Food safety in hospitals should be of the utmost importance because their populations are at a higher risk of developing a foodborne illness. “Patients may be elderly, have a chronic disease, or take medications that compromise their immune system, making it harder for them to fight an infection if they consume contaminated food,” says Sharon McDonald, MEd, RD, LDN, senior extension educator/food safety specialist, Penn State Extension, University Park, Pa.
Chemotherapy patients in particular are at risk for foodborne illness because in addition to destroying cancer cells, this cancer treatment attacks healthy cells—especially those that divide quickly such as bone marrow, which produces red and white blood cells and platelets. “With fewer white blood cells, which fight infection, it becomes more difficult to ward off harmful microorganisms that can cause illness and to fight off illness if it occurs,” McDonald says.
Ted Flood, CDM, director of food and nutrition, Tufts Medical Center, Boston, Mass., says chemotherapy patients are put on special diets, which exclude uncooked fruits and vegetables—which are more prone to harmful bacteria.
At University of Wisconsin Health, Madison, Wis., Liz Reynolds, MS, RDN, culinary education specialist, says the institution has administrative policies in place that govern its food safety procedures and operations. “We are routinely inspected by local and state regulatory authorities, like any food service establishment,” she says. Hospital inspection agencies such as The Centers for Medicare & Medicaid Services and The Joint Commission regularly conduct inspections.
McDonald says hospital food service departments have policies and procedures that address food safety, such as recording a food’s final cooking temperature, monitoring refrigeration temperatures, monitoring temperatures of food before and after service, cleaning and sanitizing procedures for equipment, and monitoring temperatures in dishwashing machines.
Flood says daily checklists, monitoring patient traylines, and completing tray accuracy reports help keep patients safe. Quality audits—conducted by an outside firm—ensure that food service workers follow food safety standards.
McDonald believes a challenge is helping hospital staff to understand their roles in keeping food safe, and to keep this top of mind. “This requires not only initial training, but refresher training as well so what they do related to food safety becomes second nature,” she says. “Staff should also feel comfortable taking action if a problem could compromise food safety. Staff in other hospital areas need to understand safe food handling practices as well, such as storing food or reheating food on nursing units.”
Reynolds says training and educating staff is an ongoing process. Solid operational systems ensure that all the little details critical for food safety are in place, so staff works in unison.
To enforce food safety in hospitals, McDonald advises making sure food service staff have a basic knowledge of how a foodborne illness can occur. “This requires understanding how bacteria, viruses, parasites, and people can contaminate food,” she says. “This foundational knowledge can then be tied into their responsibilities.” For example, if staff know that cooking foods to a specific temperature will destroy bacteria, then they can understand why it is critical to check a food’s final temperature.
All new staff at University of Wisconsin Health are required to complete a food safety training course before entering the kitchen or serving patients. “This ensures that we provide thorough training on our standards and what we expect in our kitchens,” she says. “The key is to keep staff well informed and to give them the tools they need to succeed.”