Sunday, October 30, 2011

Life of a Dietetic Intern: Food Service Management at Texas Children's Hospital

For my third rotation I learned about Food Service Management at Texas Children's Hospital in the Houston Med Center.
Texas Children's is one of the top children's hospitals in the country and a great place to get the opportunity to see and work at. However, even at the best hospitals, it's rarely that you ever hear patient's raving about hospital food. It was an eye-opening experience to get to work under the Leadership team, see how decision around food and patient services get made, and what roles health (and $$) play.

A snippet of what I did: schedules, audits of food court effectiveness (ie standing in the food court for four hours counting people and wait time. Thrilling). I got to see all aspects of hospital tray line food production and delivery, including but not limited to taking temperatures, tray passing, menu passing, patient identification, & working on the trayline. While the Children’s hospital has not only a McDonalds, but a Chik-fil-a, Pizza shop, and Subway, they do have the adorable Bernie the Bean that helps you make healthy choices

But my favorite project was a vending machine audit. 7% of the country's vending machines are in hospitals and I located 19 of the hospitals vending machines and determined how many of them fit the contractor’s “healthy food” guidelines. Their guidelines were nowhere near what I would consider a healthy food, yet the machines failed to meet the vendor guaranteed 15% of products in machines being "healthy." Instead there were cinnamon rolls bigger than your hand, cookies, 3 types of cheetos, etc etc. Sad-especially in a major hospital where these machines are one of the few sources of nourishment for families waiting on or visiting loved ones. Let's not forget that 40% of total calories consumed by 2-18 year olds comes from “empty calories”-added sugars and unhealthy fats. And we’re falling far behind on fruit, vegetable and whole grain consumption. This when Illness and chronic disease linked to obesity account for nearly 17% of our health care costs $168 billion in medical costs alone!

I think this quote tells it best:
“Hospitals and health care facilities are among the environments that could potentially influence children’s health and their adoption of healthy lifestyles. However many health care institutions or facilities provide environments that may not support the adoption of healthy nutrition habits.”
-Sally Lawrence MPH, Maria Boyle MS RD, Lisa Craypo MPH RD, Sarah Samuels Dr. “The food and beverage vending environment in healthcare facilities participating in the healthy eating, active communities program.” PEDIATRICS June 5th 2009

It's a balance between the business of a hospital and the healthcare part of the hospital. Luckily most major companies and organizations are starting to realize that these two things are not mutually exclusive. Last year Cleveland clinic banned all sugar-sweetened food and beverages (minus those sold at au bon pain & starbucks even though those companies did change their menu voluntarily) Schools are leading the way in the healthy vending machine fight (USDA will be setting national guidelines for school vending machines by December 2011). Hopefully this is the future of vending machines: H.U.M.A.N I was super excited to be presenting not only to the leadership, but eventually the company itself about proposed guidelines and ways we could present healthier options to the staff and patients.

So like my preceptor told me to do I'm going to "Dream big and Dream early" and hope that small little changes lead to big results!

I was glad I got to spend my food service time in a managerial type position and learned a lot from my preceptors there. One of the most helpful projects in terms of career development was the interview project with the director. She had me create a series of technical and behavioral skill requirements for a job and then craft the appropriate questions to determine the perfect candidate. I’ve been on a handful of interviews so I knew the basics but she really helped me learn what it takes to be an effective interviewer. It was great to see that side of the table. She also helped to prepare me for questions as a fresh-out-of-internship-RD. Her suggestions and reminders for preparing for an interview were great. Although I won’t be applying for many clinical or food service positions remembering how to effectively prepare for an interview, as well as hearing her personal opinions on salary negotiation, asking appropriate questions of the interviewer and giving specific examples of your strengths and weakness was a great refresher. Since I’m now half-way done with my internship I will be applying for positions of my own sooner rather than later. Next: Supermarket Savvy, doing what I do best: Social Media, writing and food tasting!

What do you think about hospital food? any exceptionally good or bad experiences? Do you have any suggestions for people (ahem me) fresh outta school and job searching?


carlenesfigments said...

7 percent of vending machines in hospitals!? UGH! What a great project for you to work on though!

Mei said...

You rock!!!

I just had lunch at Doernbecher Children's Hospital and it was gourmet! SO awesome!!!!

So...while hospital food is one reason why I would give birth at home so as to skip the "congrats on your new baby so please now eat this rubber steak" dinner at the hospital....Doernbecher might be the exception.


Tanya @ Dine, Dash, and Deadlift said...

Great recap! I did my food service at St. Luke's and I must say that everyone is under the impression that the McDonald's is in St.Luke's and not Texas Children's due to where it is located. I had so many people ask me why there was a McDonald's in a heart hospital. I always said, oh don't worry, it's not in tihs hospital - it is in the Children's Hospital. So much better right? hehe.

Enjoy Supermarket Savvy! Linda is great! Tell her I say hello! :-)

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