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Biomedical subjects

M B Gregoire

Publications and source records attributed to M B Gregoire.

At least 19 recordsLinked to original sources
PubMed2000

Current and future practices in hospital foodservice.

OBJECTIVES: To identify current operational practices and expectations for future practices in hospital foodservice; establish the probability that current practices will change; and determine whether differences in practices exist on the basis of profit status and hospital size. DESIGN: A questionnaire, to determine current practices, probability of change, and expectations for future practices, was mailed to foodservice directors. SUBJECTS: A random sample of 500 foodservice directors in US hospitals with 200 or more beds. A total of 214 questionnaires were returned for a response rate of 43%. STATISTICAL ANALYSIS: Descriptive statistics were used to report current practices, probability of change, and expectations for future practices. The Kruskal-Wallis test was conducted to examine whether the probability of change ratings differed on the basis of hospital profit status and size. chi 2 Analysis was used to examine whether expectations for future practices differed based on hospital profit status and size. RESULTS: Currently 81% of hospital foodservice departments have fewer than 100 employees; 73% have revenue budgets of less than $2 million; 49% have expense budgets greater than $2 million; 55% use a selective menu, often (43%) 1-week in length; 74% use conventional food production technology; 81% have a centralized, hot tray line; 91% operate a cafeteria; 96% do on-site catering; 69% have differential pricing for employee meals; 58% have subsidized employee meals; and 19% have coffee kiosks. Changes in current practices are expected in several areas. Foodservice directors expect to serve meals to fewer inpatients (71%), employ less staff (73%), have smaller expense budgets (70%), and generate more revenue (61%). Kruskal-Wallis and chi 2 analyses indicated few differences on the basis of hospital profit status and size. There was little consensus among directors on how to best respond to these environmental changes. APPLICATIONS: Hospital foodservice practices will change in the future. Foodservice directors are using a variety of strategies (e.g., revenue-generating ventures, menu changes) to respond to current environmental changes. Increased emphasis will be placed on running a hospital foodservice department as a profit center rather than a cost center.

Food Service, Hospital↗
PubMed2000

Bitter taste perception and severe vomiting in pregnancy.

Hyperemesis gravidarum or severe vomiting during pregnancy is a condition of elusive etiology that can harm both mother and fetus. This study examined the association between increased bitter-taste perception and history of hyperemesis gravidarum. Bitter-taste perception varies genetically and can be altered with conditions that damage taste-related cranial nerves. Sixty women were divided into high- (n = 21) and low-vomit (n = 39) groups based on vomiting exposure across all pregnancies and were screened for genetic variation in taste with bitterness of saturated 6-n-propylthiouracil (PROP) delivered on filter paper. Supertasters perceive PROP as intensely bitter; nontasters, as only weakly. Each reported their history of dysgeusia (persistent taste) and taste-related pathology (otitis media and head trauma). The vomit groups did not differ in the frequency of supertasters, but the high-vomit group had fewest nontasters. The high-vomit group also reported dysgeusia most frequently. A subsample (13 high-vomit and 18 low-vomit women) rated the taste intensity of sodium chloride (1 mol), sucrose (1 mol), citric acid (0.0032 mol), and quinine hydrochloride (0.001 mol) applied to areas innervated by cranial nerves VII and IX. The groups only varied significantly in bitterness of quinine hydrochloride. High-vomit women tasted least bitterness on the anterior tongue (chorda tympani branch of VII) and highest bitterness on the posterior tongue (cranial nerve IX) and palate (superficial petrosal branch of VII). In high-vomit women, elevated bitterness on the posterior tongue and palate does not appear related to hydrochloric acid exposure in vomitus; it may explain the occurrence of dysgeusia. This pattern of spatial taste perception may indicate altered oral sensations that if present during pregnancy, could increase the risk of hyperemesis.

Adult↗
PubMed1998

Quality ratings of a hospital foodservice department by inpatients and postdischarge patients.

OBJECTIVES: To examine quality of food and nutrition services using the ratings of inpatients and patients who had been discharged (postdischarge patients). DESIGN: Questionnaires were used to collect perceptions of inpatients and postdischarge patients on the quality of food and nutrition services. A 5-point scale allowed subjects to rate quality from very poor to very good. SUBJECTS: Questionnaires were completed by 252 inpatients and 437 postdischarge patients of a midwestern teaching hospital. STATISTICAL ANALYSIS: Analysis of variance was used to assess differences in quality ratings on the basis of demographic variables. Stepwise regression was used to determine variables that best predicted overall satisfaction. Paired t tests were conducted to compare matched inpatient and postdischarge ratings. RESULTS: Ratings of food and nutrition services indicated that patients were satisfied; few differences were found in ratings on the basis of patient demographics. Food quality was the best predictor of overall satisfaction for both inpatients and postdischarge patients. As patient expectations were increasingly met or exceeded, patient ratings of quality increased. The majority of patients in the matched sample gave the same ratings on the inpatient and postdischarge questionnaires. APPLICATIONS: Foodservice managers who desire to improve patient satisfaction should focus attention on meeting or exceeding patient expectations for food quality.

