Management in Food and Nutrition Systems

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION ManagementNOT in FOR Food SALE OR DISTRIBUTION and Nutrition Systems © Jones & Bartlett Learning, LLC “Food management RDs© Jones need to & haveBartlett technical Learning, expertise, LLC 1 NOT FOR SALE OR DISTRIBUTION knowledge,NOT FOR and SALE interpersonal OR DISTRIBUTION skills.”

outLInE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT• FOR Learning Objectives SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Introduction • Activities of Entry-Level Dietitians and Dietetic Technicians • Areas of Employment © Jones & Bartlett Learning,• Food and Nutrition Management in Acute Care LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR• DISTRIBUTION Food and Nutrition Management NOT in Long-Term FOR SALE Care OR DISTRIBUTION Facilities • Food and Nutrition Management in Noninstitutional Settings • School Nutrition Programs © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • Clinical Nutrition Management NOT FOR SALE OR DISTRIBUTION• Commercial Food ServiceNOT FOR SALE OR DISTRIBUTION • Additional Areas of Opportunity • Characteristics of Successful Food and Nutrition Managers • Expanded Opportunities © Jones• Expansion of Roles & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT• FOR Summary SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Definitions • References

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 107 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

108 Management in Food and Nutrition Systems

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION LEARNING OBJECTIVES The student will be able to: 1. Know the areas of employment in systems in food and nutri- © Jones & Bartletttion Learning, management. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE2. Describe OR DISTRIBUTION the activities and responsibilities ofNOT the management FOR SALE OR DISTRIBUTION dietitian. 3. Know the range of opportunities and advancements in food and nutrition management. © Jones & Bartlett Learning,4. LLCUnderstand how the functions© Jones of management& Bartlett Learning, activities LLC NOT FOR SALE OR DISTRIBUTIONdiffer in clinical, institutional,NOT and FOR commercial SALE ORfoodservice. DISTRIBUTION 5. Become aware of the impact of technology in future foodservice operations.

Food and food service are prominent in the history of the profession of dietetics. One of the main purposes of the first organized meeting of the © Jones & BartlettAmerican Learning,Dietetic Association LLC (ADA) was to discuss© Jones ways &of Bartlettmeeting Learning, LLC NOT FOR SALEfood shortages OR DISTRIBUTION during World War I. Many of theNOT first membersFOR SALE of the OR DISTRIBUTION association served overseas feeding hospitalized soldiers and people liv- ing under wartime conditions. Cooking schools, scientists who produced the first tables of food values, early-day soup kitchens, and school lunch 2 © Jones & Bartlett Learning,programs LLC were among the forerunners© Jones of institutions & Bartlett that fed Learning, the public. LLC NOT FOR SALE OR DISTRIBUTIONFood service in hospitals was theNOT primary FOR focus SALE of the OR first DISTRIBUTION dietitians. During the 1890s, food service in hospitals was managed by the chef, the housekeeper, or the nursing department. In the early 1900s, how- ever, many dietitians were in charge of dietary departments and had the responsibility for all food service as well as teaching nurses and providing © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC diet therapy for patients with metabolic diseases. Hospital dietitians dealt NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION with budgets, department organization, personnel management, and quality food service. Nutrition was recognized as an aspect of medicine, and food prescriptions were handled as apothecary compounds, thus creating a demand for special diet kitchens. The hospital dietitian had the same status © Jones & Bartlettas the superintendent Learning, of LLC nurses and was recognized as© theJones nutrition & Bartlett expert.3 Learning, LLC NOT FOR SALEDietitians OR DISTRIBUTION with food service management responsibilitiesNOT FOR became SALE mem OR- DISTRIBUTION bers of the Food Administration section in the ADA, and their practice

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 108 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Activities of Entry-Level Dietitians and Dietetic Technicians 109

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTwas referred FOR SALE to as administrative OR DISTRIBUTION dietetics. The terminology nowNOT used FOR is SALE OR DISTRIBUTION management in food and nutrition systems. Management is discussed fully later in the text as a skill needed by dietitians in all areas of practice. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEAct ORivi DISTRIBUTIONties of Entry-LevelNOT Die FORti SALEtian ORs DISTRIBUTION and Dietetic Technicians

In 2010, the Commission on Dietetic Registration conducted a practice audit among dietitians and dietetic technicians and indicated the percent- © Jones & Bartlett Learning,age LLCof time spent in selected activities.© Jones Management & Bartlett activitiesLearning, of bothLLC NOT FOR SALE OR DISTRIBUTIONgroups are shown in Table 7-1.NOT FOR SALE OR DISTRIBUTION

