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Heather Hartwell - One of the best experts on this subject based on the ideXlab platform.
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hungry in Hospital well fed in prison a comparative analysis of Food Service systems
Appetite, 2013Co-Authors: Nick Johns, John S A Edwards, Heather HartwellAbstract:Meals served in prisons and Hospitals are produced in similar ways and have similar characteristics, yet Hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and Hospital Food Service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of Food Service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and Service system was found to be much less coherent in Hospital than in prison. Transport and Service of Hospital Food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached Hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of Hospital Food Service practice.
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plate versus bulk trolley Food Service in a Hospital comparison of patients satisfaction
Nutrition, 2007Co-Authors: Heather Hartwell, John S A Edwards, John BeavisAbstract:Abstract Objective The aim of this research was to compare plate with bulk trolley Food Service in Hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods A consumer opinion card ( n = 180), concentrating on the quality indicators of core Foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict Food Service style on the basis of the Food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each Food attribute within Food Service style. Results Results showed that the bulk trolley method of Food distribution enables all Foods to have a more acceptable texture, and for some Foods (potato, P = 0.007; poached fish, P = 0.001; and minced beef, P ≤ 0.0005) temperature, and for other Foods (broccoli, P ≤ 0.0005; carrots, P ≤ 0.0005; and poached fish, P = 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two Service systems. Conclusion This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Temperature and texture were the most important attributes that measure patient satisfaction with Food, thus defining the focus for Hospital Food Service managers. To date, a model predicting patient satisfaction with the quality of Food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the Service style of dishes for improving the quality of Food and thus enhancing patient satisfaction.
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applied nutritional investigation plate versus bulk trolley Food Service in a Hospital comparison of patients satisfaction
2007Co-Authors: Heather Hartwell, John S A Edwards, John BeavisAbstract:Objective: The aim of this research was to compare plate with bulk trolley Food Service in Hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods: A consumer opinion card (n 180), concentrating on the quality indicators of core Foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict Food Service style on the basis of the Food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each Food attribute within Food Service style. Results: Results showed that the bulk trolley method of Food distribution enables all Foods to have a more acceptable texture, and for some Foods (potato, P 0.007; poached fish, P 0.001; and minced beef, P 0.0005) temperature, and for other Foods (broccoli, P 0.0005; carrots, P 0.0005; and poached fish, P 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two Service systems. Conclusion: This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Tempera- ture and texture were the most important attributes that measure patient satisfaction with Food, thus defining the focus for Hospital Food Service managers. To date, a model predicting patient satisfac- tion with the quality of Food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the Service style of dishes for improving the quality of Food and thus enhancing patient satisfaction. © 2007 Elsevier Inc. All rights reserved.
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Hospital Food Service a comparative analysis of systems and introducing the steamplicity concept
Journal of Human Nutrition and Dietetics, 2006Co-Authors: John S A Edwards, Heather HartwellAbstract:Background Patient meals are an integral part of treatment hence the provision and consumption of a balanced diet, essential to aid recovery. A number of Food Service systems are used to provide meals and the Steamplicity concept has recently been introduced. This seeks, through the application of a static, extended choice menu, revised patient ordering procedures, new cooking processes and individual patient Food heated/cooked at ward level, to address some of the current Hospital Food Service concerns. The aim of this small-scale study, therefore, was to compare a cook-chill Food Service operation against Steamplicity. Specifically, the goals were to measure Food intake and wastage at ward level; ‘stakeholders’ (i.e. patients, staff, etc.) satisfaction with both systems; and patients’ acceptability of the Food provided. Method The study used both quantitative (self-completed patient questionnaires, n = 52) and qualitative methods (semi-structured interviews, n = 16) with appropriate stakeholders including medical and Food Service staff, patients and their visitors. Results Patients preferred the Steamplicity system overall and in particular in terms of Food choice, ordering, delivery and Food quality. Wastage was considerably less with the Steamplicity system, although care must be taken to ensure that poor operating procedures do not negate this advantage. When the total weight of Food consumed in the ward at each meal is divided by the number of main courses served, at lunch, the mean intake with the cook-chill system was 202 g whilst that for the Steamplicity system was 282 g and for the evening meal, 226 g compared with 310 g. Conclusions The results of this small study suggest that Steamplicity is more acceptable to patients and encourages the consumption of larger portions. Further evaluation of the Steamplicity system is warranted. The purpose of this study was to directly compare selected aspects (Food wastage at ward level; satisfaction with systems and Food provided) of a traditional cook-chill Food Service operation against ‘Steamplicity’. Results indicate that patients preferred the ‘Steamplicty’ system in all areas: Food choice, ordering, delivery, Food quality and overall. Wastage was considerably less with the ‘Steamplicity’ system; although care must be taken to ensure that poor operating procedures do not negate this advantage. When the total weight of Food consumed in the ward at each meal is divided by the number of main courses served, results show that at lunch, mean intake with the cook-chill system was 202g whilst that for the ‘Steamplicity’ system was 282g and for the evening meal, 226g compared with 310g.
