INTRODUCING A FOOD MANAGEMENT SYSTEM FOR

HOSPITALS (HACCP)

Principle Behind HACCP

SAFE INGREDIENTS + SAFE PROCESS =

A SAFE PRODUCT

Definitions – Important to Understand

• HAZARD – Anything that may cause a food to become unsafe for humans to eat

• RISK – The probability of that hazard occurring

CONTROL

DefinitionsHAZARD = Risk of serving uncooked chicken to Patients / Customers

RISK = What is the likelihood of this occurring ?

CONTROL

WHAT TYPE OF HAZARDS CAN EXIST IN A CATERING FACILITY…

HAZARDS

PHYSICAL

CHEMICAL

BIOLOGICAL

PRODUCE SAFE FOOD

FIT TO EAT

Existing Essentials Requirements

Before the implementation of HACCP - See Annex A -

• High standards of design & maintenance MUST already exist in the kitchen & ancillary areas

• Staff MUST already be suitably trained and be receiving regular good in-house food hygiene training

• Senior Management MUST fully support the HACCP concept with equal support given to the Food Services Manager in provision of time & resources

Understand the 4 C’s Concept• C – Good Hygiene practice prevents Cross

Contamination

• C – Effective Cleaning removes harmful bacteria and stops them spreading

• C – Effective Chilling prevents harmful bacteria multiplying

• C – Thorough Cooking kills bacteria

STAGE 1 – DEVELOPING A HACCP PLAN

1. Food Services Supervisor

2. Dietician

3. Head Chef

4. Infection Control Nurse

5. External Advisors

1. Give a description of the food, ingredients, processing methods and delivery to their customers.

2. Include all possible menu Items & special occasion menus

3. Similar foods group them together e.g. raw meat to be chilled, placed in a heated servery or trolley then served

1. These will be visitors, staff and patients.

2. Some patients may have specific dietary needs e.g. low sugar (diabetics), or specific allergies e.g. nuts

1. The purpose of this is to provide a clear outline of the steps involved in the process

RECEIVING

STORING

PREPARING

COOKING

SERVIING

The Team should perform an onsite review of the operation to verify the accuracy of the flow diagram

TASK

Describe Food &

Distribution

Describe the Consumers

Create Flow Diagrams

Verify the Flow Diagrams

Assemble a HACCP Team

The HACCP Team Should:1.

2.

3.

4.

5.

PURCHASE

DELIVERY

DRIED GOODS STORAGE

CHILLED FOOD STORAGE

COOLING

RE-HEATING

SERVERY

FREEZER STORAGE & DEFROSTING

FOOD PREPERATION

COOKING

PLATING UP TROLLY & DELIVERY

EXAMPLE FLOW PLANPurchase of Raw Chicken

& Ingredients

Storing (Freezer)

Defrosting (Fridge)

Prep (Cleaning, portioning,)

Trolley Delivery

Cooking

Hot – Holding (Bain Marie)

Plating Line

Serving

Producing Curry Chicken

COOKING

SERVE HOT

PURCHASE

RECEIPT

STORAGE

PREPERATION

CHILLED

FROZEN

DRY

HOT HOLD

SERVE HOT

SERVE COLD

COLD HOLD

SERVE COLD

EXAMPLE FLOW PLAN

RE-HEAT

SERVE HOT

CHILL

There Are 7 Stages of HACCP

1. Conduct a hazard analysis i.e. look for hazards

2. Determine the Critical Control Points (CCP’s)3. Implement effective controls at the CCP’s

4. Implement monitoring systems at the CCP’s

5. Establish Corrective Actions

6. Verify & Review Procedures

7. Establish record keeping and documentation procedures

COOKING

SERVE HOT

PURCHASE

RECEIPT

STORAGE

PREPERATION

CHILLED

FROZEN

DRY

HOT HOLD

SERVE HOT

SERVE COLD

COLD HOLD

SERVE COLD

WHAT AREA DO YOU THINK IS MOST IMPORTANT TO

MAINTAIN FOOD SAFETY??

RE-HEAT

SERVE HOT

CHILL

STAGE No1: - Carry out a Hazard Analysis of the Catering Operation

WHAT HAZARDS

MAY EXIST IN A CATERING OPERATION

PHYSICAL

CHEMICAL

BIOLOGICAL

REMINDER:

Example of a Hazard Analysis Form: (See Form A)

STEP HAZARDSWHAT COULD GO WRONG?

CONTROLWHAT CAN I

DO ABOUT IT?

CONTROL ADEQUATE

(Y/N)

IS THIS CONTROL CRITICAL TO ENSURE THE FOOD IS SAFE TO

EAT? - CCP? (Y/N)

MONITORINGHOW CAN I

CHECK?