Table 7-1. Management Activities of Entry-Level Dietitians and ©Dietetic Jones Technicians & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTActivity FOR (Percent) SALE OR DISTRIBUTION RDNOT DTR aFOR SALE OR DISTRIBUTION

Managing human resources

Assign or schedule staff 15 25 © Jones & BartlettMale decisions Learning, on personnel LLC actions © Jones 10& Bartlett 23 Learning, LLC NOT FOR SALEComply OR withDISTRIBUTION labor relations NOT FOR15 SALE 23 OR DISTRIBUTION

Evaluate performance of staff 22 31

Managing food and material resources © Jones & Bartlett Learning,Maintain LLC safety and sanitation of food,© Jonesfacilities, or& equipment Bartlett Learning,27 53 LLC NOT FOR SALE OR DISTRIBUTIONMonitor stage conditions NOT FOR SALE OR DISTRIBUTION22 39

Develop menus for clients with normal needs 33 45

Evaluate food products by taste, smell, and appearance 33 50 ©Calculate Jones quantities & Bartlett to purchase Learning, of food other LLC material resources 9© 21Jones & Bartlett Learning, LLC NOTPurchase FOR food, SALE nutritional OR supplements, DISTRIBUTION equipment, or supplies 14NOT 24 FOR SALE OR DISTRIBUTION

Assess client satisfaction with food and/or nutrition service 40 59

Adjust daily menu, food production, or distribution based on 11 30 availability of food, labor, or equipment © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEInstitute OR DISTRIBUTIONor maintain sustainability practices NOT FOR8 SALE 18 OR DISTRIBUTION (continues)

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 109 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

110 Management in Food and Nutrition Systems

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC TableNOT 7- FOR1. Management SALE OR DISTRIBUTION Activities of Entry-Level DietitiansNOT and FOR SALE OR DISTRIBUTION Dietetic Technicians (Continued) Activity (Percent) RD DTRa

Manage facilities © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEMaintain OR facilities DISTRIBUTION and equipment NOT FOR11 SALE 24 OR DISTRIBUTION Assure safety of employees, patients, clients, and customers 25 38

a. The higher percentages of involvement by dietetic technicians in many of the management categories reflect the areas in which technicians are most often employed. This was a survey © Jones & Bartlett Learning,of entry-level LLC professionals, and it should be© noted Jones that more & Bartlettdietitians begin Learning, their careers inLLC NOT FOR SALE OR DISTRIBUTIONclinical areas of practice; this was borne out NOTin those FORparticular SALE areas surveyed. OR DISTRIBUTION Notes: RD 5 registered dietitian; DTR 5 dietetic technician, registered. Reprinted from Journal of the American Dietetic Association 111, Number 11 (November 2011), Ward, B., D. Rogers, C. Mueller, R. Touger-Decker, KI.L. Sauer, C. Schmidt, “Distinguishing Entry-Level RD and DTR Practice: Results from the 2010 Commission on Dietetic© Jones Registration & Bartlett Entry-Level Learning, Dietetics Practice LLC Audit, 1749–1755,” Copyright© 2011, Jones & Bartlett Learning, LLC with permission from Elsevier. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Areas of Employment

In the 2015 membership survey, 11 percent of registered dietitians (RDs) © Jones & Bartlettand 17 percent Learning, of dietetic LLC technicians, registered (DTRs)© Jones indicated & Bartlett their Learning, LLC NOT FOR SALEpractice OR is inDISTRIBUTION food and nutrition management. Further,NOT FOR 24 percent SALE ofOR DISTRIBUTION practitioners are executives, directors, or managers, and another 17 percent are supervisors or coordinators.4 In the same study, it was reported that salaries for the food and nutrition © Jones & Bartlett Learning,manager LLC are the highest of those in© any Jones practice & Bartlettarea. The Learning,salaries reflect LLC NOT FOR SALE OR DISTRIBUTIONboth geographic location and years NOTof experience FOR SALE as the food OR andDISTRIBUTION nutrition manager is nearly always a dietitian with work experience beyond entry level and may have an advanced degree or a business degree. Dietitians in food and nutrition management typically affiliate with one© or Jones more of & the Bartlett following Learning, five dietetic LLC practice groups: Management© Jones in & Bartlett Learning, LLC FoodNOT and FOR Nutrition SALE Systems, OR DISTRIBUTION Dietitians in Business and Communication,NOT FOR SALE OR DISTRIBUTION School Nutrition Services, Food and Culinary Professionals, and Hunger and Environmental Nutrition. In addition, clinical managers may belong to the Clinical Nutrition Management group. Dietitians in food and © Jones & Bartlettnutrition Learning,management LLC may be identified through ©a wideJones range & Bartlettof titles, Learning, LLC NOT FOR SALEsuch as OR coordinator, DISTRIBUTION specialist, executive dietitian,NOT director FOR of SALEfood and OR DISTRIBUTION nutrition services, director of clinical nutrition, or chief administrator.

