1
Registered Dietitians and the Interdisciplinary Anticoagulation Team Author(s): J. Standfill, A. Pennington, N. Campalans, P. Carroll, T. Pipkin, P. Bryant; Central Arkansas Veterans Healthcare System, Little Rock, AR Learning Outcome: Expanding the role of the registered dietitian as part of an interdisciplinary, anticoagulation team. Anticoagulants, such as Coumadin, are commonly used to treat cardiac disease, cerebrovascular accident and thrombolembolism. The use or misuse carries a significant potential for patient harm. The Department of Veterans Affairs (VA) has created a directive which outlines policy and guidance for the proper management of patients receiving Anticoagulation Therapy which meets the Joint Commission’s National Patient Safety Goal (NPSG 3.05.01). At Central Arkansas Veterans Healthcare System (CAVHS), the Medication Management Program (Coumadin Clinic) has approximately 500 patients with the potential of gaining a total of 2,300 patients with active Coumadin prescriptions in the next two years. The expanded clinic enrollment supported the addition of dietitian positions on the CAVHS Anticoagulation Team. This presented dietitians with a unique opportunity to give more in-depth education to patients with potential food/drug interactions as well as providing medical nutrition therapy for comorbidities for patients in the medical center and on an out-patient basis. Registered dietitians are involved in the interdisciplinary management by participating in local and regional anticoagulation teams and committees. Coumadin dietitians have updated patient educational materials and created low, moderate and high Vitamin K diets for patients receiving Coumadin and meal services. Coumadin dietitians participate in annual continuing education on anticoagulation therapy as well as participating in online discussion boards involved within the VA system. With the successful development of the Anticoagulation Team, Veterans at CAVHS are receiving comprehensive medication management and improved nutritional care. Funding Disclosure: None Mentorship Program for Dietetic Interns in a Canadian Teaching Hospital - Evaluation of 4 Years Experience Author(s): M. McCall; Specialized Complex Care Program, St. Michael’s Hospital, Toronto, ON, Canada Learning Outcome: To evaluate the mentorship program that is provided as a component of the St. Michael’s Hospital Graduate Dietetic Internship. Background: The mentorship program was initiated to provide an added level of personal and professional support to dietetic interns and to foster job enrichment for dietitian mentors. The hope was that mentorship would ease the interns’ transition into hospital culture, the professional world and provide emotional support. Methods: Interns were matched with a mentor at the start of their program, and each pair defined the frequency of meetings based upon their needs. Most interactions were private meetings between the mentor and mentee, although several group outings were also planned each year. Mentors and mentees for four consecutive, separate internship classes were asked to complete an open-ended questionnaire to evaluate the 45 week program. Results: A total of 51/58 participants completed questionnaires. Eighty-four percent of mentees felt that participating in the program was a positive experience. Subjects discussed were varied and included both personal and professional issues. Common topics included life-work balance, family issues, employment advice, stress and workload management. Eight-one percent of mentors said they would participate in the program again. The most cited positive aspects for mentors included providing support outside of an evaluator context, sharing their expertise and personal satisfaction from helping someone new to the profession. Conclusion: Overall, the mentorship component to our Dietetic Internship Program appears to be meeting its objectives and is highly valued by both mentors and mentees. Funding Disclosure: None Creating Sustainability Strategic Plans for Healthcare Foodservice Operations Author(s): D. Henroid, J. Henderson, A. Bhow, L. Vargas, R. Sullivan, F. Rivera; Nutrition & Food Services, University of California, San Francisco (UCSF) Medical Center, San Francisco, CA Learning Outcome: Learn to develop sustainable foodservice operations plans. There are considerable benefits to developing environmentally conscience and sustainable foodservice operations. A comprehensive review of environmentally conscience initiatives were evaluated in a large, urban academic medical center healthcare foodservice department. The initial step was to develop a commitment statement that would formally guide department decision making in evaluating current and future food systems. The next step was to conduct a formal set of analyses following the flow of food from the initial menu planning stage to end consumption utilizing an analysis, plan, implement, evaluate model. Waste streams were delineated between those the department maintain control and those where they did not. Ancillary areas of the department such as the department administrative office were included in a subsequent analysis. An overall sustainability framework was developed in the following areas: 1) food selection and sourcing, 2) packaging and waste management, 3) energy efficiency, 4) policy and practice changes, 5) education and awareness of environmental efforts, and 6) green buildings and facilities. The review revealed opportunities to incorporate sustainable practices in menu development, product selection, procurement practice, waste stream management, and partnership development. Department sustainability efforts were formalized into a strategic plan highlighting previous accomplishments, current programs under development, and future strategic efforts. A number of achievements have been made including a 30% reduction in the number of delivery days from the primary vendor, participation in donation program for waste oil to a bio-diesel cooperative, and the recycling or composting of 84% of retail foodservice waste from a high volume cafe ´. Funding Disclosure: None TUESDAY, OCTOBER 20 RESEARCH & PRACTICE INNOVATIONS: DIETETICS MANAGEMENT, LEADERSHIP, AND EDUCATION (PART 2) A-80 / September 2009 Suppl 3—Abstracts Volume 109 Number 9

