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Clinical Nutrition Scenario #1
Clinical Nutrition Scenario #2
Financial management Scenario #1
Financial management Scenario #2
Food Recall Scenario
Food Service Systems Management Scenario #2
Sanitation & Safety Story
Human Resources management Scenario #1
Human Resources management Scenario #2
Marketing and Promotion Scenario #1
Nutrition and Healthy Living Scenario #1
Professionalism Scenario #1
Professionalism Scenario #2

Professionalism Scenario #3
Food Quality Scenario
Quality Management Scenario




Clinical Nutrition Scenario #1
As the manager in a long term care facility in a rural area you have been called by the nursing staff to talk to a resident and his wife about his diet. He has been assessed by the part time dietitian following a diet order for a diabetic reduced sodium diet. He has been a diabetic for over fifteen years and just recently has begun to have some complications related to compromised kidney function. He is not happy with the restrictions of the new diet order and has begun to lose weight. His wife is very concerned and has begun to bring in some treats for him. Nursing wants you to tell her to spot and make him follow his diet. How do you approach the situation?


Clinical Nutrition Scenario #2
You have just begun work as the Food Service Supervisor in a 100 bed mental health facility. You have never worked with mental health clients before and find that it appears to be very different than long term care or acute food service. The clients eat meals in a dining room where they pick up their meals via a cafeteria line. Food Service Staff serve the meals based on what the clients indicate that they would like. There are many issues with food related to this group of clients and you need to understand what these are to effectively manage the department. Some questions you might have are: 

  1. Are their specific medications that these clients might be on that could increase their appetites or do some of the conditions cause over eating? How can this be managed in the dining room environment? If you have someone on a reducing diet that comes to the counter asking for double portions and gets very agitated when that is refused how can this be handled?
  2. Mental health clients may have food and color phobias that challenge menu creation and service of the food. What is the best way to handle these?
  3. Are there any nutritional risks for this client population that you need to be aware of when menu planning?



Financial management Scenario #1
As the Manager of Food Services in a 200 bed site you have always prided yourself on running a great operation. You are then shocked when the facility administrator comes to you and wants to discuss a proposal he has received from a contract food services operation. You are thankful he has come to you however very concerned that he understand why this would not be the best option. You need to review with him some key performance indicators and assist him to understand how well run the operation is. What do you do?

Financial management Scenario #2
There is a strong movement and focus on procurement practices that are local and sustainable. As the Food Service Manager at a large acute care site (125 beds) you want to operate your department with practices that use local products and support sustainability. You are not sure exactly what the financial impact will be on changing what you currently do. You get all your products through a central broadline distributor and are part of a national purchasing group. You have food costs that are very low at present. You are not sure how to find out what the costs of purchasing from another supplier will be or if you are even allowed to purchase from someone else. How do you determine what your focus should be and where do you collect data from?

 

Food Recall Scenario

On a Friday afternoon at 1530 hours the cook at the Happy days Long term Care facility receives a phone call from someone at the food distributor, Sysco that ships all of the food product to the facility. It is a small facility with only 50 beds and the supervisor is off site at another location for the day. 

The person on the phone has said the following :

“CFIA has announced recall of all ground beef products from NEW FOOD CLASSICS (Establishment 761) that were
manufactured between July 1, 2011 and July 18, 2011 because the products may be contaminated with E. Coli 0157:H7.

We are currently working to obtain detailed shipping information from NEW FOOD CLASSICS and will forward it as soon
as it is available. In the meantime please take the following actions:

1) Review your inventory for the following codes:

  1. Bearing a best Before date from BB2011JU01 up to and including BB2011JU18;
  2. Bearing a production code with a format of 11Jl 01 up to and including 11JU 18;
  3. Bearing a 5 digit lot code where the last four digits are 1831 or greater.

2) If any of the product in question is in inventory, complete a destruction form and destroy the product so it is inedible.