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 110 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

A r e a s o f E m p l o y m e n t 111

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTPractice FOR areas SALE are ORoften DISTRIBUTION categorized by work settings, such as foodNOT and FOR SALE OR DISTRIBUTION nutrition management in acute care, long-term care, and noninstitutional employment areas. To encompass the broader management area, clinical nutrition management, commercial food service, and school nutrition are added to this list. A discussion of each follows. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEFood OR and DISTRIBUTION Nutrition Management in AcuteNOT Care FOR SALE OR DISTRIBUTION Food service in acute care is the type of service provided in hospitals or similar healthcare institutions in which patients receive short-term medi- cal treatment, usually 1–5 days. Several characteristics of this type of food © Jones & Bartlett Learning,service LLC are: © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1. Fast turnover of patients with day-to-day fluctuations in the number of meals prepared and served. 2. Special diets requiring different types of food preparation. In some © Jonesinstances, & Bartlett as many Learning, as 50 percent LLC of all patients will require© specialJones & Bartlett Learning, LLC NOT FORor modified SALE diets.OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 3. Selective menus for patients, increasing the number of food items prepared. 4. Multiple serving systems in an institution, such as individual tray © Jones & Bartlett Learning,service, decentralized LLC service with pantries© Joneson patient & Bartlettfloors, and Learning, LLC NOT FOR SALE ORrestaurant-style DISTRIBUTION service providing individualizedNOT FOR patient SALE service. OR DISTRIBUTION In some institutions, food is prepared in bulk, then preportioned and held until the time of meal service, when it is rethermalized and served. In others, food is prepared centrally just before meal service and either por- © Jones & Bartlett Learning,tioned LLC individually or sent in bulk© Jones to patient & Bartlettareas for individual Learning, service. LLC NOT FOR SALE OR DISTRIBUTIONProduction and food service systemsNOT vary, FOR but SALE in each ORsystem, DISTRIBUTION the dietitian has overall responsibility for food production and service or may share this responsibility with a dietetic technician, chef, or manager. Whatever the scope of his or her responsibility, the dietitian must be knowledgeable in ©food Jones production & Bartlett techniques, Learning, food purchasing, LLC safety and sanitation,© Jones stra- & Bartlett Learning, LLC NOTtegic planning,FOR SALE human OR relations, DISTRIBUTION communication skills, managerialNOT skills, FOR SALE OR DISTRIBUTION and financial management. Food and Nutrition Management in Long-Term Care Facilities © Jones & BartlettThe provision Learning, of food LLC for clients in nursing homes,© extendedJones & care Bartlett facilities, Learning, LLC NOT FOR SALEand ORcorrectional DISTRIBUTION institutions is included in the NOTlong-term FOR care SALE category. OR DISTRIBUTION Food service in these institutions differs from that in acute care in that

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 111 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