WHO DOES THE CHECK?

CORRECTIVE ACTIONS

WHAT IF IT’S NOT

ALRIGHT?

Purchase and Delivery

Storage

Preparation

Cooking

Cooling

Chilled Storage

Hot Holding

Re-Heating

Serving

Example of a Hazard Analysis Form: (See Form A)

STEP HAZARDS

WHAT COULD GO WRONG?

CONTROLWHAT CAN

I DO ABOUT IT?

CONTROL ADEQUATE

(Y/N)

Purchase and Delivery

StorageBiological: - growth of bacteria.- Cross contamination

Biological: - growth of bacteria.

- cross contamination of bacteria from raw to ready to eat food.

Physical- Pest contamination

- Mold

Chemical- Cleaning agents

contamination

- Pesticides

STAGE No2 : - Determine the Critical Control Point (CCP’s)

STEP HAZARDSWHAT COULD GO WRONG?

CONTROLWHAT CAN I

DO ABOUT IT?

CONTROL ADEQUATE

(Y/N)

IS THIS CONTROL CRITICAL TO ENSURE THE FOOD IS SAFE TO

EAT? - CCP? (Y/N)

Purchase and Delivery

Storage

Preparation

Cooking

Cooling

Chilled Storage

Hot Holding

Re-Heating

Serving

Critical..??

STAGE No2 : - Determine the Critical Control Point (CCP’s)

• A CCP is an identifiable point in a process whereby a control or safety measure MUST be applied to remove a hazard from a food or a step which is required to make the food safe e.g.:

• Example 1: Cooking A Burger From Raw. If the burger is undercooked, any harmful bacteria present in the meat will not be destroyed and the surviving bacteria could give your customer food poisoning. In this example, ‘cooking’ is a Critical Control Point (CCP) in the food preparation process.

Example 2: Cooling Rice. If recently cooked rice is cooled too slowly, it

could give your customer food poisoning. In this example, ‘cooling’ in a food process is a Critical Control Point (CCP).

STAGE No2 : - Determine the Critical Control Point (CCP’s)

Example 3: Preparing Raw Vegetables for Cooking. A person is preparing raw vegetables by peeling and washing them. Is this a critical control point?

Example 4: Preparing Raw Vegetables For A Salad. A person is preparing raw vegetables for inclusion into a salad bar. Is this a critical Control Point

STAGE No2 : - Determine the Critical Control Point (CCP’s)

THE CCP DECISION TREE:

Setting Of Critical Limits at Identified CCP’s

• You’ve identified a area in the food process which needs to controlled to ensure food is prepared safely.

• You now need to set a “Critical Limit” i.e. what factor needs to be measured and / or controlled to ensure food is safe to eat e.g. time/temperature, concentration of chlorine

• An example of a critical limit, may be that already set by law or regulation (such as in the SASC "Poultry must be cooked so that all parts reach a minimum of 165oF (74oC))"

STAGE No3: - Implement Effective Controls at the Identified CCP’s

STEP

HAZARDSWHAT COULD GO WRONG?

CONTROLWHAT CAN I DO ABOUT IT?

CONTROL ADEQUATE(Y/N)

IS THIS CONTROL CRITICAL TO ENSURE THE FOOD IS SAFE TO EAT? - CCP? (Y/N)

MONITORINGHOW CAN I CHECK?

WHO DOES THE CHECK?

CORRECTIVE ACTIONSWHAT IF IT’S NOT ALRIGHT?

CookingInsufficient cooking time.Survival of bacteria …..

Correct Time for cooking.Correct temp achieved……..

No – Additional staff awareness training required by staff

Yes – Temperature checks conducted on every batch.Temperature results are recorded.

Cooling

1. In setting any critical limit it must be based on common sense and recognized as a control which will prevent, eliminate or reduce a hazard to an acceptable level. 2. A critical limit maybe based upon factors such as:

- Time- Temperature- Physical parameters- Available Chlorine e.g. used to disinfect ready to eat fruit & vegetables - Preventing Cross- Contamination

Record what CCPs you have introduced onto your HACCP Record

Sheet

Monitoring:• And / or you can use

technical equipment:

Whatever method you use to have a successful HACCP program you must physically record the

results of your monitoring.

• Can be very simple from using your human senses:

Monitoring Must Be:• Accurate - Be aware of false or same readings• Representative – Batch monitoring / product size• Unbiased – Staff should not change results• Competently Done – Conducted by competent /

trained staff who know what they are doing and can implement corrective action.

• Timely – Carried out regularly and in a timely manner• Supervised – Check the records. Enforce the checks

HAZARD STAGE No5: - Establish Corrective Action

So you’ve identified a PROBLEM or potential failure in one of your food processes –

What are you going to do to correct it?

