By Jo Miller, MPH, RDN, VP of Nutrition and Linda Eck-Mills, MBA, RDN, LDN, FADA, Regional Executive
The health and safety of patients is healthcare’s highest priority, and important considerations to maintain that health and safety during an emergency include both the availability and the skill level of individuals preparing meals. The COVID-19 pandemic has illustrated gaps in staffing assumptions with many Food and Nutrition Services (FNS) departments having staff wearing multiple hats, and they have come up against some very difficult questions:
- What happens when available staff members are not skilled in using food service equipment?
- What if these individuals do not know Hazard Analysis Critical Control Point (HACCP) principles?
- What happens when there are simply not enough — or any — food service staff available to produce meals?
Based on our experiences training essential staff, we recommend creating a detailed plan to prepare meals with limited staffing, practicing frequent and thorough training, and implementing solid infection control protocols to stay ahead in these trying times.
Have a Plan
Emergency menus which require food items to be pulled, combined during preparation, prepared using equipment, then served can be cumbersome or impossible. Sandwiches may be easy to make, but they are very labor intensive. To ensure as little disruption as possible, train all FNS staff, Incident Command staff, and safety team members on all emergency and disaster meal plans – such as Meals for All — identified in a hazard vulnerability assessment. Preparing training manuals and videos in advance may be critical if essential FNS staff are not available during the incident.
Ongoing & Frequent Training
Ongoing training is vital for food service staff so they can continue to provide meals during an emergency, and drills are a critical component of preparedness planning. While healthcare facilities perform annual wide-scale drills in Incident Command or Facilities Management, Food and Nutrition Services does not always take part. FNS departments should consider table-top exercises for each identified community hazard and should work through the exercises with team members as a part of regular in-services. You may also want to consider multiple ways your community will set up traylines depending on the five most likely hazards identified. As well as creating comprehensive table-top exercises, a planogram or detailed drawing of a modified disaster meal trayline could be an essential training component to support staff who are not regular members of the FNS team.
Infection Control Protocols
Managing and eliminating the risk of foodborne illness is critical during a disaster. The CDC highlights this challenge in the May of 2020 issue of Morbidity and Mortality Weekly Report (MMWR) while addressing multiple norovirus outbreaks during the 2018 Camp Fire evacuations (3). Ensure protocols and cross-training for any staff members that may not be a part of the FNS team, store all items to ensure HACCP guidelines are met with your disaster meal plan, and evaluatetime as an alternative to temperature as a public health control measure. If HACCP protocols can be managed in the five most likely hazards identified, then risk of an outbreak can be managed.
Staffing in food service is always a challenge, but as we have learned during the COVID-19 outbreak, managing food service staff during a pandemic is even more difficult. An option for facilities with staff who test positive for the virus, or who need to quarantine after exposure, is to divide remaining essential staff into multiple “quaran-teams”. Quaran-team A may work three 12-hour days while Quaran-team B works four 10-hour days. These social quaran-teams can minimize the number of staff in the department on any given day, thereby reducing the risk of infection and/or possible absences. As winter continues, and the ability to distance six feet apart becomes more challenging, working in quaran-teams may become a more common staffing alternative.
Many healthcare facilities are currently experiencing widespread coronavirus-related staffing shortages throughout the industry, affecting patients’ access to care. Healthcare workers are doing all they can to minimize the impact of these shortages on their patients, and a streamlined, comprehensive emergency meal solution like Meals for All can help. Meals for All’s convenient, complete, regulatory complaint, delicious, and nutritious meals can be easily prepared, even when food service equipment and trained food service staff are unavailable. Meals for All’s comprehensive program and qualified team of Registered Dietitians support Food & Nutrition Services departments while mitigating the effects of staffing shortages in food service.
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