112 Management in Food and Nutrition Systems

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC clientsNOT are FOR long SALE term andOR areDISTRIBUTION usually served in group settings. CentralNOT FOR SALE OR DISTRIBUTION food production and few special diets are typical because most of the long- term clients will be following a normal, healthy eating pattern. The food service, especially in smaller nursing homes and extended care facilities, may be managed by a dietetic technician or by a certified dietary manager © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC under the direction of a dietitian consultant. In correctional institutions, NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION the day-to-day management is often provided by nonprofessionals under the direction of a dietitian consultant when one is available. All aspects of food service management are equally as important in long-term care as in the hospital with the added necessity of ensuring nutritional adequacy © Jones & Bartlett Learning,and acceptability LLC over longer periods© Jones of time. & BartlettIn almost Learning,all long-term LLC NOT FOR SALE OR DISTRIBUTIONfacilities, there are federal and stateNOT regulations FOR relatingSALE toOR the DISTRIBUTION provision of food services to clients that must be followed for the institution to receive government funding and provide quality care. The qualifications for the food service manager are also specified in the regulations. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC FoodNOT and FOR Nutrition SALE ORManagement DISTRIBUTION in Noninstitutional SettingsNOT FOR SALE OR DISTRIBUTION Management of food and nutrition in noninstitutional settings is typically provided in colleges and universities, employee cafeterias, and business and commercial enterprises. The food service may be for-profit or © Jones & Bartlettnonprofit, Learning, depending onLLC the type of institution. Generally,© Jones institutions& Bartlett Learning, LLC NOT FOR SALEserving OR the DISTRIBUTIONpublic will be for profit while schoolsNOT or businesses FOR SALE provid OR- DISTRIBUTION ing employee food services are more often nonprofit. Clients choose to patronize the food services offered and the type of food services may vary widely. A college or university, for instance, may offer cafeteria, dining © Jones & Bartlett Learning,room, LLCrestaurant, catering, and vending© Jones services. & Bartlett School Learning,and employee LLC NOT FOR SALE OR DISTRIBUTIONfood service is often provided by cafeteriaNOT FOR service SALE along ORwith DISTRIBUTIONvending and dining room service. Many businesses provide employee cafeterias or restaurant service. The dietitian’s responsibility is to provide food that is safe and acceptable to the customers, meets financial expectations, and promotes© Jones good & nutrition.Bartlett Learning, LLC © Jones & Bartlett Learning, LLC SchoolNOT NutritionFOR SALE Programs OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION School nutrition programs, offering either lunch or breakfast, or both, are available in 100,000 public schools through grade 12, nonprofit private 5 © Jones & Bartlettschools, and Learning, residential LLC child care institutions. Over© Jones31 million & Bartlettstudents Learning, LLC NOT FOR SALEfrom preschool OR DISTRIBUTION through grade 12 were fed daily. AnNOT average FOR of 11SALE million OR DISTRIBUTION children per day participated in the federal school breakfast program in

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 112 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

A r e a s o f E m p l o y m e n t 113

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT2009. FOR The programsSALE OR are DISTRIBUTION administered and partially funded byNOT the fed FOR- SALE OR DISTRIBUTION eral government, and they must meet specific guidelines for nutritional quality of meals and for student eligibility. Free or reduced-price meals are provided based on the family economic status. The emphasis is on long-term health benefits for children through establishing good eating © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC habits. The following is a position statement supporting school nutrition NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION programs: It is the position of the Academy, School Nutrition Association, and Society for Nutrition Education that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential © Jones & Bartlett Learning, componentLLC of coordinated school© Jones health &programs Bartlett that Learning, will improve LLC NOT FOR SALE OR DISTRIBUTIONthe nutritional status, health, andNOT academic FOR performance SALE OR of DISTRIBUTION our nation’s children. Local school wellness policies may strengthen comprehensive nutrition services in schools by providing opportunities for multidisci- plinary teams to identify and address local school needs.6 © JonesDietitians & Bartlettin school Learning,nutrition programs LLC need both managerial© Jones and & Bartlett Learning, LLC NOTnutrition FOR education SALE skills.OR DISTRIBUTION That school nutrition programs provideNOT satisfy FOR- SALE OR DISTRIBUTION ing careers to many is shown in a recent study of job satisfaction; dietitians with management responsibilities, including those in school child nutrition programs, showed the highest level of satisfaction with the nature of © Jones & Bartlettthe work Learning, and a higher LLC overall level of satisfaction© Jonescompared & Bartlettto national Learning, LLC NOT FOR SALEindices. OR7 DISTRIBUTION NOT FOR SALE OR DISTRIBUTION The customer is the most important consideration when offering school food service that meets strict guidelines for safety and nutritional quality while also controlling costs.8 Some programs use websites to pro- © Jones & Bartlett Learning,mote LLC offerings and others use newspaper© Jones &advertising Bartlett to Learning, publish menus LLC NOT FOR SALE OR DISTRIBUTIONand gain public support. NOT FOR SALE OR DISTRIBUTION Clinical Nutrition Management As discussed earlier, the clinical nutrition manager is the professional who ©directs Jones the &activities Bartlett of Learning,a clinical unit LLC in hospitals and healthcare© Jonesinsti- & Bartlett Learning, LLC NOTtutions. FOR This SALE may include OR DISTRIBUTION responsibility for one or more unitsNOT and the FOR SALE OR DISTRIBUTION supervision of other professionals in clinical areas. The clinical manager performs many of the same management functions as the food service dietitian—management of human, financial, and material resources. The © Jones & Bartlettclinical Learning,dietitian who LLC progresses from an entry-level© Jones position & to Bartlett a manage Learning,- LLC NOT FOR SALEment OR position DISTRIBUTION will normally have 5–10 years orNOT more FOR of experience SALE ORand DISTRIBUTION may not be involved in day-to-day activities directly related to patient care.