Adult↗
PubMed1997

Profitability and acceptability of fat- and sodium-modified hot entrees in a worksite cafeteria.

OBJECTIVES: To compare the acceptability of fat- and sodium-modified entrees before and after implementation of a marketing program and to determine the effect offering and marketing these healthful entrees had on total cafeteria and entree sales in a worksite cafeteria. DESIGN: The research was conducted in five phases, including sales data collection, acceptance testing of unmodified hot entrees, acceptance testing of modified entrees, and implementation of a marketing campaign for promoting low-fat, sodium-controlled food selections. SETTING: The Kansas Farm Bureau and Affiliated Services (KFB) employee cafeteria. SUBJECTS: KFB employees who ate lunch in the employee cafeteria and were willing to participate in the study. MAIN OUTCOME MEASURES: Sales data (percent of customers purchasing a modified entree and sales of modified entree as a percent of total sales); nutrient analysis data (energy, grams of total fat, percent of energy from fat, milligrams of cholesterol, and milligrams of sodium); and acceptability data (11 characteristics were measured using a seven-point hedonic scale). STATISTICAL ANALYSIS PERFORMED: General linear model analysis of variance was used to compare sales data from phases 1 to 5 and to compare acceptability data from phases 2 to 4. RESULTS: No significant differences in sales data were observed during the 7-month study. No significant changes in overall acceptability were found for any entree. However, customers tended to rate overall acceptability higher when entrees were marketed as lower in fat and sodium. APPLICATIONS/CONCLUSIONS: Customers in worksite cafeterias may be more willing to tolerate changes in flavor attributes when modified entrees are marketed as "healthful" and nutrition information is available.

Diet, Fat-Restricted↗
PubMed1997

Analysis of the decision to select a conventional or cook-chill system for hospital foodservice.

OBJECTIVE: The objectives of this study were to determine what variables hospital foodservice directors consider when selecting a conventional or cook-chill system, to determine the importance of each variable considered, and to compare decision variables by type of foodservice system. DESIGN: Survey questionnaire. SUBJECTS/SETTING: Hospital foodservice directors in general, medical-surgical hospitals who had been involved in the decision to select a conventional or cook-chill system (N = 127). STATISTICAL ANALYSIS: Analysis of variance and chi 2. RESULTS: The decision process used by foodservice directors who selected a conventional system appears to differ significantly from the process used by directors who selected cook-chill systems. However, directors in this study who selected a cook-chill system were more likely than those who selected conventional systems to consider more issues in the decision process, visit other operations, place more importance on return on investment and projected labor costs, calculate more values, consider both conventional and cook-chill options, and use nonfoodservice personnel such as manufactures' representatives and consultants. APPLICATIONS: Results of this research suggest that the decision process to select a foodservice system in hospitals is complex and is one that foodservice directors will likely be involved in several times throughout their careers. Directors who have made such decisions appear to consider many issues, both quantitative and qualitative, when selecting either a conventional or cook-chill system. Regardless of the system chosen, directors indicated that numerous issues were important in the decision.

Analysis of Variance↗
PubMed1994

Quality delegation grid: a decision tool for evaluating delegation of management tasks in hospital dietetics departments.

This research was designed to determine perceptions of the quality of task performance; identify personnel currently performing selected management and food production tasks in a hospital dietetics department; and develop a grid for examining delegation strategies. Information on task quality and delegation was obtained from 309 dietitians and 208 support personnel in 151 hospitals. This information was used to develop a quality delegation grid. The grid is divided into four quadrants: High Quality/High Delegation; High Quality/Low Delegation; Low Quality/High Delegation; and Low Quality/Low Delegation. The grid was used to evaluate the delegation of management tasks reported by participants in this study. Our results indicated that the majority of tasks were placed in the High Quality/High Delegation quadrant (28 tasks) and the Low Quality/Low Delegation quadrant (17 tasks), suggesting that delegation was appropriate for the quality expected if the task was delegated. Three tasks were placed in the Low Quality/High Delegation quadrant indicating that tasks were delegated even though quality of the completed task was perceived as low when delegated, suggesting that dietitians should have performed these tasks themselves. Four tasks were placed in the High Quality/Low Delegation quadrant indicating that dietitians were performing tasks that were perceived to have high quality when performed by support personnel, yet these tasks were rarely delegated. Foodservice directors could use the grid to identify training needs, differentiate perceptions between dietitians and support personnel, and evaluate current delegation patterns.

