• 대한영양사협회학술지
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• 제19권4호
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• pp.317-342
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• 2013

The purpose of this study was to evaluate the current state of foodservice and clinical nutrition management in a hospital-based nutrition department. Nutritional guidelines and survey reports of hospital evaluation programs from 2004 to 2009 were analyzed. In total, 275 hospitals in the first period and 288 hospitals in the second period were evaluated. The division of knife and chopping board use decreased from 97.2% in 2005 to 89.7% in 2008, the maintenance of a proper freezer temperature (below $-18^{\circ}C$) increased from 82.1% in 2004 to 97.7% in 2007 (88.9% to 97.4% from large hospitals and 69.8% to 86.5% from small/medium hospitals in 2005 and 2008, respectively). In tube-feeding management, the performance rate of material cold storage and the offer rate of tube-feeding were 65.9% and 94.2% in 2007, respectively. The cold storage of material, proper use within 24 hours after opening or production, and the use of an appropriate label were 47.3%, 71.2% and 67.2% in 2009, respectively. The rate of a management system for undernourished patients was 86.0% in 2007 (56.4% for large hospitals, 18.9% for small/medium hospitals) and 14.3% in 2009. In standards of nutrition support management, the performance rates of constructing a nutrition support team, the nutrition support team activity, and organizing multidisciplinary team were 66.7%, 43.6%, and 64.1% respectively, in 2004. For large hospitals, those rates were 61.1%, 36.1%, and 58.3%, in 2005, 93.0%, 62.8%, and 91.9% in 2007, and 69.2%, 43.6%, and 69.2% in 2008, respectively. The results of this study suggest standards on sanitary foodservice preparation, production, and tube-feeding production need to correspond with HACCP regulations for small/meidium hospitals in standards of a healthcare accreditation system. It will be necessary to understand the operating conditions of nutrition departments in convalescent hospitals, psychiatric hospitals, and geriatrics hospitals. As the application of accreditation is required from 2013, standards will need to be improved and continuously updated for healthcare accreditation.

• 대한지역사회영양학회지
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• 제9권2호
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• pp.233-240
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• 2004

This study was design to grope the suggestions leading synergic effects by bridging the gap between headquarters and branch office, and so to identify the infra-system of contract foodservice management company (CFMC) necessary for operating any kind of branch office including school, hospital and business and industry (B＆I). Among 8 categories consisted of infra-system in CFMC, 'C8. Evaluation ＆ analysis for branch office's operation' was the most important category in the headquarter's viewpoint, while 'C3. Sanitation management system' was the most important category in branch office's viewpoint. In support and application, 'C3. Sanitation management system' was the highest category in both headquarters and branch offices including school, hospital and B＆I. As a result of analysis on gap between main and branch office in importance, support and application in 8 categories, the efforts of communication and community of perception for infrastructure were needed, because 'C4. Education ＆ training for human resource management (HRM) system' and 'C8. Evaluation ＆ analysis for branch office's operation' in importance, 'C2. Menu management system', 'C4. Education ＆ training for HRM system', 'C6. Facility ＆ utility support system' and 'C8. Evaluation ＆ analysis for branch office's operation' in support had a gap. Correlation analysis to grasp the relation between importance of infra-system and headquarters' support or branch office's application showed that headquarters's importance and support were correlated positively in 'C3. Sanitation management system', 'C6. Facility ＆ utility support system', 'C7. Customer satisfaction management system' and 'C8. Evaluation ＆ analysis for branch office's operation' and branch office's importance and application were correlated positively in 'C1. Procurement ＆ food processing system', 'C5. Management Information system', 'C7. Customer satisfaction management system' and 'C8. Evaluation ＆ analysis for branch office's operation'. Lastly, 'C6. Facility ＆ utility support system' in the branch office of school and hospital and 'C2. Menu management system' in the branch office of B＆I were high in importance, low in support and application, therefore Intensive support for these categories was needed. In conclusion, continuous check and improvement for categories, which were identified as an urgent problems to be solved in this study, among infra-structure qualifying for CFMC, would enable contract foodservice industry that has grown quantitatively till now to grow qualitatively.