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 113 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

114 Management in Food and Nutrition Systems

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC CommercialNOT FOR FoodSALE Service OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Commercial food service is described as retail and hospitality food service establishments that prepare food for immediate consumption on or off premises. The types of establishments employing dietitians include © Jones & Bartlettindependent Learning, restaurants, LLC catering services, casual and© Jones family dining& Bartlett res- Learning, LLC NOT FOR SALEtaurants, OR and DISTRIBUTION fine dining restaurants. Supermarket NOTchains, FOR limited SALE service OR DISTRIBUTION (fast-food) chains, and hotel chains also have high potential for dietetic services. Five specific areas of need in these institutions are nutrition education, healthful menu planning, recipe and menu analysis, marketing, © Jones & Bartlett Learning,and quality LLC assurance. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONSkills in public relations, communications,NOT FOR marketing, SALE OR purchasing, DISTRIBUTION and financial management are expected of dietitians who work in commercial food services. Therefore, additional training and experience are often needed by the dietitian to be fully qualified for these roles. Additional© Jones Areas& Bartlett of Opportunity Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Additional opportunities for dietitians in food service management include positions in food corporations, such as research and development, consumer affairs, communications, government liaison, emergency feeding for displaced persons, disaster planning centers, military-based homeless © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC shelters and food distribution centers, worldwide religious ministries and NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION government food programs, adult and child care programs, and academic units with food, nutrition, or hospitality programs. Many dietitians are employed in contract food service companies that provide for-profit management services. Hospitals, colleges and universities, schools, employee © Jones & Bartlett Learning,cafeterias LLC in businesses, hotels and ©restaurants, Jones & and Bartlett healthcare Learning, institutions LLC NOT FOR SALE OR DISTRIBUTIONmay contract with a company whoNOT manages FOR food SALE services OR for DISTRIBUTION a negotiated fee. The companies hire and often train their own personnel, including dietitian managers.

C©h Jonesaract & Bartletterist Learning,ics of LLCSuccessful Food© Jones & Bartlett Learning, LLC aNOTnd FORNutr SALEiti ORon DISTRIBUTION Managers NOT FOR SALE OR DISTRIBUTION

Employment areas in food and nutrition management require registered dietitian nutritionist (RDN) leaders who are effective in the management © Jones & Bartlettof human, Learning, material, and LLC financial resources. Food and© Jonesnutrition & services Bartlett in Learning, LLC NOT FOR SALEhealthcare OR facilitiesDISTRIBUTION are becoming more complex inNOT meeting FOR the SALE demands OR DISTRIBUTION of the administration, patients, and clients. From a historical standpoint,

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 114 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Characteristics of Successful Food and Nutrition Managers 115

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTmeal serviceFOR SALEto patients OR was DISTRIBUTION the primary focus of foodservice departmentsNOT FOR SALE OR DISTRIBUTION in healthcare especially in hospitals. Services are now expected in other units within an institution as shown in Figure 7-1. With this expansion of services offered, the RDN and DTR have a wide scope of practice responsibilities in healthcare systems as well as in © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC business, industry, and consulting. These include planning, organizing, NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION staffing, budgeting, directing, and controlling.9 Managers must make decisions in the best interests of both the department and the institution and be able to communicate effectiveness to the organization’s leadership. The productivity of the department is directly related to the quality of the © Jones & Bartlett Learning,managerial LLC decisions and to the ©outcomes Jones of& departmental Bartlett Learning, efforts. LLC NOT FOR SALE OR DISTRIBUTIONAccording to Puckett,9 today’sNOT management FOR SALE RDN OR must, DISTRIBUTION at a mini- mum, possess competencies in the following areas: • Environmental protection rules © Jones• The political & Bartlett environment Learning, LLC © Jones & Bartlett Learning, LLC NOT• Marketing FOR SALE and ORcustomer DISTRIBUTION satisfaction NOT FOR SALE OR DISTRIBUTION • Continual quality improvement • Work design and productivity • Innovative cost-containment measures © Jones & Bartlett• Food Learning, consumption LLC patterns © Jones & Bartlett Learning, LLC NOT FOR SALE• ORHuman DISTRIBUTION resource trends NOT FOR SALE OR DISTRIBUTION • Food and water safety • Disaster and emergency planning • Project and process management • Cultural diversity in the marketplace © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Patient Meal Services Retail Clinical • Room service • Cafes • Inpatient • Guest meals • Food courts • Out-patient ©• JonesCelebration & meals Bartlett Learning,• Vending LLC • Community outreach© Jones & Bartlett Learning, LLC • Post-discharge • Catering • Clinical research NOT meal FOR deliver ySALE OR DISTRIBUTION• Convenience stores NOT FOR SALE OR DISTRIBUTION • Coffee shops

Figure 7-1. Scope of Services. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Reproduced from Practice Paper of the Academy of Nutrition and Dietetics: Principles of NOT FOR SALEProductivity OR DISTRIBUTION in Food and Nutrition Services: Applications inNOT the 21st FOR Century SALE Health OR Care DISTRIBUTION Reform Era. J Acad Nutr Diet 2015;115(7):1141–1147.

