Lisa Martino, the RD of Pleasant Valley School District, is trying to increase they school participation

rate. Within this scenario, several learning problems were developed:

1. What is a student meal survey?

2. What does a food and nutrition service director do?

3. What is a CQI?

4. What is a fishbone diagram?

5. What is brainstorming?

6. What are the proper handling techniques of milk for schools?

7. How do you determine participation rate?

What is a student meal survey?

- A student meal survey is composed of questionnaires that are given to students regarding the meals eaten at school. These meals include lunch and sometimes breakfast.

-The student meal survey is given to every student regardless if they eat school meals or bring their own meal. This allows for the most accurate results.

- Surveys are created by school groups or clubs, such as Student Government, or larger organizations, such as a university program.

- The purpose of a student meal surveys is to research how students enjoy and perceive the offered meals offered and to better understand the knowledge the students have towards school nutrition.

- Questions are intended to find out information like meal quality, how many students eat the meal and how often, reasons for eating/not eating, favorite items, amount of waste, and potential problems within the meals or services provided.

- Student meal surveys are typically used in a CQI programs. They can be used to first identify areas of improvement and then secondly to evaluate the outcomes of the action plan.

What does a food and nutrition service director do?

- The food and nutrition service director is responsible for overseeing a district-wide nutrition program.

- The job of a food and nutrition service director has job responsibilities in a variety of functional areas including financial management, food production and operation management, menu and nutrition management, just to name a few. Overall, it has been determined that the director’s responsibility spans over 10 functional areas.

- The food and nutrition service director is responsible for the daily operations that involve preparing and serving meals to their specific community.

- The director is responsible for ensuring school meals are age appropriate and appealing to the age group.

- Food and nutrition service directors are in charge of food inventory and the ordering of new food and equipment that is necessary to complete tasks in a timely manner.

- In addition to placing orders correctly, the directors must know the portion sizes of food being served so they will have enough with not much leftover and must also place the order in on time to receive shipments for specific dates.

- Directors also do a lot of administrative work such as payroll, recruiting employees and employee work records.

- Directors within the schools work with families who meet the National School Lunch Program’s income and additional criteria for the student to eat for free or at a reduced price.

- The directors also plan meals to meet the recommendations of the Dietary Guidelines for Americans: no more than 30% of calories from fat, less than 10% from saturated fat, and must provide one-third of RDA for protein, vitamin A, vitamin C, iron, calcium and calories.

What is a CQI?

-CQI stands for continuous quality improvement.

-CQI is a focused management philosophy for providing leadership, structure, training and an environment that is capable for continuously improving all organizational processes.

- In the food service industry, CQI helps an organization works towards providing high quality programs to their customers.

- The purpose of CQI is to continuously improve every process and outcome within each operational section. There is no endpoint in quality efforts and this is a continuous process.

- CQI aims to improve the customer/patient experience and making continuous progress.

- During the course of a CQI, the focus is on the processes rather than people. The program works to improve the process without placing blame on individuals.

-The goal of a CQI program is to incorporate the process into the operation’s daily routine.

- A CQI program involves multiple steps. The steps include:

1. The first step is forming a team that has knowledge of the system needing improvement. This team includes employees with varying degrees of work experience, education, and background.

2. The next step is defining a clear aim for the program. This includes having a deep understanding of the needs of the people who are served by the system. Within this step, the team will also identify and define measures of success.

3. Once the area of improvement has been determined, the team then brainstorms all potential causes that are leading towards the problem. A very useful tool in this process is the creation of a fish diagram.

4. After the causes have been identified, the brainstorming continues to identify potential strategies to improve the problem. This phase will lead to the eventual development of an action plan to solve the problem.

5. With an action plan fully prepared, the next step is the implementation of the action plan.

6. Once the action plan has been developed, the program must be evaluated. This is one of the most important steps in the CQI process because it gives information on if the action plan is successful or not. Without the evaluation process, money and time could potentially be wasted in all this planning when the process hasn’t made the impact that it is intended to have.

7. The last step of a CQI process is the standardization of the CQI process. This step is only to be completed when a successful action plan has been implemented. The determination of success of a plan is based upon the evaluation of the program. The standardization of the CQI process means an implementation of the action plan into organization policy and daily routine.

What is a fishbone diagram?

- A fishbone diagram, also known as a cause and effect diagram, incorporates brainstorming to identify all possible causes of a problem.

- The fish bone diagram can be very useful in finding causes to problems, procedures that are hindering a processes and where the process is falling short.

-The creation of a fishbone diagram includes the following steps:

1. The first step is to clearly identify the problem.

2. The next step is to identifying major categories that that the causes could be sorted under. Examples include materials, methods, training, budget, and staff.