• 한국식품조리과학회지
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• 제12권3호
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• pp.339-345
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• 1996

Food waste is an inverse measure of consumer acceptability of the food as served and hence a potential determinant of food qualify. The plate waste of patients was examined by a visual method at one hospital. Patients were asked to record after each item on their menu the amount consumed in quantitative terms: None, 1/4, l/2, 3/4, all. The survey showed that 65% of all patients surveyed left some of their food during hospitalization. Mean wastes for soups and meat side dishes were found to be larger than those for cooked meals and vegatable side dishes. At the same time, a questionnaire survey was used to determine the view of patients of key aspects of the hospital foodservice system. The majority of patients surveyed left their cooked meal because of low appetite, whereas patients indicated that Food is not tasty was the primary reason for leaving soups and other side dishes.'Satisfaction' scores were significantly correlated with the patients' age and appetite at the time.

• 한국식생활문화학회지
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• 제11권1호
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• pp.107-121
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• 1996

This study was carried out to develop the computer-assisted Hazard Analysis and Critical Control Point (HACCP) program for a systematic approach to the identification, assessment and control of hazards for foodservice manager to assure the microbiological quality of food in hospital foodservice operations. Sanitation practices were surveyed and analyzed in the dietetic department of 4 hospitals. Among them, one 762-bed general hospital was selected as standard model to develop computer-assisted HACCP program. All data base files and processing programs were created by using Foxpro package for easy access of HACCP concept. HACCP program was developed based on the methods suggested by NACMCF, IAMFES and Bryan. This program consisted of two parts: the pre-stage for HACCP study and the implementation stage of the HACCP system. 1. Pre-stage for HACCP study includes the selection of menu item, the development of the HACCP recipe, the construction of a product flow diagram, and printing the HACCP recipe and a product flow diagram. A menu item for HACCP study can be selected from the menu item lists classified by cooking methods. HACCP recipe includes ingredients, their amount and cooking procedure. A flow diagram is constructed based on the HACCP recipe. The HACCP recipe and a product flow diagram are printed out. 2. Implementation of HACCP study includes the identification of microbiological hazards, the determination of critical control points, the establishment of control methods of each hazard, and the complementation of data base file. Potentially hazardous ingredients are determined and microbiological hazards are identified in each phase of the product flow. Critical control points (CCPs) are identified by applying CCP decision trees for ingredients and each process stage. After hazards and CCPs are identified, criteria, monitoring system, corrective action plan, record-keeping system and verification methods are established. When the HACCP study is complemented, HACCP study result forms are printed out. HACCP data base file can be either added, corrected or deleted.

• Journal of Nutrition and Health
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• 제38권9호
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• pp.765-776
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• 2005

The purposes of this study were to a) examine IC (intellectual capital) circumstance of CFMC (contract foodservice management company), b) identify the correlation between IC of CFMC, c) analyze the cause and effect of IC in the viewpoint of contractor, client, and customer. The questionnaires of IC measurement were handed out to 108 CfHCs, there composing of main office employees, foodservice managers, customers, and clients of 207 school, 38 hospital, and 86 business/industry foodservices. The statistical data analysis was completed using SPSS Win (ver 12.0) for descriptive analysis, correlation analysis, simple linear regression analysis. First, CFMCs had operational experience for an average of 8 years and 8 months, and served an average of 38,540 meals a day. Most of the respondent companies operated 'food supply/distribution($50\%$)', 'catering ($46.7\%$)', and restaurant business ($43.3\%$)' except for institutional foodservice and managed an average of 66 clients for the contract period of 2 years and 3 months. Second, there was positive correlation between $\ulcorner$sales of foodservice$\lrcorner$ and 'market ability', $\ulcorner$client satisfaction$\lrcorner$ and necessary intellectual capital for managing branch/chain foodservice office, and $\ulcorner$customer satisfaction$\lrcorner$ and $\ulcorner$renewal and development$\lrcorner$, 'market ability', 'infrastructure support for foodservice operation', 'employee satisfaction', respectively. Finally, the result of the cause and effect analysis on CFMCs, clients, and customers was positively influenced by 'client satisfaction' with 'customer satisfaction', 'infrastructure support for foodservice operation' and 'customer satisfaction' with 'employee satisfaction', and 'infrastructure support for foodservice operation'. In conclusion, if CFMCs were to perform a routine checkups by utilizing CFMC's IC measuring tool, improvements in CFMC operational capacities as well as foodservice quality can be noted. Additionally, CFMCS can satisfy their client-customer relationship by employing internal marketing thechniques for employee, a more efficient infrastructure support system, and construc tive infrastructure utilization. Therefore, CFMCs can show significant improvement in their sales and foodservice quali-ty though continuous maintenance of the client and customer satisfaction.