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a comparative analysis of plated and bulk trolley Hospital Food Service systems
Food Service Technology, 2003Co-Authors: Heather Hartwell, John S A EdwardsAbstract:It has been recognized that Hospital Food Service could be improved with malnutrition a target concern. The hypothesis of this study is that a Food Service system that enables patients to see and smell the Food on offer and interact with the staff serving the meals will result in better patient nutritional intake and increased meal satisfaction. Data were collected from two wards, Women's Health and Orthopaedic (patients n = 31 in each study), over two 3-day consecutive periods. First, for a pre-ordered, plated meal Service; and second, 9 months later, for a trolley Service offering choice at the point of consumption. Food was weighed before and after the meal experience. Questionnaires were also administered and interviews were conducted with the patients (n = 614) to evaluate patients’ acceptability of both catering systems. Results show that nutritional intake was not dependent on the catering systems and that possibly in Hospital, unlike other ‘eating out’ situations, there are barriers to ‘complete nutrition’. However, patient satisfaction was improved with the trolley system, where 93% of patients were satisfied compared to 76% with the plate system. This research indicates that nutritionally, the method of meal delivery is immaterial but patients do prefer choice at the point of consumption.
John S A Edwards - One of the best experts on this subject based on the ideXlab platform.
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hungry in Hospital well fed in prison a comparative analysis of Food Service systems
Appetite, 2013Co-Authors: Nick Johns, John S A Edwards, Heather HartwellAbstract:Meals served in prisons and Hospitals are produced in similar ways and have similar characteristics, yet Hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and Hospital Food Service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of Food Service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and Service system was found to be much less coherent in Hospital than in prison. Transport and Service of Hospital Food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached Hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of Hospital Food Service practice.
-
plate versus bulk trolley Food Service in a Hospital comparison of patients satisfaction
Nutrition, 2007Co-Authors: Heather Hartwell, John S A Edwards, John BeavisAbstract:Abstract Objective The aim of this research was to compare plate with bulk trolley Food Service in Hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods A consumer opinion card ( n = 180), concentrating on the quality indicators of core Foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict Food Service style on the basis of the Food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each Food attribute within Food Service style. Results Results showed that the bulk trolley method of Food distribution enables all Foods to have a more acceptable texture, and for some Foods (potato, P = 0.007; poached fish, P = 0.001; and minced beef, P ≤ 0.0005) temperature, and for other Foods (broccoli, P ≤ 0.0005; carrots, P ≤ 0.0005; and poached fish, P = 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two Service systems. Conclusion This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Temperature and texture were the most important attributes that measure patient satisfaction with Food, thus defining the focus for Hospital Food Service managers. To date, a model predicting patient satisfaction with the quality of Food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the Service style of dishes for improving the quality of Food and thus enhancing patient satisfaction.
