Table 1 Actions and strategies implemented to achieve food allergy safety in Hadassah Medical Center
From: Food allergy safety: a descriptive report of changing policy in a single large medical center
Aim and scope of the intervention | Target workstations | Hospital sectors/ employees involved | New practice implemented | Practice prior to intervention |
|---|---|---|---|---|
Getting the intervention approved | Hospital administrators | Hospital director, computer division, risk management dept., quality and safety dept | Approval of the intervention and prioritization of developments in the computerized system | – |
Proper communication: Food allergy documentation | Computerized system | Physician / nurse during patients’ evaluation/ reception | A dedicated list of food allergens: the 9 most common and “other” | A long list of materials (including food, latex). |
Proper communication: Writing instruction for patients’ food trays | Computerized system | Physician / clinical dietitian | Cancellation of “regular diet” as the default diet. Physicians prescribe diet type. To the option, “Allergy Diet by Sensitivity”, additional dietary restrictions may be added (e.g., diabetes diet). | Default diet was “regular diet” |
Proper communication: Enteral feeding instruction | Computerized system | Physician / clinical dietitian | If a food allergy is indicated, an enteral feeding cannot be prescribed. | Enteral feeding instruction for patients with food allergy was possible |
Proper communication and proper food preparation: Notes that label diets in the hospital kitchen | Computerized system | Computer division, kitchen employees | Notes include patients’ details; “Allergy Diet by Sensitivity” and the specified food allergy type are highlighted | The food allergy type was not highlighted |
Proper communication: Daily summary report | Computerized system, hospital kitchen | Food service dietitian, Kitchen management | Daily report of all patients with food allergy in the hospital | – |
Proper communication, and food labeling and delivery to patients: Highlighting food trays with food allergy diets | Hospital kitchen | Kitchen food-distribution manager, Kitchen shift manager | Highlighted placemats for food trays of “Allergy Diet by Sensitivity” | – |
Proper communication and food labeling and delivery to patients: Food tray checkup | Hospital kitchen | Food service dietitian, Kitchen shift manager | Food tray checkup prior to delivery to patients | – |
Defining and identifying food allergens and proper communication: Creating a list with food allergy information | Hospital kitchen, Dept. of Nutrition and Diet | Kitchen shift manager, Kitchen employees | A list of foods that cannot be integrated into allergy food trays according to allergy type and meal type, hung on a kitchen billboard | – |
Proper cleaning and hygiene methods, proper food preparation | Hospital kitchen | Food service dietitian, storekeeper | Sealed food trays delivered from a factory with standards for non-allergen food production | Food prepared in the hospital kitchen |
Proper communication and information distributing: Writing a procedure for food preparation and delivery to patients with food allergies | Dept. of Nutrition and Diet | Director of the Dept of Nutrition and Diet, the hospital procedures writing manager | A written procedure for food preparation and delivery to patients with food allergies, to inform all hospital staff | – |
Proper communication and information dissemination: Training program | Hospital kitchen, wards and deliverers to wards | Physicians, clinical dietitians, nurses | Hospital staff and employees’ training program | – |