Portion Size AuditA Summary

The Background

• To measure the accuracy of portion sizes served to hospital patients

• To identify possible reasons for portion size inaccuracy• To develop suggestions to increase portion size accuracy

The Purpose

Doctors and Dietitians work together to assign specific diets to patients based on their medical condition and nutritional status. Some patients are assigned diets that are limited in certain nutrients such as fat and sodium while some are on diets that require large amounts of calories and protein. It is important that patients receive adequate nutrition during their stay here.

The Process1. Order Test Trays including all items on the Regular Patient Menu

2. Use appropriate tools to measure portions served and record• Scale: grams and ounces• Beaker: fluid ounces• Measuring cups and spoons: volume

3. Compare the portions served to the portions on the tickets

4. Identify possible factors causing inaccurate portion sizes

5. Develop solutions to correct portion size inaccuracy

The Results

Service ErrorsProduction Errors Recipe Errors

• Service Errors• Problems: Incorrect scoop/spoodle, incorrect weight of portion• Solutions: Ensure that correct serving utensils are being used and that line cooks are familiar with the correct recipe portions

• Production Errors• Problems: Recipe followed incorrectly, items not pre-portioned correctly, items not made on-site

• Solutions: Review recipes with Chefs to verify recipes are being followed correctly, contact manufacturers for items not made on-site to obtain correct portion sizes

• Recipe Errors• Problems: Recipe over/under portioned, recipe does not account for cooking losses (Actual Portion versus Edible Portion incorrect in recipe)

• Solutions: Correct recipes in Computrition and re-run nutritionals for each item modified

The Problems and The Solutions

The Discussion

Many people are involved in providing nutrition to hospital patients: chefs, cooks, dietitians, diet techs, diet clerks, expeditors and servers

The goal of the Nutrition Department is to serve patients food that support their health and healing while being appealing and satisfying

Sometimes, there is a weak point somewhere in the process and it’s important to examine that process to identify where the weak points are and what can be done to strengthen them

Examining the accuracy of portion sizes served to patients is an important step in ensuring that patients are receiving the proper nutrition to help them heal

Patients on certain therapeutic diets are limited as to what they can order based on the nutritional values in the recipes.

The diet techs and clerks who take patient orders are trained to make sure patient meals fall within their diet type. It is important that they are using accurate information when helping a patient order their meal. Examples.