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applied nutritional investigation plate versus bulk trolley Food Service in a Hospital comparison of patients satisfaction
2007Co-Authors: Heather Hartwell, John S A Edwards, John BeavisAbstract:Objective: The aim of this research was to compare plate with bulk trolley Food Service in Hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods: A consumer opinion card (n 180), concentrating on the quality indicators of core Foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict Food Service style on the basis of the Food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each Food attribute within Food Service style. Results: Results showed that the bulk trolley method of Food distribution enables all Foods to have a more acceptable texture, and for some Foods (potato, P 0.007; poached fish, P 0.001; and minced beef, P 0.0005) temperature, and for other Foods (broccoli, P 0.0005; carrots, P 0.0005; and poached fish, P 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two Service systems. Conclusion: This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Tempera- ture and texture were the most important attributes that measure patient satisfaction with Food, thus defining the focus for Hospital Food Service managers. To date, a model predicting patient satisfac- tion with the quality of Food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the Service style of dishes for improving the quality of Food and thus enhancing patient satisfaction. © 2007 Elsevier Inc. All rights reserved.
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Hospital Food Service a comparative analysis of systems and introducing the steamplicity concept
Journal of Human Nutrition and Dietetics, 2006Co-Authors: John S A Edwards, Heather HartwellAbstract:Background Patient meals are an integral part of treatment hence the provision and consumption of a balanced diet, essential to aid recovery. A number of Food Service systems are used to provide meals and the Steamplicity concept has recently been introduced. This seeks, through the application of a static, extended choice menu, revised patient ordering procedures, new cooking processes and individual patient Food heated/cooked at ward level, to address some of the current Hospital Food Service concerns. The aim of this small-scale study, therefore, was to compare a cook-chill Food Service operation against Steamplicity. Specifically, the goals were to measure Food intake and wastage at ward level; ‘stakeholders’ (i.e. patients, staff, etc.) satisfaction with both systems; and patients’ acceptability of the Food provided. Method The study used both quantitative (self-completed patient questionnaires, n = 52) and qualitative methods (semi-structured interviews, n = 16) with appropriate stakeholders including medical and Food Service staff, patients and their visitors. Results Patients preferred the Steamplicity system overall and in particular in terms of Food choice, ordering, delivery and Food quality. Wastage was considerably less with the Steamplicity system, although care must be taken to ensure that poor operating procedures do not negate this advantage. When the total weight of Food consumed in the ward at each meal is divided by the number of main courses served, at lunch, the mean intake with the cook-chill system was 202 g whilst that for the Steamplicity system was 282 g and for the evening meal, 226 g compared with 310 g. Conclusions The results of this small study suggest that Steamplicity is more acceptable to patients and encourages the consumption of larger portions. Further evaluation of the Steamplicity system is warranted. The purpose of this study was to directly compare selected aspects (Food wastage at ward level; satisfaction with systems and Food provided) of a traditional cook-chill Food Service operation against ‘Steamplicity’. Results indicate that patients preferred the ‘Steamplicty’ system in all areas: Food choice, ordering, delivery, Food quality and overall. Wastage was considerably less with the ‘Steamplicity’ system; although care must be taken to ensure that poor operating procedures do not negate this advantage. When the total weight of Food consumed in the ward at each meal is divided by the number of main courses served, results show that at lunch, mean intake with the cook-chill system was 202g whilst that for the ‘Steamplicity’ system was 282g and for the evening meal, 226g compared with 310g.
