Jennifer Valdez

6/10/16

NUTR 5413 Food Service Management

3 Day Menu Assignment

1. Market Analysis
Date: _________

New Patient Food Service Survey Tool

Room No. _______

Name:
DOB:
Sex:

Male
Female

Race: (circle at
least one)

American Indian or Alaska Native

Asian
Black or African American
Native Hawaiian or other Pacific Islander
White

Ethnicity: (circle
one)

Hispanic or Latino or Spanish origin

Not Hispanic or Latino or Spanish origin

Type of Diet:
(RN must indicate
& initial)
Known food
allergies: (peanuts,
eggs, soy, dairy,
wheat, tree nut,
fish, shellfish, etc.):
Food Preferences:

B) This New Patient Food Service Survey Tool will be administered by either a
diet technician or a Patient Care Service employee. The employee will greet
each newly admitted patient, as by standard protocol, and will gather the
information listed on the tool by communicating with the patient or a pertinent
family member. The information gathered from the tool will help the RDN and

Jennifer Valdez
6/10/16

NUTR 5413 Food Service Management

3 Day Menu Assignment

food service department be aware of any possible allergens, specialized

diets, and if there are any cultural preferences to consider. For example,
being aware that a patient is of Spanish origin will allow us to remember to
have Latin food items available.
C) Results
Low Sodium
8%
High Protein Diet

Diet Type (out of 40 patients)

3%

Full Liquid NPO

5%
3%

Regular
17%

Clear Liquid
2%
Renal
10%
Diabetic +
Mechanical Soft
25%

Cardiac
27%

Results were taken over a 2 week period, running from Monday to Friday.
The survey tool was administered every time there was a newly admitted
patient. The completed survey tools were then given to the RDN to keep.
Additional results from analysis of the New Patient Food Service Tool also
showed that the average patient in our inpatient population is 67 years old,
white, and female. (60% female, 40% male)
2. Three Day Menu
A) The 2 menu modifications chosen by my preceptor was a mechanical soft
diet that is also a diabetes diet. According to the hospitals epidemiological data,
25% of patients are either overweight or obese, diabetic and are on a mechanical
soft diet due to difficulty chewing, swallowing or difficulty with moving or feeling
parts of their mouth, such as lips or tongue. Therefore, this was identified as an
area of need. For the mechanical soft diet modifications, all items are blended,
chopped, pureed, mashed or grounded up so that the patient is able to chew and
swallow food items without any difficulty. For the diabetic diet modification, each
daily caloric total is set to meet approximately 1600 kcals, as chosen by my
preceptor. Carbohydrate, protein, fat, saturated fat, cholesterol, fiber, sodium

Jennifer Valdez
6/10/16

NUTR 5413 Food Service Management

3 Day Menu Assignment

intake is also based on the recommended DRI values for a 50-70 year old
women.
Thus, these 1600 kcal daily menus provide:

~55% CHO= 220 g CHO

~20% Protein= 80 g PRO
~25% Fat= 44 g Fat
Fiber: >21 g
Sodium: <2300 mg
Cholesterol: <300 mg
Saturated Fat: <13 g

220 grams of carbohydrates is equivalent to 15 carbohydrate exchanges daily.

Carbohydrate intake was kept consistent each day and was distributed as
follows:
4 CHO exchanges per meal (breakfast, lunch, dinner) = 60 g CHO
3 CHO exchanges per Mid Afternoon Snack= 45 g CHO
Majority of carbohydrate items offered on the menu come from non-starchy
vegetables, fruit, whole grains, beans, legumes, low fat dairy products. High fiber
foods were also emphasized along with lean meats and poultry. All menu items
also meet the modified texture requirements of a mechanical soft diet.
B) This menu appeals to the specific market because it offers a variety of well
known, appetizing entrees, sides and snacks daily. The meals offered from the
menu are representative of what is typically offered in local restaurants
surrounding the hospital. Visually, each meal was put together with the intent that
there is a variety of color represented on the plate. For example, on Dinner Day
2, chicken and corn enchiladas with red sauce are offered with black beans,
brown rice, orange colored mango sorbet, and bright green guacamole. Though
all entres are texture modified, there is a variety of lean proteins offered such as
eggs, turkey, chicken, Greek yogurt, and beef. There is also no consecutive
repetition of vegetables, fruits, and sides from day to day.
C) See Excel worksheet for Modified Menu standardized recipes.
3) Production Plan
A) This hospitals food service facility currently has 1 head chef, 1 cook
supervisor, 2 cooks, 1 patient care services employee, 1 front of house
supervisor and 5 cashiers. They have 2 stoves, 3 ovens, a large kitchen
preparation area, 1 walk in freezer, and 1 dry storage room. Specifically, they
also have 2 blenders, 1 food processor, 1 food grinder, and vegetable masher
that will be readily available for use when cooking and preparing food items
for a mechanical soft diet.