Dietetics↗
PubMed1994

Quality of patient meal service in hospitals: delivery of meals by dietary employees vs delivery by nursing employees.

OBJECTIVE: To compare patient assessment of meal-service quality and employee-service orientation in hospitals where dietary employees deliver meals trays and in hospitals where nursing employees deliver meal trays. DESIGN: Survey. SETTING: General, medical-surgical (not Veterans Administration) hospitals of 300 to 500 beds with a self-operated foodservice department and a centralized, conventional food production system. SUBJECTS: 552 patients and 192 employees in nine hospitals geographically dispersed in the midwestern and eastern United States. Dietary employees delivered meal trays in five of the hospitals and nursing employees delivered trays in four. MAIN OUTCOME MEASURES: On a five-point scale, patients indicated level of agreement with 16 statements about hospital meal service. Employees who delivered meal trays rated their agreement with 20 service orientation statements on a five-point scale. STATISTICAL ANALYSIS: Factor analysis with varimax rotation, chi 2 analysis, and analysis of variance. RESULTS: Patient assessment of the quality of meal service was multidimensional. Patients gave more positive ratings to characteristics of the personnel delivering the tray than to the quality of the food. Patients in hospitals were dietary employees delivered meal trays rated the quality of food significantly higher (P < .01) than did patients in hospitals where nursing employees delivered trays. Service orientation of the personnel delivering the trays was also multidimensional. Dietary and nursing employees did not differ in their personal motivation toward providing service; however, dietary employees rated the organizational support for providing service significantly higher (P < .001) than did nursing employees. Nursing employees were significantly more positive (P < .05) than dietary employees about their interactions with patients. CONCLUSIONS: Patient perceptions of service quality differed in hospitals where dietary employees delivered meal trays and in those where nursing personnel delivered trays. Dietary and nursing employees differed in some aspects of their service orientation.

Adult↗
PubMed1993

Relevance of competencies to graduate education and experience in foodservice management.

The objectives of this research were to identify professional and educational characteristics of graduates from master's degree programs in foodservice management; determine the relevance of specific concepts to present professional responsibilities; rate the quality of master's degree educational preparation; and determine whether competence was gained from sources other than the graduate program. Participants were 85 graduates of master's degree programs in foodservice management (1980 through 1988) from five universities. The research instrument contained three scales to assess 43 foodservice management concepts regarding relevance, educational preparation, and competence gained from other sources. Demographic information was also requested. The most commonly held present position was foodservice director. Graduates were most likely to be employed in health care facilities or colleges and universities. All concepts were rated as relevant to graduates' present professional responsibilities, and quality of educational preparation was rated satisfactory or better. Principal component analysis, using a varimax rotation, resulted in four factors, which were titled food production, management, organizational communication, and strategic thinking. Analysis of variance was conducted to determine whether differences existed in the factor scores on the basis of position title or graduate program attended. Foodservice directors rated the food production and management of organization factors more relevant to their present position than did clinical dietitians. Scores for quality of educational preparation for the four factors did not differ on the basis of graduate program attended.

Analysis of Variance↗
PubMed1993

Use of capital budgeting techniques by foodservice directors in for-profit and not-for-profit hospitals.

Foodservice directors, who often control one of the largest cost centers in the hospital, are being challenged to manage resources more effectively. Capital budgeting techniques can help enhance a department's cost-effectiveness. The purpose of this study was to assess the use by foodservice directors in nongovernment, not-for-profit and investor-owned, for-profit hospitals of capital budgeting techniques such as payback period, average accounting rate of return, net present value, profitability index, and internal rate of return. Data collected from 84 directors included their use of capital budgeting techniques and operational information about their department. Results indicated that not-for-profit hospital foodservices had significantly more full-time equivalent employees than for-profit hospital foodservices--means of 66 and 52, respectively. Size of capital budget was not strongly correlated with any of the operational variables measured. Many of the directors in both types of hospitals used some capital budgeting techniques. However, directors in for-profit hospitals were much more likely than those in not-for-profit hospitals (92% vs 72%) to use capital budgeting techniques.

Analysis of Variance↗