Creating Sustainability Strategic Plans for Healthcare Foodservice Operations

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TUESDAY, OCTOBER 20

RESEARCH & PRACTICE INNOVATIONS: DIETETICS MANAGEMENT, LEADERSHIP, AND EDUCATION (PART 2)

A

egistered Dietitians and the Interdisciplinarynticoagulation Team

uthor(s): J. Standfill, A. Pennington, N. Campalans, P. Carroll,. Pipkin, P. Bryant; Central Arkansas Veterans Healthcare System,ittle Rock, AR

earning Outcome: Expanding the role of the registered dietitians part of an interdisciplinary, anticoagulation team.

nticoagulants, such as Coumadin, are commonly used to treatardiac disease, cerebrovascular accident and thrombolembolism. These or misuse carries a significant potential for patient harm. Theepartment of Veterans Affairs (VA) has created a directive whichutlines policy and guidance for the proper management of patientseceiving Anticoagulation Therapy which meets the Jointommission’s National Patient Safety Goal (NPSG 3.05.01). Atentral Arkansas Veterans Healthcare System (CAVHS), theedication Management Program (Coumadin Clinic) has

pproximately 500 patients with the potential of gaining a total of,300 patients with active Coumadin prescriptions in the next twoears. The expanded clinic enrollment supported the addition ofietitian positions on the CAVHS Anticoagulation Team. Thisresented dietitians with a unique opportunity to give more in-depthducation to patients with potential food/drug interactions as well asroviding medical nutrition therapy for comorbidities for patients inhe medical center and on an out-patient basis. Registered dietitiansre involved in the interdisciplinary management by participating inocal and regional anticoagulation teams and committees. Coumadinietitians have updated patient educational materials and createdow, moderate and high Vitamin K diets for patients receivingoumadin and meal services. Coumadin dietitians participate innnual continuing education on anticoagulation therapy as well asarticipating in online discussion boards involved within the VAystem. With the successful development of the Anticoagulationeam, Veterans at CAVHS are receiving comprehensive medicationanagement and improved nutritional care.

unding Disclosure: None

entorship Program for Dietetic Interns in a Canadianeaching Hospital - Evaluation of 4 Years Experience

uthor(s): M. McCall; Specialized Complex Care Program, St.ichael’s Hospital, Toronto, ON, Canada

earning Outcome: To evaluate the mentorship program that isrovided as a component of the St. Michael’s Hospital Graduateietetic Internship.

ackground: The mentorship program was initiated to provide andded level of personal and professional support to dietetic internsnd to foster job enrichment for dietitian mentors. The hope was thatentorship would ease the interns’ transition into hospital culture,

he professional world and provide emotional support.

ethods: Interns were matched with a mentor at the start of theirrogram, and each pair defined the frequency of meetings based uponheir needs. Most interactions were private meetings between theentor and mentee, although several group outings were also

lanned each year. Mentors and mentees for four consecutive,eparate internship classes were asked to complete an open-endeduestionnaire to evaluate the 45 week program.

esults: A total of 51/58 participants completed questionnaires.ighty-four percent of mentees felt that participating in the programas a positive experience. Subjects discussed were varied and

ncluded both personal and professional issues. Common topicsncluded life-work balance, family issues, employment advice, stressnd workload management. Eight-one percent of mentors said theyould participate in the program again. The most cited positivespects for mentors included providing support outside of anvaluator context, sharing their expertise and personal satisfactionrom helping someone new to the profession.

onclusion: Overall, the mentorship component to our Dieteticnternship Program appears to be meeting its objectives and is highlyalued by both mentors and mentees.

unding Disclosure: None

-80 / September 2009 Suppl 3—Abstracts Volume 109 Number 9

reating Sustainability Strategic Plans for Healthcareoodservice Operations

uthor(s): D. Henroid, J. Henderson, A. Bhow, L. Vargas,. Sullivan, F. Rivera; Nutrition & Food Services, University ofalifornia, San Francisco (UCSF) Medical Center, San Francisco, CA

earning Outcome: Learn to develop sustainable foodserviceperations plans.

here are considerable benefits to developing environmentallyonscience and sustainable foodservice operations. A comprehensiveeview of environmentally conscience initiatives were evaluated in aarge, urban academic medical center healthcare foodserviceepartment. The initial step was to develop a commitment statementhat would formally guide department decision making in evaluatingurrent and future food systems. The next step was to conduct aormal set of analyses following the flow of food from the initial menulanning stage to end consumption utilizing an analysis, plan,mplement, evaluate model. Waste streams were delineated betweenhose the department maintain control and those where they did not.ncillary areas of the department such as the departmentdministrative office were included in a subsequent analysis. Anverall sustainability framework was developed in the followingreas: 1) food selection and sourcing, 2) packaging and wasteanagement, 3) energy efficiency, 4) policy and practice changes, 5)

ducation and awareness of environmental efforts, and 6) greenuildings and facilities. The review revealed opportunities toncorporate sustainable practices in menu development, productelection, procurement practice, waste stream management, andartnership development. Department sustainability efforts wereormalized into a strategic plan highlighting previousccomplishments, current programs under development, and futuretrategic efforts. A number of achievements have been madencluding a 30% reduction in the number of delivery days from therimary vendor, participation in donation program for waste oil to aio-diesel cooperative, and the recycling or composting of 84% ofetail foodservice waste from a high volume cafe.

unding Disclosure: None