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a comparative analysis of plated and bulk trolley Hospital Food Service systems
Food Service Technology, 2003Co-Authors: Heather Hartwell, John S A EdwardsAbstract:It has been recognized that Hospital Food Service could be improved with malnutrition a target concern. The hypothesis of this study is that a Food Service system that enables patients to see and smell the Food on offer and interact with the staff serving the meals will result in better patient nutritional intake and increased meal satisfaction. Data were collected from two wards, Women's Health and Orthopaedic (patients n = 31 in each study), over two 3-day consecutive periods. First, for a pre-ordered, plated meal Service; and second, 9 months later, for a trolley Service offering choice at the point of consumption. Food was weighed before and after the meal experience. Questionnaires were also administered and interviews were conducted with the patients (n = 614) to evaluate patients’ acceptability of both catering systems. Results show that nutritional intake was not dependent on the catering systems and that possibly in Hospital, unlike other ‘eating out’ situations, there are barriers to ‘complete nutrition’. However, patient satisfaction was improved with the trolley system, where 93% of patients were satisfied compared to 76% with the plate system. This research indicates that nutritionally, the method of meal delivery is immaterial but patients do prefer choice at the point of consumption.
John Beavis - One of the best experts on this subject based on the ideXlab platform.
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plate versus bulk trolley Food Service in a Hospital comparison of patients satisfaction
Nutrition, 2007Co-Authors: Heather Hartwell, John S A Edwards, John BeavisAbstract:Abstract Objective The aim of this research was to compare plate with bulk trolley Food Service in Hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods A consumer opinion card ( n = 180), concentrating on the quality indicators of core Foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict Food Service style on the basis of the Food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each Food attribute within Food Service style. Results Results showed that the bulk trolley method of Food distribution enables all Foods to have a more acceptable texture, and for some Foods (potato, P = 0.007; poached fish, P = 0.001; and minced beef, P ≤ 0.0005) temperature, and for other Foods (broccoli, P ≤ 0.0005; carrots, P ≤ 0.0005; and poached fish, P = 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two Service systems. Conclusion This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Temperature and texture were the most important attributes that measure patient satisfaction with Food, thus defining the focus for Hospital Food Service managers. To date, a model predicting patient satisfaction with the quality of Food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the Service style of dishes for improving the quality of Food and thus enhancing patient satisfaction.
-
applied nutritional investigation plate versus bulk trolley Food Service in a Hospital comparison of patients satisfaction
2007Co-Authors: Heather Hartwell, John S A Edwards, John BeavisAbstract:Objective: The aim of this research was to compare plate with bulk trolley Food Service in Hospitals in terms of patient satisfaction. Key factors distinguishing satisfaction with each system would also be identified. Methods: A consumer opinion card (n 180), concentrating on the quality indicators of core Foods, was used to measure patient satisfaction and compare two systems of delivery, plate and trolley. Binary logistic regression analysis was used to build a model that would predict Food Service style on the basis of the Food attributes measured. Further investigation used multinomial logistic regression to predict opinion for the assessment of each Food attribute within Food Service style. Results: Results showed that the bulk trolley method of Food distribution enables all Foods to have a more acceptable texture, and for some Foods (potato, P 0.007; poached fish, P 0.001; and minced beef, P 0.0005) temperature, and for other Foods (broccoli, P 0.0005; carrots, P 0.0005; and poached fish, P 0.001) flavor, than the plate system of delivery, where flavor is associated with bad opinion or dissatisfaction. A model was built indicating patient satisfaction with the two Service systems. Conclusion: This research confirms that patient satisfaction is enhanced by choice at the point of consumption (trolley system); however, portion size was not the controlling dimension. Tempera- ture and texture were the most important attributes that measure patient satisfaction with Food, thus defining the focus for Hospital Food Service managers. To date, a model predicting patient satisfac- tion with the quality of Food as served has not been proposed, and as such this work adds to the body of knowledge in this field. This report brings new information about the Service style of dishes for improving the quality of Food and thus enhancing patient satisfaction. © 2007 Elsevier Inc. All rights reserved.
