Keeping Patients Safe
Written by: April Rascoe, RD & LD on December 6, 2016
The most important role we have as food service providers is to assure the safety of our patients. One of the primary ways we do this is by following proper procedures and not cutting corners when it comes to providing high-risk meals. Sound food safety procedures are so important to avoid fatal outcomes that can occur by cutting corners. I will share procedures and best practices gathered from Morrison managed hospitals in this article.
So let’s begin by answering, what exactly is a High Risk Meal?
The answer is that it is any meal that has the potential to cause an adverse event such as death.
Patients with a food allergy can have what is called an anaphylaxis reaction if they eat or come into contact with foods they are allergic to. Let’s pause and review exactly what this means. Anaphylaxis is a rapidly progressing response to an allergen, which can occur within minutes, or even seconds of exposure to the allergen. The result can be a rash, hives or itching. That’s on the mild end of the reaction. The extreme end can result in death as the person can’t breathe because their airway has swollen shut.
Modified food textures such as puree, mechanical and the dysphagia level diets are ordered because a patient has a risk of choking. A patient ingesting the wrong consistency of liquids has resulted in aspiration pneumonia, and a subsequent transfer to the ICU. As we talk about High Risk meals in this post, we are referring to all food allergy and modified texture diet restrictions.
So how many people have food allergies in the US?
Believe it or not, there are an estimated 15 million Americans who have a food allergy. That is equivalent to taking the number of people who can fit in the Met Life Football Stadium… the largest NFL stadium in the US … and multiplying it by 181.
People visit the emergency room about 200,000 times each year because of food allergies. Almost 10,000 people stay in the hospital each year because of food allergies. Five Americans die each day from anaphylaxis.
Keep in mind that those estimates do not include the added number of patients we serve who require a modified texture diet. Bottom line is that we ever-strive to follow all the procedures in place to assure we are providing safe meals. Statistics from Asthma and Allergy Foundation of America and Food Allergy Research and education
Let’s talk further about the act of accountability. None of us would ever want to be the cause of a reaction and want to do all we can to prevent adverse events. There are 4 steps to accountability that we share with our Morrison team members.
- See it – Acknowledge the Problem
- Own It – Take Responsibility for it
- Solve it – Determine What I can Do
- Do it – Take Action
We have to first acknowledge if you see a problem. If we ever see any of the process below NOT being completed, we have to OWN it and take responsibility to kindly remind our co-worker of our processes and/or report it up to your direct supervisor. Don’t ignore a problem… determine what you can do to solve a problem and then most importantly DO IT. The subject of high-risk meals is a matter of life or death when it comes to actually DOING SOMETHING to fix an identified problem.
We encourage all of our Morrison team members to follow these three steps
to prevent adverse events from happening related to food allergies and modified textures.
- Complete requitraining. Whether a team member is a food service associate, supervisor, chef, dietitian, etc… everyone must complete training to assure everyone has the necessary education and tools.
- Following Morrison policy is instrumental. All Morrison teams review the policy periodically. We encourage every Morrison team member to conduct a self-evaluation and discuss how they are doing with meeting the policy every day for every meal. We also encourage them to ask if there are some areas where they can individually do better?
- Lastly —we ask each team member to hold each other accountable. Example: if the high-risk tray check isn’t being completed at every meal, say something.
I’m thrilled to share our Food Safety and Handling procedures at a high level. There is a lot more for sure. I love what I do and feel it is important to share how seriously we take consistent patient care in our Morrison managed hospitals.
As the National Director of Patient Dining, April Rascoe is responsible for the patient meal program standards, implementation of new patient dining services and driving positive patient satisfaction results when it comes to the quality of food served. April has also worked with the Morrison culinary team to develop over thirty menu cycles used to serve hospital patients. The menu cycles include an emphasis on wellness, condition specific diets, regional preferences, controlled food cost, and production efficiency.
April is the Past President of the Georgia Academy of Nutrition and Dietetics. An affiliate of the American Academy of Nutrition and Dietetics, the Georgia Academy is the largest organization of food and nutrition professionals in the state. More than 1600 strong, the Georgia Academy members are employed in a variety of settings including hospitals, schools, community agencies, and more.
April’s previous experience includes development of clinical nutrition communications, resources and continuing education training. She has worked within hospitals in the clinical setting both as a clinical dietitian, and in Clinical and Patient Service manager roles.
She received her B.S. degree in Dietetics and Distributive Science from David Lipscomb University in Nashville, TN. She went on to receive her Master’s Degree in Clinical Nutrition at East Tennessee State University in Johnson City, TN.
April lives in beautiful St. Augustine, Florida with her husband Patrick. She spends the majority of her free time cheering on her two sons in a variety of sports.