3. After the major categories have been identified, brainstorming process is used to identify causes within each category.

4. Once all of the possible causes have been written down, the last step is to examine the causes that are most likely having the greatest impact of the process.

Effect: Warm Off-flavored Milk

Category Causes

Materials - Refrigerator not working properly (thermostat) - Not enough space to store milk separately from other foods - All milk does not fit properly in refrigerators and is overcrowded - Need for properly calibrated thermometers - Milk packaging material, such as cardboard, is creating an off flavor for the milk

Procedure - Lack of procedure in place for checking temperature and quality - No HACCP plan in place - No clearly determined quality control points (Receiving, storage, and serving) - Too much handling of milk on serving line - Too much exposure to room temperature - Lack of rotation of stock

Staff - Not properly trained to examine milk temperatures upon delivery - Not properly trained to examine milk and check temperatures throughout the day (at each lunch period) - Not properly trained on quality control points (Receiving, storage, and serving) - Not properly trained in FIFO (first-in, first-out) - Lack of training on disposal of spoiled foods

Budget - Not enough budget to train employees - Not enough budget to upkeep equipment/purchase new equipment - Not enough participation in lunch program

What is brainstorming?

- Brainstorming is a technique used to identify the possible causes and solutions to a problem.

- Brainstorming involves all team members and encourages everyone to participate. The diversity of the group is the key to a successful brainstorming session, so participants are ideally varied in their job title, department, skill level, education, and background. When everyone participates, it allows for more creative ideas.

- The brainstorming process typically occurs in sessions where people present any ideas and thoughts that come to their head and the ideas are written down exactly as they are presented on a chart visible for all participants to see. No ideas, no matter how crazy they may seem at first, are criticized or judged.

- The first step necessary to brainstorm is to thoroughly explain the purpose of the session before it begins.

- The whole goal of brainstorming is to come up with ideas and solutions that think outside the box in order to come up with the most likely cause or the best plan of action for a solution.

- Once all ideas have been gathered, the group will go through the ideas and try to narrow down to the best action to solve the problem.

Outcome for Program Improvement: Milk is served at appropriate temperature

Action Plan Measurement Evaluating Measurement Outcome

Person Responsible

Time Line

Evaluate equipment used for milk storage. Replace/repair if necessary

1. Refrigerator stays at appropriate temperature (33°F -41°F) 2. Thermometers are appropriately calibrated 3. Clean and organized milk storage areas

1. Check daily for consistent appropriate temperature (33-41°F) 2. Check for calibration of thermometers weekly 3. Check for spills and milk is stored separately from foods with strong odors after each lunch period and at end of day

Food and nutrition service director and Staff

July

-

Develop new/ update old HACCP plan

HACCP plan follows FDA standards

Refer to standards for HACCP plan and coordinate with newly developed plan

Food and nutrition service director

August

1. Training of staff on HACCP plan 2.Special focus on quality control points ((A)Evaluate upon delivery, (B)checking temperature of storage unit, and (C) evaluating serving temperatures)

1. Follows HACCP standards 2. Quality Control Points A. Temperatures upon delivery are 33-41°F B. Temperature of storage unit is between 33-41°F and checked daily C. Serving temperatures are between 33-44°F

1. Weekly staff meetings to review HACCP to ensure that it is being followed 2. Quality Control Points A. Receiver of shipment checks temperatures upon delivery and records temperatures to ensure its between 33-41°F B. Temperature of storage unit is taken daily and recorded to ensure it is between 33-41°F C. Temperatures of milk are taken and recorded at each lunch period and averaged for the day. All temperatures are required to range between 33-41°F, with an optimal range of 35-37°F

Food and nutrition service director and staff

August

Evaluate packaging

Determine if changing to plastic

- Switch to a plastic milk carton and monitor

Food and nutrition

August- September

materials for the milk

carton from cardboard carton would increase milk satisfaction rate at as acceptable price

student acceptability through surveys.

- Evaluate pricing to ensure new container cost is not overweighing benefit

service director

Student meal survey

- Overall student satisfaction has increased by 15% - Responses to milk questioning show improvement in quality scores

-Student meal survey is developed by food and nutrition service director - Student meal survey is distributed by teachers - Results are analyzed by food and nutrition service director to ensure the student satisfaction has increased by 15% - Complaints about milk temperature and taste are analyzed

Food and nutrition service director (develop) Teachers (administer)

December

Analyze student meal survey responses for milk acceptability and revamp plans of action

New action plan is developed to address areas showing need for improvement

- Food and nutrition service manager reviews student meal survey and asses milk response

Food and nutrition service director

December

Evaluate participation rate

- Student participation rate goal of 50% for first year

- Review and analyze the school year’s participation rate and end of school year. - This participation rate should be compared to previous year. - Student participation rate should reach 50% for first year

Food and nutrition service director

June

What are the proper handling techniques of milk for schools?