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 115 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

116 Management in Food and Nutrition Systems

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTCompetencies FOR SALE typical OR of DISTRIBUTION visionary leaders who are effective inNOT their FOR SALE OR DISTRIBUTION position and in the organization and who are successful in their practice are shown in Table 7-2. As in other areas of practice, the RDN in food service management usually begins at a competent level of knowledge and skills at entry-level © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC following registration. The next stage is proficiency in operational skills NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION and the possible beginning of specialist credentials followed by the expert who continues to build on his/her knowledge, skills, and credentials.10

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONTable 7-2. Competencies NeededNOT FORby Healthcare SALE OR Food DISTRIBUTION Service Managers Successful healthcare food service managers will: • Use management techniques to cultivate relationships in and out of the institu- ©tion Jones and achieve & Bartlett cooperation Learning, through teamwork. LLC © Jones & Bartlett Learning, LLC NOTDemonstrate FOR effectiveSALE communications OR DISTRIBUTION to achieve understanding of personnelNOT FOR SALE OR DISTRIBUTION • and departmental policies. Achieve an organizational structure, mission statement, policies, and procedures • that effect necessary changes when indicated. • Possess technological knowledge of food service, practice experience, and external © Jones & Bartlettbusiness Learning, and administrative LLC needs. © Jones & Bartlett Learning, LLC Use management techniques based on sound character, compassion, insight, and NOT FOR SALE• personal OR integrity.DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Exhibit personal behaviors and attitudes consistent with professional and • institutional goals. • Pursue professional knowledge and growth. Possess effective supervisory and managerial skills to derive optimal employee © Jones & Bartlett Learning,• performance. LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION• Achieve ways to enhance performanceNOT and growth FOR of SALE employee. OR DISTRIBUTION Understand the policies of the institution and an ability to interface effectively • with superiors. Exhibit effective use of resource (fiscal, personnel, and material) to facilitate • planning and current operations. • ©Possess Jones analytic & Bartlett and decision-making Learning, techniques LLC to achieve maximum quality© for Jones & Bartlett Learning, LLC NOTcustomer FOR and SALEclients. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Formulate a creative vision that integrates mutually satisfying department and • institutional goals.

Adapted from Journal of the American Dietetic Association, 95, Watabe-Dawson, M. “Visionary © Jones & BartlettLeaders Are Learning,Key to Success inLLC Food Service,” p. 13. Copyright ©1995, Jones with permission & Bartlett from Learning, LLC NOT FOR SALEElsevier. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 116 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

E x p a n s i o n o f R o l e s 117

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTExp FORand SALEed OORpportun DISTRIBUTIONities NOT FOR SALE OR DISTRIBUTION Entry-level dietitians with management responsibilities are employed pri- marily in food service or clinical nutrition service operations. The pre- dominant responsibilities at this level involve technical skills that ensure © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC that food is procured, managed, prepared, and delivered to patients and NOT FOR SALEother OR clients, DISTRIBUTION and that appropriate nutrition servicesNOT are FOR provided. SALE With OR DISTRIBUTION experience and perhaps advanced study, conceptual skills are utilized to identify problem areas requiring attention, to select appropriate techniques, analyze alternative strategies, and select solutions consistent with © Jones & Bartlett Learning,organization LLC goals. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONFrom entry-level positions, dietitiansNOT FOR may SALE advance OR to DISTRIBUTIONthe assistant or associate director level of a department and eventually to director or chief administrator. They may manage multidepartmental units or a complex of smaller hospitals, specialty clinics, or long-term care centers. They may ©become Jones the & chief Bartlett operating Learning, officer of LLC a healthcare facility. © Jones & Bartlett Learning, LLC NOTDietitians FOR SALE directing OR food DISTRIBUTION and nutrition services must have aNOT diversi FOR- SALE OR DISTRIBUTION fied, multipurpose, broad-based education and experiences from which to draw for expanded roles. They must be familiar with applicable computer software, business organization, marketing, labor relations, industrial © Jones & Bartlettengineering, Learning, writing LLCand media relations, public© relations, Jones financial& Bartlett man Learning,- LLC NOT FOR SALEagement OR DISTRIBUTIONdata evaluation, policy formation and problemNOT FOR solving, SALE decision OR DISTRIBUTION making, negotiation, behavior modification techniques, and dealing with challenges.

