not at risk for being in the danger zone. Failure to abide by the food safety recommendations and pay attention to this detail could result in a patient becoming severely sick. Ensuring all patients have hot food, receive great customer service, and an accurate tray is the goal for every meal at St. Agnes. 

Picture 2: Test Tray Evaluation Form (left) and Test Tray Order Form (right)

Feedback and testing systems are two valued pieces of information within a hospital setting. Receiving information from patients on their experience with their food, cleanliness of their room and customer service of the employees aids in identifying areas needing improvement. Much of my time in the kitchen was spent taking temperatures of the food before serving, during the service line, and when the food had reached the patient to ensure limited time in the danger zone. This process falls under the responsibility of many clinical dietitians through the completion of test trays (picture 2). The goal of this is to consistently provide feedback to the kitchen on areas that could be improved. The feedback received from patients and the systems in place are what ultimately lead to a better experience for the patient in the hospital. 

My takeaway from this rotation is that a strong food service team stems from dedicated leadership, staff who pay attention to detail and routine assessment of patient satisfaction. It begins with managers setting a cohesive and hardworking standard for their staff when they lead by example. The attitude of the leadership is what pushes other staff members to take pride in their trays and patient services. Finally, St. Agnes values receiving feedback from the patient. After all, pleasant patient experiences and providing nourishment to improve patients’ health is why the food service team works so hard. St. Agnes provides a great example from leadership to staff that each detail, temperature, and patient is important to them. 

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