- HACCP, hazard analysis and critical control point, conducted a study and found three critical control points for a school milk program: receiving, storage, and serving.

- The starting point for quality control is receiving, which is very important because the state in which the milk is received will affect its quality throughout the rest of the process.

- It is important that the truck in which the milk is delivered is inspected to ensure that it is clean and refrigerated to the appropriate temperate. The crates must then be inspected to ensure that the cartons are clean, sealed, and undamaged

- The “sell by date” must also be checked to verify that the quantity of milk that is received will be used by that date. A sample carton must be chosen to check the temperature to verify that it is 33 to 41°F. The milk must also be sampled through smell and taste. It is important to be conscious of any off odors or flavors. If either of these problems detected, the milk shipment should be rejected.

- The next step is storage. It is crucial the refrigerator or cooler is at the correct temperature (33 to 41°F) before delivery.

- The milk should be put directly into cold storage and the stock should be rotated regularly, with first in, first out method in mind. Milk should also be stored separately from other food products like onions and garlic so it does not absorb the taste.

- The cooler should also be kept clean, odor free, and any spills should be taken care of right away. A regular cleaning and maintenance schedule should be put into place.

- Milk stored outside of the appropriate temperature range will decrease shelf life significantly. The shelf life is shortened by 50% for every 5 degree rise over 40°C.

- The last critical control point is serving.

- Milk should be kept between 33 and 41° throughout the entire serving process. The temperature should be checked and recorded at the beginning, middle, and end of the meal period.

- Milk should be displayed on the serving line, in insulated containers or barrels or in a cooler.

- The students may also be allowed to select their own milk cartons to reduce the amount of handling, which helps to keep the milk colder.

- The FDA food code states that milk taken by a student cannot be redistributed; it must be discarded even if it is unopened. Milk that is kept cold and left on the serving line may be used at another meal.

How do you determine participation rate?

- Participation rate is the number of lunches served in the preceding year (9 months, excluding summer) by schools participating in the program under the terms of the School Lunch Act.

- The median percentile for participation rates in 2011 was 71% according to School Nutrition Operations Report 2011.

- Participation rate reflects the amount of students that purchase lunches at school. Improving the quality of milk may help increase the low participation rate at the Pleasant Valley School District, which has a participation rate of only 21%.

References

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3. "Competencies, Knowledge, and Skills for District-Level School Nutrition Professionals in the 21st Century." Applied Research Division of The University of Southern Mississippi, Mar. 2009. Web. 6 Feb. 2012.

4. "Continuous Quality Imrovement (CQI)." Department of Children & Family Services | State of Louisiana. Web. 4 Feb. 2012. <http://www.dss.louisiana.gov/index.cfm?md=pagebuilder>.

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6. Coppess, Susan, and Jennifer Lewi. "School Nutrition Operations Report 2011: The State of School Nutrition." School Nutrition Association, 2011. Web. 4 Feb. 2012.

7. Gregoire, M. Foodservice Organizations: A Managerial and Systems Approach. 7th ed. Upper Saddle River, NJ: Pearson, Prentice Hall Company, 2010.

8. Lambert, Laurel, Deborah Carr, Shellie Hubbard, Oakley Charlotte, and Travis Brewington. "Continuous Quality Improvement Process Tailored for the School Nutrition Environment." National Food Service Management Institute The University of Mississippi, 2006. Web. 4 Feb. 2012.

9. "National School Lunch Program." Food & Nutrition Service Home Page. Web. 4 Feb. 2012. <http://www.fns.usda.gov/cnd/lunch/>.

10. "Occupational Outlook Handbook, 2010-2011." U.S. Bureau of Labor Statistics. Web. 4 Feb. 2012. <http://www.bls.gov/oco/ocos024.htm>.

11. "Proper Care and Handling of School Milk: A HACCP Case Study - Document #229 - EZ Facts

Safety Info - Lab Safety Supply." Lab Safety Supply - Safety Products, Material Handling,

Industrial Supply, Respirators, Safety Glasses and More! Web. 3 Feb. 2012.

<http://www.labsafety.com/refinfo/ezfacts/ezf229.htm>.

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Baumgartner: Collaborative Creativity and Brainstorming Specialist at Your Service. Web. 04 Feb. 2012. <http://www.jpb.com/creative/brainstorming.php>.

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