Mieke Uyttendaele - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the Food safety management system in a Hospital Food Service operation toward Listeria monocytogenes
Food Control, 2015Co-Authors: Evy Lahou, Liesbeth Jacxsens, Ellen Verbunt, Mieke UyttendaeleAbstract:Abstract The unique aspects of a Hospital environment, such as the multitude of dietary needs and thus the variety of meals to be served and incoming (raw) materials to be used, challenge the development and application of appropriate control and assurance measures to guarantee Food safety. Besides, Listeria monocytogenes is considered a risk for most Food Service operations producing and serving ready-to-eat Foods. Therefore the Food safety management system of a Hospital Food Service operation has been evaluated toward L. monocytogenes with an extensive questionnaire in the preset of this case study. In addition, 49 samples of Food products and 145 environmental samples were taken and analyzed for L. monocytogenes to verify the implemented control measures. From this case study, it becomes clear that incoming (raw) materials, produced final products and their immediate supply to patients/consumers are high risk situations. This was demonstrated by the presence of L. monocytogenes in six incoming (raw) materials ( n = 19) and one final product ( n = 9). These risky situations are in need to be mitigated by the implementation of proper control measures, e.g. intensified supplier control, low storage temperatures, cleaning and disinfection to control cross-contamination. However major improvements can be made on the hygienic design of equipment and facilities and on the level of the sampling design. In terms of assurance activities, such as setting up a sampling plan, only a basic level was obtained for the validation and verification of their Food safety management system. This case study illustrates that the combination of data from the questionnaire together with data of the sampling result in an overview on the performance of the current Food safety management system and that major non-compliances and possibilities for improvement in the system can be defined.
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the development and elaboration of a risk based sampling plan to control listeria monocytogenes in a Hospital Food Service operation
IAFP Annual Meeting 2012 (IAFP 2012), 2012Co-Authors: Evy Lahou, Liesbeth Jacxsens, Mieke UyttendaeleAbstract:Introduction : Although listeriosis can occur in healthy adults and children, the most commonly affected populations include pregnant women, neonates, the elderly, and those persons who are immunosuppressed by medications or illness. The high prevalence of L. monocytogenes in Foods in general, together with a high fatality rate of listeriosis suggests that L. monocytogenes represents an important hazard to human health. Purpose : The occurrence, spread, growth and survival of L. monocytogenes in Foods and Food environments has to be controlled. Therefore, a risk based sampling plan for the verification of the Food Safety Management System (FSMS) towards L. monocytogenes was developed and elaborated for a Hospital Food Service Operation (FSO). Methods : First the classification of all used Food types in various Food categories, with similar microbiological ecology towards L. monocytogenes took place. Next a score system based on i) the reported epidemiological association of the Food type with listeriosis outbreaks, ii) the reported prevalence of L. monocytogenes in the Food types, and iii) the potential of L. monocytogenes to grow or survive during storage and/or further processing, was set up and through summation of the attributed scores, a minimum score of zero (low risk) and a maximum score of nine (high risk) could be obtained. A similar methodology was applied to identify critical sampling locations in the environment where L. monocytogenes is possibly present. Results : The attribution of risks to the defined Food categories and critical sampling locations was the basis for selection of Food types and environmental samples to be taken up in the sampling plan. Seven Food products (n=49) and none of the environmental samples (n=145) were found to be positive for L. monocytogenes. Significance : The developed sampling plan can be used to improve the Food safety output of the current FSMS, i.e. to control L. monocyogenes, in the FSO.