3) Sign and fax the document to 123-456-7890. Retain a copy on file and ensure all costs are accounted for as
necessary.”

What should the cook do in this situation?

Answer – immediately remove any affected product and destroy it documenting what has been done. As soon as the
notice is received whether by phone or email it must be auctioned. CFIA inspectors often follow up on recalls to ensure
the proper procedures were completed in a timely fashion.

What should she not do?

Make a note in the communication book for the supervisors next time she is at the site. The cook must also not panic or
refuse to check for the product because it is inconvenient or too cold in the freezer?\

What are the legal requirements?

The site is legally required to follow the instructions from the distributor. The manufacturer is required to notify the
distributor who then can identify who has been shipped the product during the affected time. The distributor also has
all of the contact information for the site which the manufacturer will not have. Sites do not begin recall procedures
based on information received via media and should always contact distributor if there are questions about a product.

Food Service Systems Management Scenario #2

Resident surveys are done at your site twice a year. For the residents in long term care the surveys are given to the residents themselves and families to complete. Often the nursing staff are observed taking the survey from the resident and filling it out for them. The response is sometimes appropriate and accurately reflects the residents opinion however often it is the nurse’s opinion and not the resident. This practice seems to be getting more frequent as the level of acuity of the resident increases and they are unable either physically or cognitively to respond.

The results of your patient satisfaction have been going down steadily for the past year however residents continue to eat all or most of the food served. This is documented by waste audits that are completed once a month. As well, residents are not losing weight or having any other clinical indicators for poor nutrition.

You have approached the nursing manager about this issue and she has replied that her nurses would only be filling the surveys out if the resident couldn’t. She says that she can tell her nurses not to do it at all and then very few surveys would be completed. The information from the surveys is extremely valuable and auditors are looking for the documentation.

What do you do?

Sanitation & Safety Story

It’s 11:00 am  and the cook  notices a drip from the ceiling outside the dairy fridge door and reports it to  the supervisor.

The course of action to take:

  1. Get a bucket to catch the drips.
  2. Page maintenance.
  3. Inform staff to be careful.
  4. Clean  & sanitize wet floor area and fridge door.
  5. Put a “Wet Floor” sign out
  6. Discuss with maintenance the  source of leak.   i.e. determine if leak is clean water or dirty water.
  7. This water is  from a sewer line.  The  area is sealed from ceiling  to floor while repair is made. All surrounding  work areas and equipment must be cleaned and sanitized
  8. Inform  public health of incident. An officer will come to inspect.

Once all of the action has been completed which documents will need to be completed and other followup.


Human Resources management Scenario #1

Your facility is not unionized and it is a strategic objective of the organization to ensure that the location does not get certified within any union for support services staff. The staff have an organization agreement that outlines their benefits and wages and typically these are kept just slightly (1%) above those of comparable facilities in the area that are unionized. You have heard that several of the food service staff have met with and/or been approached by union representatives asking them to consider certifying the site and joining the union. You are upset that your staff are the ones who seem to be pushing the issue and feel they really have no reason to do this.

How can this be handled?

Human Resources management Scenario #2

An employee that you recently terminated has now grieved the dismissal and a meeting has been scheduled to do the second step of the grievance process. You consulted with human resources prior to the termination and are confident all rules and processes were completed appropriately. The grievance was expected however you are still feeling nervous and uncomfortable going into the meeting. You have asked human resources for some clear instructions and they have just said to answer only the questions they specifically ask you about. This does not make you feel any better and you decide to press for more detail of what to expect. They just continue to say it will be fine.

The meeting day arrives and the room has six people in it. You, the human resources representative, the griever, the shop steward and someone from the union district office. The HR rep asks the shop steward to outline the grievance; why they feel it is not justified and what they want to see as resolution. The griever is asked to speak by the shop steward and proceeds to tell a completely different version of the story. She also states that everyone steals food but that you, the supervisor, turn a blind eye and only fired her because you don’t like her. You feel completely attacked and want to defend yourself. The HR rep doesn’t ask you to respond and just thanks the union for the information and states that management will get back to them in three days as to whether the grievance will be resolved.