© Jones & Bartlett Learning,Exp LLCansion of Ro©les Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Expanded roles may include new and challenging positions that come from the foundation the dietitian receives and that may not even generally be associated with dietetics. In health care, for instance, there is ©heightened Jones & consumer Bartlett interest Learning, in what LLC constitutes healthy food. The© Jones food & Bartlett Learning, LLC NOTindustry FOR wants SALE effective OR marketing DISTRIBUTION of its products, including informationNOT FOR SALE OR DISTRIBUTION about safety and nutrient value, and wants to develop new products. All these areas represent opportunities in consumer education, writing, food safety, media positions, public policy, food demonstration, and more. Disaster planning and emergency training is a further need for the © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC food service manager. In events such as floods, hurricanes, earthquakes, NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 117 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC andNOT fires, FOR the availability SALE OR of DISTRIBUTION food and water becomes of paramountNOT con- FOR SALE OR DISTRIBUTION cern.11 “Nutrition security,” defined as “secure access to appropriate diets, a sanitary environment and adequate health services and care,” may become huge issues if they are not met.12 Fortunately there are many evidence-based food-related resources available to RDNs and © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC DTRs for personal training and to share with clients and others in pub- NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION lic health and healthcare settings. The Food and Drug Administration, the Centers for Disease Control and Prevention, organizations, and the Internet all provide resource materials. The U.S. Department of Agri- culture also maintains a hot line for food safety information.12 A tuto- © Jones & Bartlett Learning,rial on LLCdisaster planning is available© Jones from the & Academy.Bartlett 13Learning, Many local, LLC NOT FOR SALE OR DISTRIBUTIONstate, and national groups provideNOT credible FOR sources SALE of ORinformation DISTRIBUTION and training in these areas. The RDN or DTR may also consider obtaining certificates of training offered by groups such as the Food Marketing Institute, the National Restaurant Association, the National Registry of Food© Jones Safety Professionals,& Bartlett Learning, and others. SuchLLC certifications can be further© Jones & Bartlett Learning, LLC usedNOT to meetFOR requirements SALE OR DISTRIBUTIONfor professional development and to NOTmain- FOR SALE OR DISTRIBUTION tain state licensure credentials.14 Interesting and informative accounts of events during actual world disasters such as the Japanese earthquake and Hurricane Sandy in © Jones & BartlettNew Orleans Learning, give insight LLC into how food and nutrition© Jones issues & Bartlett can be Learning, LLC NOT FOR SALEhandled. OR15,16 DISTRIBUTION NOT FOR SALE OR DISTRIBUTION A new dimension in foodservice management is the use of automa- tion to simplify many tasks—especially those of a repetitive or dangerous nature. With the rapid advances in technology today, machines may take © Jones & Bartlett Learning,over many LLC foodservice tasks in the future.© Jones An example & Bartlett of one Learning, type of auto LLC- NOT FOR SALE OR DISTRIBUTIONmation under development is an NOToptical FOR scanner SALE that ORanalyzes DISTRIBUTION food for nutrient content, actual ingredients, and any additives or contaminants.17 A database of standard foods and food varieties is to be developed after which it will be possible to test whether the food contains what the label claims© Jones and allowing & Bartlett reliable Learning, and immediate LLC information to the manager.© Jones & Bartlett Learning, LLC NOTMachines FOR could SALE conceivably OR DISTRIBUTION take over tasks such as cleaning,NOT trash FOR SALE OR DISTRIBUTION collecting, controlling temperatures, tray delivery and pickup, managing storerooms, loading and unloading dish machines, and others. The foodservice manager needs to be cognizant of emerging technological trends such as these in order to make decisions about their applicability © Jones & Bartlett Learning,18 LLC © Jones & Bartlett Learning, LLC NOT FOR SALEin practice. OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 118 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTSUMM FORA SALERY OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION The dietitian in food service management has career opportunities in food, food production and service, management, and the higher levels of activities associated with management and leadership. For the motivated © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC and skilled dietitians, higher salary levels and greater degrees of responsi- NOT FOR SALEbility OR and DISTRIBUTION self-actualization can be realized. NOT FOR SALE OR DISTRIBUTION

DEFINITIONS © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONFood production. The process NOTof preparing FOR SALE and serving OR DISTRIBUTIONfood, including purchasing, storage, and processing. Food services. Production and service of food; also refers to the unit or group responsible for feeding groups. © JonesFood service & Bartlett systems. ActivitiesLearning, that LLC together form the inputs, ©transfor Jones- & Bartlett Learning, LLC NOT mation,FOR SALE and outputs OR DISTRIBUTION that make up an entire food operation.NOT FOR SALE OR DISTRIBUTION Human resources. The personnel in an organization. Management. The administration and coordination of the activities and functions in an organizational unit. © Jones & BartlettQuality Learning, assurance. LLC The certification of the continual,© Jones optimal, & Bartlett effective, Learning, LLC NOT FOR SALE ORand DISTRIBUTION efficient outcomes of a service or program.NOT FOR SALE OR DISTRIBUTION Resource allocation. The equitable distribution of financial, physical, and human capital.