Jennifer Valdez
6/10/16

NUTR 5413 Food Service Management

3 Day Menu Assignment

B) See Excel worksheet for standardized recipes and Production Worksheet

Report pdf.
C) Production Schedule
Hot
Entre

Cold
Prep

Hot
Side

Bakery

Total
Employees
Needed at
each Shift

Day 1
Breakfast/Lunch
Snack/Dinner

2
1

1
1

1
1

1
1

1
2

1
1

2
1

1
1

1
1

5
4

Day 2
Breakfast/Lunch
Snack/Dinner

3
4

Day 3
Breakfast/Lunch
Snack/Dinner

1
1

4
4

Based on the production worksheet for the recipes, the above chart indicates
approximately how many kitchen staff will be needed for the Breakfast/Lunch AM
shift and Snack/Dinner PM shift. Typically, the head chef will prepare main
entrees and there will be 2-3 additional cooks that can assist and alternate in
between preparing cold prep, hot side, and baked goods. Due to limited budget
constraints, the fewer employees needed, the better it is in terms of costs, and
finding the most efficient strategies to produce the menu items is of critical
importance. I made sure that all of the items put on the menu are able to be
produced by this facilitys food service staff, budget, their resources, and
available equipment.
3. Rationale
A) Since 25% of this hospitals population has diabetes and is on a mechanical
soft diet, it is evident this is an area of need. A mechanical soft diet is offered
when a patient has difficulty chewing or swallowing their food. This menu was
modified to be able to meet the patients caloric and nutrient needs while at the
same time, consisting of a texture that is well tolerated by this specific population.
All menu items are mechanically altered by being pureed, shredded, blended,
chopped, grinded, or mashed with a blender, food processor, food chopper,
grinder, or masher. Any bread products offered can be easily crumbled with
hands and eaten. All fruits and vegetables are moist, soft boiled, well cooked.
There is an emphasis of items like sherbets, puddings, cottage cheese, and
yogurt in this menu. Food items are also served with gravies or sauces to
moisten the foods and to add flavor. Large chunks of meats, fruits, vegetables, or
items such as nuts or grapes were avoided.
According to the Nutrition Care Manual, it is recommended to eat a consistent
amount of servings of carbohydrates foods at each meal and snack while on a
diet for diabetes, therefore 4 CHO exchanges per meal and 3 CHO exchanges

Jennifer Valdez
6/10/16

NUTR 5413 Food Service Management

3 Day Menu Assignment

per snack was given. The Nutrition Care Manual also emphasizes foods high in
fiber, lean protein, low sodium, healthy fats, and limited amounts of saturated fat
in the diet. The modified menu follows this type of diet and offers multiple fruit
and vegetables items, low fat dairy products, healthy fats such as guacamole,
plenty of high fiber products, and lean protein sources at every meal. The division
of macronutrients (55% CHO, 20% PRO, 25% Fat) is also based on the DRI for
healthy adults in this age group.
B) The budget for this hospitals price per plate is $3.26. The menu cost report
(see excel spreadsheet) shows that all of the menu plate items are well under
this cost, with the highest cost per plate on the menu being at $2.32.
C) This hospital food service facility participates in the national program, Food
Buy, where the director of the local regional area can purchase, with a P card,
any item or ingredient needed for our facility. When looking at available suppliers
and vendors, there are a number of companies that are able to provide our
facility with the best delivery/pricing: Abbot Nutrition, Bimbo Bakeries USA, Chef
Works Inc., Coca Cola Enterprises, Hardies Fruit and Vegetables, Sysco Food
Service, and US Food Service Inc. Buying items in bulk from these companies is
most cost effective. Buying fruits and vegetables in season will also reduce costs,
as most of these vendors offer seasonal reduced items.
D) If possible, it would be best to utilize reusable plates and silverware. Items
that are biodegradable are also emphasized in order to reduce environmental
impact. There is also a food waste reduction program, Trim Trax, which aims to
reduce food waste and carbon footprints in landfills. In the kitchen facility, the
employee would implement this program by tracking and measuring production
waste, over produced/unusable food, and unused/out of date inventory. These
food scraps would be composted in a commercial facility. Participating in this
program will help in reducing food waste, which could potentially cut operational
costs.