• Journal of Nutrition and Health
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• 제39권4호
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• pp.417-425
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• 2006

The purpose of this study were to a) investigate operation of human resource in contract foodservice management company (CFMC), b) identify the staffing indices for the establishment an labor productivity for CFMC, and c) develop standardized model of staffing demand as foodservice's scale in CFMC. The data was collected using FS intra-net system from 138 contract-managed foodservice operations in A CFMC and statistical analysis was completed using the SAS/win package (ver. 8.0) for description analysis, ANOVA, Duncan multiple comparison, pearson correlation analysis, and regression analysis. The types of operation were included factory (45%), small scale operation (26%), office (11%), department store (10%), training institute (4%), and hospital (3%). The distribution of foodservice scale was classified by meal served was as follows; 'less than 500 meals (47%)', 'from 500 to 1500 meals (25%)', 'from 1500 to 2500 meals (17%)', and 'more than 2500 meals (12%)'. There was two types of contract method, fee-contract (53%) and profit-and-loss contract (46%) Some variables were significantly high operation indices such as selling price, food cost, monthly sales, net profit and others were significantly low operation indices such as labor, meal time a day in the small foodservice on meal scale (p<.001). The more foodservice was large, the more human resource was disposed on dietitian, cook, cooking employee altogether (p<.001). Foodservice in A CFMC was divided into 2 groups by 500 meals a day, according to comparative analysis of labor productivity as meal scale per working hour, meal scale a day and operation indices as meal per foodservice employee, meal per cooking employee (p<.001). The regression equation model was developed as 'the number of employees=1.82+0.014 ${\times}$ meal served' in the operation of less than 500 meals, 'the number of employees=9.42+0.013 ${\times}$ meal scale a day -0.94 ${\times}$ meal scale per working hour' in the operation over 500 meal scale using labor productivity indices and operation indices. Therefore, CFMC could be enhanced efficiency of human resource arrangement using the standardized model of staffing demand and would be increased effectiveness of profit.

• 대한영양사협회학술지
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• 제16권4호
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

• 한국식품영양학회지
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• 제22권1호
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• pp.141-149
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• 2009

본 연구의 분석결과, 컨조인트 도출모형의 적합성은 Pearson's R은 0.420, Kendall's tau는 0.402(<0.05)로 나타나 도출된 모형은 적합한 것으로 판정되었다. 급식서비스 속성에 대한 중요도는 영양사와의 상담이 51.2%로 가장 높았으며, 배식원의 서비스가 48.7%, 음식의 조리법이 0.1% 순으로 조사되었다. 급식서비스 각 속성의 효용성을 세부적으로 살펴보면 음식 의 경우 '부드러운 조리법 음식의 효용성'이 0.001로서 '일반적인 다양한 음식' -0.001보다 선호되고 있었다. 다음 배식원의 경우 '친절한 배식원의 서비스'가 0.086으로서 '신속한 배식원의 서비스' -0.086보다 선호되는 것을 보여주고 있다. 마지막으로 영양사 상담은 '주 1회'가 -0.138로서 '주2회' -0.2 6보다 선호되는 것을 나타내고 있다. 즉, '부드러운 조리법의 음식/친절한 배식원의 서비스/주 1회 영양사 상담'이 노인의료전문 병원의 환자들로부터 가장 선호되는 급식 서비스 프로파일로 나타나고 있다. 결론적으로 응답자들이 급식서비스를 선택할 때 가장 중요시 하는 속성은 영양사와의 상담(51.2%) 이었으며, 다음으로 배식원의 서비스(48.7%)이었다. 반면 음식의 조리법에 대한 중요도는 0.1%로서 음식의 조리법 자체는 급식서비스를 선택/선호하는 데에 거의 영향을 미치지 않으며, 그보다는 영양사의 상담과 배식원의 배달 서비스가 더욱 중요한 요인으로 파악되었다. 결과적으로 가상의 급식서비스 선호도 모델로써 제시된 8개의 모델에서 일반적인 조리방법, 친절한 말과 미소를 건네는 배식원의 서비스, 주 1회 담당 영양사와의 상담을 제시한 3번 모형이 가장 선호되는 것으로 조사되었다. 노인의료전문 병원 급식서비스의 중요 요소를 파악한 후 가상적인 급식소에 대한 상대적 중요도를 파악을 위한 컨조인트 분석을 실시하였다. 컨조인트 분석은 특정 제품이 가지고 있는 각각의 속성에 고객이 부여하는 효용을 추정함으로써, 고객이 선택할 제품을 예측하기 위한 기법으로 서로 다른 제품 속성에 대한 고객의 중요한 관점을 제시해 준다$^{26)}$. 즉 병원 급식에서 환자들은 정보를 얻고 가능한 대안들을 알고 난 후, 선택 속성의 패턴을 정의하여 이것을 급식소의 결정에 이용할 수 있게 된다. 노인의료전문 병원에서 급식서비스는 치료의 한 분야로써 그 중요성이 증가되고 있으며, 병원에 입원한 환자들을 위한 급식 서비스는 진료외적인 서비스의 한 요소로써 노인급식서비스의 향상을 위한 노력과 품질관리의 중요성이 부각되고 있다. 그러므로 본 연구에서 도출된 노인급식서비스 가상 모델은 노인의료전문 병원에서 행하여지는 급식서비스의 최적화 품질관리를 위하여 이용될 수 있을 뿐만 아니라 만족도 제고를 위하여 사용될 수 있을 것으로 사료된다.