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the evaluation of the Food safety management system of a Hospital Food Service operation towards l monocytogenes
Food Safety Management Abstracts, 2012Co-Authors: Evy Lahou, Liesbeth Jacxsens, Mieke UyttendaeleAbstract:Introduction : During the last 15-20 years there has been an increasing concern world-wide about L. monocytogenes and its implications for Food safety. Listeriosis is lately associated with elderly people and those persons who are immune-compromised by medications or illness such as frequently encountered in Hospital settings. Consequently, the occurrence, spread, growth and survival of L. monocytogenes in Foods and the Food environment of Hospital Food Service operations has to be carefully controlled. Materials and methods : The context, performance and Food safety output of the current Food safety management system (FSMS) in place in a Hospital Food Service operation was evaluated, in particular with respect to L. monocytogenes, according a Diagnostic Instrument (Jacxsens et al., 2011). The diagnostic instrument consists of comprehensive lists of indicators to analyse which core control (e.g. cleaning and disinfection, cold chain) and core assurance activities (e.g. sampling plan, audits) are addressed in the company specific FSMS, which context factors could affect the FSMS and to analyse the microbiological safety performance of the FSMS. In addition on 3 separate occasions, sampling for L. monocytogenes in the Food Service operation was performed (including environmental swab samples and product samples). Results and discussion : During sampling L. monocytogenes was absent in all (n= 145) environmental samples and detected in 7/49 product samples namely in cooked, salt-free ham, raw meat sandwich spread, smoked salmon, raw salmon (two times) and raw chicken meat. According the Diagnostic Instrument the Food Service operation (FSO) is operating in an medium risk context. The hypothesis of the diagnostic instrument for a FSO with a medium risk context is that an average FSMS should be sufficient to cover the risk of L. monocytogenes. However, according to this diagnosis tool in the FSO only a moderate Food safety output is reached. This is due the lack of assurance activities such as a sampling plan to control L. monocytogenes in the FSO and the validation and verification of the production process. Conclusion : The evaluation of the FSMS according a diagnostic instrument can be used to identify the weak points of the FSMS and to adjust its FSMS to improve Food safety output. In addition the awareness on the issue of L. monocytogenes (which was overall quite low in the Food Service operation) was raised because of this internal validation study of the FSMS using the diagnostic instrument and sampling. References JACXSENS L., LUNING PA., MARCELIS WJ., VAN BOEKEL T., ROVIRA J., OSES S., KOUSTA M., DROSINOS E., JASSON V. & UYTTENDAELE M. (2011) Tools for the performance assessment and improvement of Food safety management systems. Trends in Food science & technology. 22: 80-89.
Evy Lahou - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the Food safety management system in a Hospital Food Service operation toward Listeria monocytogenes
Food Control, 2015Co-Authors: Evy Lahou, Liesbeth Jacxsens, Ellen Verbunt, Mieke UyttendaeleAbstract:Abstract The unique aspects of a Hospital environment, such as the multitude of dietary needs and thus the variety of meals to be served and incoming (raw) materials to be used, challenge the development and application of appropriate control and assurance measures to guarantee Food safety. Besides, Listeria monocytogenes is considered a risk for most Food Service operations producing and serving ready-to-eat Foods. Therefore the Food safety management system of a Hospital Food Service operation has been evaluated toward L. monocytogenes with an extensive questionnaire in the preset of this case study. In addition, 49 samples of Food products and 145 environmental samples were taken and analyzed for L. monocytogenes to verify the implemented control measures. From this case study, it becomes clear that incoming (raw) materials, produced final products and their immediate supply to patients/consumers are high risk situations. This was demonstrated by the presence of L. monocytogenes in six incoming (raw) materials ( n = 19) and one final product ( n = 9). These risky situations are in need to be mitigated by the implementation of proper control measures, e.g. intensified supplier control, low storage temperatures, cleaning and disinfection to control cross-contamination. However major improvements can be made on the hygienic design of equipment and facilities and on the level of the sampling design. In terms of assurance activities, such as setting up a sampling plan, only a basic level was obtained for the validation and verification of their Food safety management system. This case study illustrates that the combination of data from the questionnaire together with data of the sampling result in an overview on the performance of the current Food safety management system and that major non-compliances and possibilities for improvement in the system can be defined.
