Kristin Bell, Ellinor Lagerberg, Rachael Woods
Tray retrieval study CRD 2.8
The Florida Hospital Orlando campus has around 1400 beds. Like other Florida Hospital campuses, the Orlando campus has implemented a room service menu. The room service menu is a wonderful option for patients but it appears to be very labor intensive for the patient service area kitchen servers. For example, each time trays are delivered they have to be picked up at the end of every meal time by the dietary servers. Understandably, this is not a favored job. There have been complaints that the work load is not divided evenly among employees that go to different areas of the hospital to retrieve trays.
We went along to observe a standard tray retrieval service to experience how the system works. We learned the work load varies depending on what floors the servers are assigned. For example, if servers are assigned the pediatric units, there is less work because nurses are more likely to take the trays out of the room and put them into the designated cart for them to be retrieved. If assigned to another unit for example, the cardiac units in the Ginsberg tower, the nurses are less likely to remove the trays from patient rooms. This creates more work for the retriever. It can become rather time consuming to have to enter each room to retrieve trays, therefore increasing tray retrieval time, work load, and frustration felt by the retriever. Another problem that was brought to our attention was that the same people who are retrieving are also responsible for serving. The carts that are used to serve food get backed up due to the fact that the employees that are out retrieving are not back as quick as the carts are ready to go out.
We asked the retrievers if they had any recommendations on how to improve the process of tray retrieval. One of the remarks was that if someone was hired to only do retrieval, it would cause less controversy because that is the person’s designated job. It was also mentioned that if the nurses were able to remove the trays from the room and put them into the designated carts it would greatly improve the process.
In addition to the changes made to break schedules that should improve retrieval process we have a few suggestions:
· Require nurses to check their patient rooms every hour to remove patient trays. This would not only improve the cleanliness of the patient’s room, but it would also make the retrieval process more efficient, lessen work load on the retriever and decrease tray delivery time because retrievers have returned from retrieval quicker.
· Consider the implementation of designated dietary elevators. If the hospital is unwilling to designate to dietary staff elevators the hospital could consider putting an elevator hierarchy into effect.
We understand that nurses have other tasks on hand other than tray removal, but it is to our understanding that tray removal is also a part of their job duties. If the nurse managers could emphasize the importance of removing trays from patient rooms this would help dietary staff increase their efficiency.
Although some may not consider the implementation of dietary elevators as being essential, we must consider that patient tray delivery and retrieval is also a priority treatment. It is important that patients get their trays in a timely manner to assure that their comfort level is maintained. Retrieval is just as important as delivery in that increased retrieval time causes backflow in carts and so tray delivery also becomes delayed thus decreasing patient satisfaction.
We discussed our findings during the Patient Service Area Supervisor meeting on Wednesday, October 9th. The supervisors were very receptive toward our findings. Since then, we have developed a realistic goal for them to include in their “New Enhanced Zone and Retrieval Team [protocol]” it is as follows:
“Starting on November 1st, 2013, the patient service area will decrease tray retrieval time by 15 minutes by increasing nurse involvement.”
We agree that this can be achieved by having the Patient Service Area supervisors schedule a meeting with the nurse managers to discuss the importance of nurse assistance in patient tray retrieval. We developed the following plan for Jason, the nutritional services manager to monitor the success of the aforementioned goal.
Enhanced Retrieval Method EvaluationRetrieval periods / Retrieval 1 / Retrieval 2 / Retrieval 3
Retrieval times / Time out / Time in / Time out / Time in / Time out / Time in
Retriever 1
Retriever 2
Retriever 3
Retriever 4
Retriever 5
Retriever 6
Retriever 7