After the meeting you are furious and vent to the HR person! Is this typical way for these meetings to go and how can they get away with a different version and personal attacks? How can you deal with this?


Marketing and Promotion Scenario #1

Your facility has been directed by senior leadership to change the cafeteria menu to make it more nutritious and healthy. They have given no other specific instructions or guidelines. They have also suggested that it might be good to work with the ladies Auxiliary to change to some healthier options. You are the Manager of Food Services and have a part time dietitian at the site. How would you plan to respond to this request ?

Identify the steps in your implementation plan as well as where you would get resources to assist you with this request?

 

Nutrition and Healthy Living Scenario #1

As part of the planning for Staff Health week in your facility you have been asked to do a short lunch time (lunch and learn) presentation for the staff. It would be about 15 mins delivered to a group of staff who bring their lunch and eat while listening to your presentation. You will not be able to use power point and only can afford to give out one handout. You decide to focus on two areas that are a very hot topic at present (Vegetarian and gluten free). There is a seemingly growing number of staff who do not have a diagnosed food allergy or condition but believe their general health improves with the omission of certain food ingredients such as gluten. These staff create a challenge in the cafeteria as they often ask for different products or want to know what is in everything.

What kind of a message can you give that will make a real difference?

 

Professionalism Scenario #1

The work day starts at 0900 after a long weekend.

You are covering for another manager who is on vacation so you have three extra areas that you are responsible for. This is not uncommon in smaller facilities as there are limited numbers of management staff.

You haven’t even had time to get your office light on and there are three staff members standing at your door, all with “important” things to discuss with you.

You have to get the payroll done as soon as possible because it is a short work week and pay day is on Friday.

One staff tells you that the full time cook who is to work at 0930 has called in sick all weekend and won’t be in today. They tried to replace this person but there is no one available to come in. Another staff from the laundry department informs you that the “big” washer is down and that the food service department will not have bibs for the rest of the day. The third staff member informs you that the water will be shut off at 1400 hours for an hour for repairs to the water line.

What do you do first????
 

Professionalism Scenario #2

The facility that you work in has one walk in freezer and two walk in coolers. Overnight, the condenser on the walk in freezer stops working. When the early cook comes into work at 0545 , she immediately realizes the issue when she opens the freezer to get muffins.

She calls maintenance who discover what the problem is and rectifies it. When you report for work at 0900 hours, the unit is running correctly and the staff tell you about the early morning problem.

What is the next step???


Professionalism Scenario #3

You are working the evening shift in a long term care facility and it is mid July. The weather outside is deteriorating rapidly and a tornado has been sighted in the area. The nurse in charge for the evening shift has only worked four shifts as she is new to the facility. She is unaware of the Severe Weather protocol for the facility. All eyes look to you for guidance. 

What do you do?


Food Quality Scenario

Here is a situation that happens today:

We are sharing the kitchen with patient food service. We are the cafeteria team.
My chef brought to my attention that all of our soap spray bottles have disappeared. After a little tour of the department I notice that another group of employees (patient food service) are actually using our spray bottles for cleaning purpose without the right labelling.

What would you do if you were the supervisor???


Quality Management Scenario 

You are the chairperson of the Emergency Response committee.
You work in a long term care facility.
Two fire drills have been conducted in the past week. Staff are expected to respond to the “fire area”. There are written protocols in place.
Each time, another problem has occurred, from improper evacuation of the affected residents to poor communication between the Charge nurse and the care staff. Staff are not following the protocols and when asked, they state that they don’t know what to do.
There have been drills conducted over the past year but not consistently.
There is a Charge person assigned to each nursing unit but they also claim that they are unaware of the procedure.

What is the next step?