• 대한영양사협회학술지
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• 제12권4호
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• pp.313-328
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• 2006

This study was objectively performed to identify dietitians' job in the elderly health-care facilities, to assess facilities and dietitian's demographic characteristics, and to determine performance and importance of dietitian's job including the demand of therapeutic diet development. Survey was conducted by mail and samples were the dietitians working in 376 facilities which capacity is over 50 members from nationwide 583 the elderly health-care facilities. Returned questionnaire was 102 and used for statistic analysis. The distributions of the elderly health-care facilities showed 39 the elderly nursing facilities(38.2%), 32 skilled nursing facilities (32.4%), 13 geriatrics hospital facilities(12.7%) and 9 the elderly cost nursing facilities(8.8%). 60.0 percent of the samples showed its menu price as 1,000 to 1,500 won. A cycle-menu program was in-use at the 79.0% facilities, but only 7.1% facilities have been introduced a selected menu system. 92.9% facilities employed only one dietitian. In the demographic characteristics of dietitian only 14.7% dietitian had a clinical dietitian license and 51.5% of respondents answered at least 1 to 3 months internship program is needed. Job activities of the dietitian in the elderly health-care foodservice were identified as 45 activities with 9 dimensions. Job performance score evaluated dietitian oneself was 4.71 of 7 points. The average importance score that the dietitian evaluated their own job was 5.66 points of 7. The job activities shown higher importance but lower performance were therapeutic diet development for in-patients, menu development suitable for taste of the elderly, and leadership. Job performance score by characteristics of dietitian and their elderly health-care facilities was significantly associated with experience of dietitian in elderly health-care (F=4.480, p<0.05), education of dietitian(F=2.659, p<0.01), number of dietitian(F=2.245, p<0.05), and number of employee in foodservice(F=2.607, p<0.05). Most common diseases of the aged was proved as hypertension(81.7%), diabetes mellitus(71.4%), and dementia(65.0%). The therapeutic diets frequently provided were diabetes mellitus diet, dysphagia diet, low sodium diet, high fiber diet, and high protein diet, in order. For those reasons, dietitian in the elderly health care emphasized that the information about therapeutic diet development such as diabetes mellitus diet, dysphagia diet, low sodium diet and hypertension diet must be continuously developed and provided. The result from this study can be applicable to enlarge and enrich job activities of dietitian in elderly health-care foodservice.

• 한국생활과학회지
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• 제19권4호
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• pp.719-732
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• 2010

This study assessed knowledge-based environments for knowledge management in hospital dietetic departments. This study categorized the current knowledge management environment into routine habits, capability, culture and system. A questionnaire was conducted on dieticians in general hospitals with 400 beds in Seoul and Gyeong-in areas. Excluding responses with significant missing data, 160 usable questionnaires were analyzed by SPSS package programs for the study. The result of the study is summarized as follows. The average number of licensed beds in the hospitals was 717.5 and the average number of meals provided daily was 1,626.3. 53.2% of dieticians were aged between 26 and 35. Of the maximum score of 5 points, habits scored $3.65{\pm}.44$ points, capability scored $3.38{\pm}.44$ points, culture scored $3.21{\pm}.46$ points and system scored $2.77{\pm}.74$ points. Hospitals with a high ratio of occupied beds also had significantly higher points in capability, culture and system. The older the group the higher points it scored in habits and culture. The married group scored higher points in habits while the higher educated group scored higher points in habits and capability. The dietitians in charge of clinical nutrition scored higher points in habit, capability and culture while the higher salaried group scored higher points in habit, culture and capability. Therefore this study would provide useful information for the introduction of knowledge management in hospital dietetic departments.