© Jones & Bartlett Learning,Re LLCferences © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION1. Puckett, R.P., W. Barkley, G.NOT Dixon, FOR K. Egan,SALE C. ORKoch, DISTRIBUTION T. Malone, J. Scott-Smith, B. Sheridan, et al. “The American Dietetic Association Standards of Professional Performance for Registered Dietitians (Generalist and Advanced) in Management of Food and Nutrition Systems.” J Am Diet Assoc 109 (2009): © Jones540–543. & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 2. Cassell, J.A. Carry the Flame: The History of the American Dietetic Association. NOT(Chicago: FOR SALEAmerican OR Dietetic DISTRIBUTION Association, 1990). NOT FOR SALE OR DISTRIBUTION 3. Barker, A., M. Foltz, M.B.F. Arensberg, and M.R. Schiller. Leadership in Dietetics: Achieving a Vision for the Future. (Chicago: American Dietetic Association, 1994). © Jones & Bartlett4. Rogers, Learning, D. “Compensation LLC and Benefits Survey 2015.”© JJones Acad Nutr & Diet Bartlett 115, no. Learning,3 LLC NOT FOR SALE OR(2015): DISTRIBUTION 370–388. NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC© Jones & Bartlett Learning, LLC.© NOTJones FOR SALE& Bartlett OR DISTRIBUTION Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284158199_CH07_107_120.indd 119 01/12/16 4:42 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 5.NOT www.fns.usda/gov/nslp/national FOR SALE OR DISTRIBUTION (3/20/16). NOT FOR SALE OR DISTRIBUTION 6. “Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive School Nutrition Services.” J Acad Nutr Diet 110 (2010): 1738–1748. 7. Sauer, K., D. Canter, and C. Shanklin. “Job Satisfaction of Dietitians with © Jones & BartlettManagement Learning, Responsibilities: LLC An Exploratory Study Supporting© Jones ADA’s & Bartlett Research Learning, LLC NOT FOR SALEPriorities.” OR DISTRIBUTION J Am Diet Assoc 110 (2010): 1432–1440. NOT FOR SALE OR DISTRIBUTION 8. Boyce, B. “Satisfying Customers and Lowering Costs in Foodservice: Can Both Be Accomplished Simultaneously?” J Acad Nutr Diet 111 (2011): 1458–1466. 9. Puckett, R.P. “Leadership Managing for Change.” In Food Service Manual for Health Care Institutions, 3rd ed. (San Francisco: Jossey-Bass, 2004), p. 30–32. © Jones & Bartlett Learning,10. Berthelsen, LLC R.M., W.C. Barclay, P.M.© Oliver, Jones V. McLymont, & Bartlett R. Puckett. Learning, “Academy LLC NOT FOR SALE OR DISTRIBUTIONof Nutrition and Dietetics: Revised NOT2014 StandardsFOR SALE of Professional OR DISTRIBUTION Performance for Registered Nutritionist in Management of Food and Nutrition Systems.” J Acad Nutr Diet 114, no. 7 (2014): 1104–1112. 11. “Position of the Academy of Nutrition and Dietetics: Food and Water Safety.” J Acad Nutr Diet 114, no. 11 (2014): 1819–1828. 12.© See Jones Note 11. & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 13.NOT www.eatright.org/disaster FOR SALE OR (4/3/15). DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 14. See Note 11. 15. Amagai, T., S. Ichimaru, M. Tai, Y. Ejira, A. Muto. “Nutrition in the Great East Japan Earthquake Disaster.” Nutr in Clin Pract 29, no. 5 (2014): 585–594. 16. Trent L, Allen S. “Hurricane Sandy: Nutrition Support During Disasters.” © Jones & BartlettNutr I ClinLearning, Pract 29, no. LLC 5 (2014): 576–584. © Jones & Bartlett Learning, LLC NOT FOR SALE17. Washington OR DISTRIBUTION Post: March 30, 2016. NOT FOR SALE OR DISTRIBUTION 18. “Man and Machine Knowledge Work in the Age of the Algorithm.” Harvard Business Review (June 2015): 57–65.