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The Development of a Quality Measurement Tool for a Contract-Managed Hospital Foodservice
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Il Sun Yang, Hyun Ah Kim, Young Eun Lee, Moon Kyung Park, Suyen Park
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Korean J Community Nutr 2003;8(3):319-326. Published online June 30, 2003
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- The purposes of this study were: a) to develop the a quality measurement tool for the contract-managed hospital foodservice, and b) to evaluate their performance with the developed quality measurement tool, and c) to verify the reliability and validity of the quality measurement tool. The developed quality measurement tool comprised two parts, which were foodservice management and medical nutrition care service. The foodservice management part was classified into six functional categories which were Menu, Procurement and Storage, Production and Distribution, Facility and Utility, Sanitation and Safety, and Management and Evaluation. The medical nutrition care service part indicated the medical nutrition care provided. Quality measurement tool had 91 standards and 324 indicators. The quality measurement tools were distributed to the hospital foodservice manager employed by the foodservice company. The 324 indicators were measured by foodservice manager on the 5-Likert-type scales, and then adapted to a 100 point scale. The SPSS Ver. 11.0 was used for statistical analysis. The categories whose scores were evaluated as being high were Procurement', General Sanitation', Personal sanitation' and Waste' and the categories whose scores were evaluated as being low were Diet Order Manual', Standard Recipe', Appropriateness (Facility and Utility)', Check (Facility and Utility)' and Information Management'. All the categories of medical nutrition service were evaluated as having seriously low scores. Therefore, it was necessary for the contract-managed hospital foodservice to improve its performance in the area of medical nutrition care service. For the verification of the developed quality measurement tool, the reliability obtained by calculating Cronbach's alpha was 0.8747, and the content validity was also proved by scrutiny of the modification of the Professional group's techniques.
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A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System
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Eun Cheol Park, Hyun Ah Kim, Hae Young Lee, Young Eun Lee, Il Sun Yang
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Korean J Community Nutr 2002;7(6):852-862. Published online December 31, 2002
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- The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as "the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases". Also, the MNT Act defined "conditions for coverage of MNT", "limitations on coverage of MNT", and "qualifications of MNT service provider". To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therfore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by policy makers, so the ADA contracted with the Lewin Group to carry out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, "The Cost of Covering Medical Nutrition Therapy under Medicare: 1998 through 2004", it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion). Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MNT. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.
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School Food Service in Korea: Investigation of the Operation and Management Systems
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Young Eun Lee, Il Sun Yang, Jin A Cha, In Sook Chae, Hye Seung Kang
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Korean J Community Nutr 2002;7(3):361-372. Published online June 30, 2002
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- The purpose of this study was to investigate the operation and management systems of the school food services in Korea and to provide useful data for improving the quality of the school food services. This study was conducted in school food service operations nationwide using a written questionnaire. The questionnaires were mailed to the dieticians of three types of school food service systems-conventional, commissary, and joint-management. Of the 660 schools that participated in this study, the responses from 212 conventional system, 212 commissary system and 200 joint-management system services were selected for analysis. Statistical analysis was performed utilizing the SAS/Win 6.12 program so as to provide a descriptive statistics. The main results of this study can be summarized as follows: The average number of meals served per day was 1014, 738 and 695 in the conventional food service, the commissary food service and the joint-management food service systems, respectively. Over half (58.9%) of food service facilities were utilizing computer programs for their operations. Most of the commissary food service systems (52.4%) had a satellite school and served a maximum of 2000 meals per day. In most of the joint-management food service systems (87.1%), the number of food service schools managed was two and a maximum of 3330 meals were served. Only one dietician was posted irrespective of the school food service system. The mean hours of work by the dietician per day was 8.9, 8.6 and 8.6 in the conventional food service, the commissary food service and the joint-management food service systems, respectively. The principal work functions of cook personnel were cooking and cleaning.
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College Students' Dietary and Health Behaviors related to Their Myers-Briggs Type Indicator Personality Preferences
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Byung Sook Kim, Young Eun Lee
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Korean J Community Nutr 2002;7(1):32-44. Published online February 28, 2002
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- The objective of this study was to evaluate college students' dietary and health behaviors in relation to their Myers-Briggs Type Indicator (MBTI) personality preferences. Dietary and health behaviors were surveyed for 444 college students who performed the MBTI personality test. Only 6.1% of the subjects regularly had three meals a day, while 27.1% ate breakfast every day. Fifty-six point nine percent of the students took less than 15 minutes to eat a meal and had the habit of eating fast. The number of food groups they ate was, on average, 2.74 and was eaten mainly at dinner. This showed that college students did not eat a large variety of foods. Eighty-two percent of the subjects drank alcoholic beverages, 21.4% smoked, and 69.3% exercised. In addition, 73.9% of them were not satisfied with their body image, but they were not eager to try weight control. There were not many significant differences between Extraversion (E)-Introversion (I), Sensing (S)-iNtuition (N), and Thinking (T)-Feeling (F) in their dietary and heath behaviors, although some gender differences existed. Significantly better dietary and health behaviors were shown in subjects preferring Judging (J) rather than Perceiving (P). There behaviors included eating breakfast, regularly eating three meals a day, smoking less, exercising more and having a lower tendency to night-eating. The personality preference of J-P could be useful index for nutritional education and counseling or behavior modification programs for obese people.
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