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*This picture is chosen from the padlet "search online" option. It is not a real picture of Humber River Hospital ordering process.

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NOTES:

Deliveries are Mon-Fri

Seasonal menu

Mental Health(MH) has a 4-week rotation menu

Special orders take 2-4 weeks to come in from Sysco*

Currently, there is no designated inventory person(a different dietary aide fills in every day, as inventory is done every day).

1st inventory count is done by said individual, who then gives the inventory sheet summary to the Purchaser (Eric).

Eric is responsible for ordering products.

2nd Eric will then place the orders to the designated supplier for the specific product items that they are running low on, based on the inventory sheet. (The inventory sheets provide info on # of items to keep on hand, and to # of items in-house.

3rd once the products have been chosen, he will then review his shopping cart before checking out.

Software Use:

No software is used currently, slowly integrating the use of Prima.

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Pantry Level Entrance from Food Service Elevator 

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Pantry Level Entrance from Food Service Elevator 

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Provide a brief overview of servery or belt-line, the key food safety issues/audits involved, and corrective action for any deficiencies.

At Humber River Hospital once the carts are dropped off at their designated spot, (as seen in the pictures the strip on the floor is where the carts get loaded off, and there is a sensor right above on the ceiling). The dietary aides will receive the food, and place all the food for service in the cold wells ( a holding area that is meant to keep the food cold). They will start to plate each patient's meals based on their ticket order and placing it back onto the trays on the trucks they have prepared, before putting it all in the oven to get heated and served.

Food Safety issue/audits:

Unsafe food storage

cold food mixed with ready-to-serve food

cross-contamination

Cleaning audits

cleanliness

Improper cooking temperatures

internal audit checklist

kitchen audit

Corrective action:

Audits

Conducting informal and formal workplace inspections

Safety meetings

Preparing near-miss incident reports and investigations

Suggestion box from employees

Prepare a hazard report

See if there have been safety trends over the year

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Rm Temp around 4-5 degrees as it is located in a temperature controlled room.

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In this room, products such as:

bananas

condiments

dressings

oatmeal

tea

coffee

pasta

seasoning spices

oils

puddings

cereals

cutlery

broth powders

etc are held here.

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Here is where they keep all the supplements such as:

boost

boost lite

Ensure

Ensure for diabetic

Isosource 1.0, 1.5

Glucerna. Quite the variety depending on the patient's diet needs.

Flavors:

chocolate

strawberry

vanilla

Latex gloves (different sizes) are also kept in this room.

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Identify major production equipment used:

Rational ovens

Glass freezer

Kettle

Robo Coupe

Stove

Briefly identify the staff involved and how they know what and how much to cook.

There are 2 Full-time Staff (Patrick, and Anna ) and 3 part-time staff ( Erwin, Sasheiky, and Yara,).

They know what to cook based on the printed menu provided to them. They know how much to cook because the Food Service manager (Melanie) provides them with a forecasted summary sheet for the upcoming day listing how much of each item to prep and cook.

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Breifly explain the main prep areas, the staff involved and how staff know what and how much to prepare for production.

This is where over 15+ dietary aide workers will prep sauces, sandwiches, and package cookies/desserts, to get ready for service.

This is where they also receive from their supervisor the tallies ( a printout of all the food items they will need for either breakfast, lunch, or dinner service). The dietary aide workers will go around with their carts to collect from the fridges, and dry storage area, all the food they will need for their patients.

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At the very back on the right side (open door) is the chemical room.

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Briefly explain the staff involved and the basic process.

There is no designated "dishwashing person" 2 different dietary aides are scheduled from 11:30 am-7:30 pm during the week.

They assist in washing the tools and utensils the cooks have used during the day, and place clean dishes/cutlery back onto shelves. Assist with the AGV.

At 2:30 pm- about 3 pm 1 of the dietary aides goes to do sensus ( They go to visit the patients in their room and ask them if they know how to make a meal section on the IBT(Integrated Bedside Terminals), if the patients do not know how to they will show them.)

Garbage runs between 4-8 pm.

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Behind the Orca you can see on the floor a grate, this is where you can see the liquid flowing through, and if the pipes were to get over flown.

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An Orca mixes all your food waste with the help of these tiny black microorganisms within the compactor. It turns the solids into a liquid that safely gets eliminated down the waste pipe.

*FUN FACT, because it is constantly on and running, it does have a funky smell, that you can smell from a distance!...it is not Greek yogurt, or sour cream that you smell*

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(Left to right)condiments, scoops bin, cold well(1), cold well (2)

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Briefly explain how staff know what to serve, who gets which items, portion sizes and identify any safety concerns.

Infront of cold well (2) on the wall is a plating guide of the complete menu. This tells you the portion size, the scoop to use (color handle, and oz), which items are being served that day, how to plate it step by step, and how it should looked served on the plate.

On the trays, there are tickets placed on there informing the dietary aide the patients name, room number, and meal order breakdown.

Safety Concern:

cross- contamination

Unsafe food storage

cold food mixed with ready-to-serve food

cleanliness

Inproper cooking temperature

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Usually, 2 dietary aide per floor, if there is not many patients on a floor then 1 dietary aide is needed. 