1st response – Protect the consumer and deal with the Food

2nd response – Deal with the cause. Investigate & identify the cause of the problem & correct it.

Examples of Corrective Actions:

1. What is the problem?2. Where / how can it be dealt with? 3. When will it be dealt with?4. Who can deal with it?

Example 1. Chicken probed on removal from oven is 69oC (156oF) core temp

Return it to the oven

Until core temp >75oC (165oF) min 30secBy Master chef who: 1st - Protects the consumer by not

allowing the undercooked poultry to be served to patients.

2nd - Corrects the cause of non-compliance e.g. returns the chicken to the oven for a longer time

Chicken is undercooked

In any Corrective Action scenario, you need to ask yourself the following questions:

WHAT DO YOU THINK ?

Example 2. Delivery of dairy food from local supplier in an un-refrigerated vehicle

Milk, yogurts and cream all warm to touch

Reject delivery & return it to supplier

Prior to receipt of food by the catering unit

By Master chef who: 1st - Protects the consumer by not

allowing the potentially high risk un-refrigerated dairy products to be used for catering purposes.

2nd - Corrects the cause of non-compliance e.g. rejects delivery & reassess competency of supplier

Examples of Corrective Actions:As before In any Corrective Action scenario, you need to ask yourself the following questions:

1. What is the problem ?2. Where can it be dealt with ?3. When can it be dealt with ?4. Who can deal with it ? WHAT DO YOU

THINK ?

STEP

HAZARDSWHAT COULD GO WRONG?

CONTROLWHAT CAN I DO ABOUT IT?

CONTROL ADEQUATE(Y/N)

IS THIS CONTROL CRITICAL TO ENSURE THE FOOD IS SAFE TO EAT? - CCP? (Y/N)

MONITORINGHOW CAN I CHECK?

WHO DOES THE CHECK?

CORRECTIVE ACTIONSWHAT IF IT’S NOT ALRIGHT?

CookingInsufficient cooking time.Survival of bacteria……….…………

Correct Time for cooking.Correct temp achieved……..………………

No – Additional staff awareness training required by staff………..…………….

Yes – Temperature checks conducted on every batch.Temperature results are recorded……………..…………………

Check core temp >72oCComplete temperature records………….

Chef, Master-chef

Cooling

HAZARD STAGE No5: - Establish the Corrective Actions

Your Corrective Actions must be written into your HACCP plan. It is essential that staff are trained accordingly on all these Corrective Actions and know what to do.

VERIFICATION

HAZARD STAGE No6: - Verify & Review Procedures

“…checking that the safety measures that you have implemented are working correctly..”i.e. correct temp & time visual checks etc

Check It & Review It?

What else can you see that may be

wrong here?…..look…

Consider reviewing the HACCP plan when:

• Operations Change e.g. new equipment

• Consumer Groups Change e.g. new patients, diabetics

• Indication of HACCP plan failure e.g. insect found in food or complaints of food being cold

HAZARD STAGE No7: - Establish Records and Documentation Procedures

Use the Hazard Plan & Examples Template Forms (A-N) Located in the Safer Food Better Business Folder

A. Hazard Analysis FormsB. Approved Hospital Suppliers ListC. Delivery Check RecordD. Fridge Temperature ChecksE. Freezer Temperature ChecksF. Defrosting Temperature/Time

ChecksG. Cooking Temperature RecordsH. Servery Temperature RecordsI. Trolley Temperature RecordsJ. Training RecordsK. Cleaning ScheduleL. Pest Control RecordsM. Probe Thermometer Maintenance

RecordsN. Internal AuditO. HACCP Diary Planner

ANNEX PAGES IN FOOD SAFETY GUIDANCE NOTES

• A – Essential Programs Needed Before The Implementation of HACCP

• B – Useful Guidelines For Typical Hospital

• C – Tips on the Correct Use of Thermometers

• D – Food Safety Training Programs

HAZARD STAGE No7: - Establish Records and Documentation Procedures

Questions that you constantly need to ask…..

Check your records every daily or weekly.

Are your control adequate

Periodically review your HACCP system – any changes needed?

Physically check potentially hazards.

Do not assume…

Are all your employees trained? Do they understand your

recording procedures and what to do if something goes wrong?

Any customer complaints?

Any new chemicals being used?

FINALLY…….ANY QUESTIONS?

WHAT NOW!• Complete the Hazard Analysis

Form• Amend your Policies &

Procedures• Amend Monitoring / check

forms• Train Your Staff• Revisit Date…….

Assignment• Hend Ahmed Ibrahim.

Recommended text book• Janet Brown