-
the development and elaboration of a risk based sampling plan to control listeria monocytogenes in a Hospital Food Service operation
IAFP Annual Meeting 2012 (IAFP 2012), 2012Co-Authors: Evy Lahou, Liesbeth Jacxsens, Mieke UyttendaeleAbstract:Introduction : Although listeriosis can occur in healthy adults and children, the most commonly affected populations include pregnant women, neonates, the elderly, and those persons who are immunosuppressed by medications or illness. The high prevalence of L. monocytogenes in Foods in general, together with a high fatality rate of listeriosis suggests that L. monocytogenes represents an important hazard to human health. Purpose : The occurrence, spread, growth and survival of L. monocytogenes in Foods and Food environments has to be controlled. Therefore, a risk based sampling plan for the verification of the Food Safety Management System (FSMS) towards L. monocytogenes was developed and elaborated for a Hospital Food Service Operation (FSO). Methods : First the classification of all used Food types in various Food categories, with similar microbiological ecology towards L. monocytogenes took place. Next a score system based on i) the reported epidemiological association of the Food type with listeriosis outbreaks, ii) the reported prevalence of L. monocytogenes in the Food types, and iii) the potential of L. monocytogenes to grow or survive during storage and/or further processing, was set up and through summation of the attributed scores, a minimum score of zero (low risk) and a maximum score of nine (high risk) could be obtained. A similar methodology was applied to identify critical sampling locations in the environment where L. monocytogenes is possibly present. Results : The attribution of risks to the defined Food categories and critical sampling locations was the basis for selection of Food types and environmental samples to be taken up in the sampling plan. Seven Food products (n=49) and none of the environmental samples (n=145) were found to be positive for L. monocytogenes. Significance : The developed sampling plan can be used to improve the Food safety output of the current FSMS, i.e. to control L. monocyogenes, in the FSO.
-
the evaluation of the Food safety management system of a Hospital Food Service operation towards l monocytogenes
Food Safety Management Abstracts, 2012Co-Authors: Evy Lahou, Liesbeth Jacxsens, Mieke UyttendaeleAbstract:Introduction : During the last 15-20 years there has been an increasing concern world-wide about L. monocytogenes and its implications for Food safety. Listeriosis is lately associated with elderly people and those persons who are immune-compromised by medications or illness such as frequently encountered in Hospital settings. Consequently, the occurrence, spread, growth and survival of L. monocytogenes in Foods and the Food environment of Hospital Food Service operations has to be carefully controlled. Materials and methods : The context, performance and Food safety output of the current Food safety management system (FSMS) in place in a Hospital Food Service operation was evaluated, in particular with respect to L. monocytogenes, according a Diagnostic Instrument (Jacxsens et al., 2011). The diagnostic instrument consists of comprehensive lists of indicators to analyse which core control (e.g. cleaning and disinfection, cold chain) and core assurance activities (e.g. sampling plan, audits) are addressed in the company specific FSMS, which context factors could affect the FSMS and to analyse the microbiological safety performance of the FSMS. In addition on 3 separate occasions, sampling for L. monocytogenes in the Food Service operation was performed (including environmental swab samples and product samples). Results and discussion : During sampling L. monocytogenes was absent in all (n= 145) environmental samples and detected in 7/49 product samples namely in cooked, salt-free ham, raw meat sandwich spread, smoked salmon, raw salmon (two times) and raw chicken meat. According the Diagnostic Instrument the Food Service operation (FSO) is operating in an medium risk context. The hypothesis of the diagnostic instrument for a FSO with a medium risk context is that an average FSMS should be sufficient to cover the risk of L. monocytogenes. However, according to this diagnosis tool in the FSO only a moderate Food safety output is reached. This is due the lack of assurance activities such as a sampling plan to control L. monocytogenes in the FSO and the validation and verification of the production process. Conclusion : The evaluation of the FSMS according a diagnostic instrument can be used to identify the weak points of the FSMS and to adjust its FSMS to improve Food safety output. In addition the awareness on the issue of L. monocytogenes (which was overall quite low in the Food Service operation) was raised because of this internal validation study of the FSMS using the diagnostic instrument and sampling. References JACXSENS L., LUNING PA., MARCELIS WJ., VAN BOEKEL T., ROVIRA J., OSES S., KOUSTA M., DROSINOS E., JASSON V. & UYTTENDAELE M. (2011) Tools for the performance assessment and improvement of Food safety management systems. Trends in Food science & technology. 22: 80-89.