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Briefly explain the process for each meal (plate or tray) being served to the patient/resident.

First, the dietary aides set up the black trays with the tickets on the bottom left side, a napkin on the bottom right side with cutlery placed on top. ( Only when chicken/ beef is being served do they get knives).

Second, they place all the cold items such as beverages, and snacks on the tray. ( snacks on the top left, beverages on top right).

Third, soups are being heated up (2 hours before service).

Fourth, dietary aides read each slip to see what each patient was getting, portion the food accordingly, and place it back on the truck with all the trays.

The other dietary aide is potioning out coffee and soups.

Fifth, once all the meals are portioned they place them in order into the preheated setting option of the oven for 10 minutes. ( The oven can hold 30 plates total, 3 plates per shelf).

Sixth, soups and coffee are placed on the trays, and once the meals come out of the oven the dietary aide probes one plate to ensure the desired temperature is reached before placing the plate on the base, and then covering it with the dome.

Finally, the dietary aide put on their PPE before leaving the pantry rooms and delivering the meals to the patients. ( extra PPE is provided at the doors/hallways for those rooms that need extra protection.

*Can take about 20 minutes to 1 hour to deliver the meals depending on how many isolation rooms there are. (With the isolation rooms you need to wear full PPE (not just gloves, and a mask, but also a gown, and face shield), therefore it takes more time to put on and take off the gear.

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Each pantry has a dishwashing station. Each floor has the exact same layout.

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3 compartment sink is provided, and right next the sink against the wall, on the rack you can see there are bases and dome. (These keep the meals warm for up to 30 minutes)

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These are called AGVs there are 8 in total, and they help carry the food up to the pantry levels, as well as other departments such as EVS use them to move linens on all the floors.

How they work is one of the dietary aides will program the AGV to launch, (for example lunch dish out is at 12 pm) at 10:45 am, to deliver all the food to each pantry floor (11 in total).

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The busiest floor gets delivered to 1st, everyday it can change

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In this picture, you can see the AGV are carrying the carts that are filled with the cold lunch items towards the elevator to go up to the pantry floors.

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These are the carts in which food will be held They are held in a temperature-controlled room.

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This fridge is where the cooks keep there cooked meals for the day and upcoming days.

As well as produce.

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This is the freezer where they keep all the frozen products such as ice cream, cheeses, chicken breast, basa fish, mash potatoes, cod nuggets, frozen cauliflower, vegetable medley, and many more items.

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Receiving procedure and staff responsible for putting inventory away:

Once the products have been offloaded from the vehicle the receiver will have a copy of the shipment expected to arrive on that day.

They will inspect the products for:

proper name and brand ordered

any wear and tear

damaged goods

count the number of products to see if they received the right amount ordered

Ensure the right dimensions of what was ordered

temperature check of items (frozen goods, meats, dairy, etc.

The receiver Nelson is responsible for putting away the inventory and is sometimes assisted by 1 dietary aide.

Please refer to the "Ordering Column" to see schedule for delivery days"

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All of the staffs are responsible for the cleanliness of the rooms.

Which included removing an empty boxes, and keeping the shelves organized.

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There are 8 AGV, but they are always on the move coming and going, that they are all not there at the same time.

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There is one located in each room/per bed. From the left, 2nd column, 2nd row, the icon with the cloud that says "Order Your Meal". 

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Briefly explain how patients/residents know what is being served and which staff is involved with meal service.

Thanks to the IBT patients/residents can click on the bubble and see the menu selection for that day and up to 2 days in advance.

There are 2 meal options per day available.

Dietary Aides are involved with gathering all of the menu items, from soups, main meals, snacks, dessert, drinks, to bringing it up to the pantry level. (Also restocking the fridges they have upstairs for the next day). Then portion out the meals onto the plates, setup each individual tray, soup heated, coffee/ tea ready, individually.

Each floor is different, it can range to as much as 60 patients per floor to only 15. The reason is some patients are on fluids only or tube feeding therefore no meal is needed from the dietary aides.

Nurses are also involved with meal service as they communicate with the dietary aides if there are new patients who need meals. Sometimes patients register may already be passed the cut-off time for when meals have been inputted, as a result, no meals have been entered for them.

OR

If tickets are missing they can ask the nurse, and the nurse will need to send the slip down to the dietary office where the supervisors are located, to get it printed for the dietary aide to receive it.

Supervisors are involved with meal service to communicate with the dietary aide if they are short on portions and need more, or any changes and questions dietary aides may have. They also do check in, audits during meal service to ensure everything is running smoothly.

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The top portion is the regular ordering schedule. The second half of the paper is the ordering schedule for holidays.

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Suppliers:

Sysco- For the majority of items

Banford- For fresh items and small quantities (ex: 1 piece of celery)

Agropur- For milk

CanadaBread- For bread

Lechain- For Kosher meal

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At Humber River Hospital we work out of a decentralized assembly kitchen

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Decentralized- Food is produced in one main area and then shipped off to various locations (pantries) to be assembled by the dietary aides. This is where each location (pantry) will have a complete kitchen set up to maintain the temperature of the food.

( Fridge, freezer, 3-compartment sink, equipment to maintain food items to the required temperature (food well, and the base and domes to keep food warm for delivery).