Karina Almanza, CSUN 2017-2018 Dietetic Intern

R.D., Deborah Lomax, Pacifica Hospital of the Valley

Selective Menu: Menu, Staff and Budget Proposal

Pacifica Hospital of the Valley is committed to providing the highest quality care to its
patients in a culturally sensitive environment and provides Spanish-speaking physicians and staff on all
units. We endeavor to make our patients stay as comfortable and familiar as possible by including
elements of their culture through ethnic hospital meals.

Introduction
Traditionally, Pacifica Hospital of the Valley has used the non-selective menu platform that
allows for consistency and limitations of variable menu items. While it accomplishes the goal of serving
the maximum capacity of all 244 patients that are usually located on the facility, it hinders the opportunity
for providing the highest quality care to patients-- one of Pacificas many goals.
When comparing a non-selective menu versus a selective menu, the non-selective menu,
sometimes referred to as a house menu, is limited to only one option and/ or menu category. Whereas a
selective menu offers at least two or more choices per each menu category. On the last page of this
proposal, there is a side-by-side comparison of the non-selective menus currently used (top) and the
proposed selective menu (bottom); see Appendix A (Cycle 1, Regular, Sunday).

Table 1. The table below demonstrates the number of items that will be offered for each component of a
non-Selective Menu Regular (gray), along side of the number of additional items that will be changed
when implementing the Selective Menu Regular (Green for addition and Red for subtraction).

Breakfast Lunch Dinner

Juices/ Fruits 2 2 Appetizers 1 ------ 2 ------

Entrees 3 1 Entrees 1 1 1 1

Bread 1 2 Bread 1 4 1 5

Beverages 6 4
Beverages 6 4 6 4

Cereal 1 5
Accompaniments 2 2 1 2

Desserts 6 1 2 1
 Karina Almanza, CSUN 2017-2018 Dietetic Intern
R.D., Deborah Lomax, Pacifica Hospital of the Valley
In offering a selective menu, the patients health can be well attended by ensuring they are
well-nourished, there will be a decrease in food waste and Pacifica will be meeting its goal of providing
quality service to each patient. The ultimate purpose of this proposal is to incorporate the selective menus
that are already created and implement the necessary staff to appropriately plan this change.

Importance of Offering Selective Menu

There are currently 3 different cycle menus prepared for the selective menu options which will
accommodate the needs of regular, renal, soft, soft-bland, diabetic, low-fat, mechanical soft, sodium
restricted and pureed diets. In providing the selective menu option, there is a significant opportunity to
increase patient satisfaction, for personalization of meals, limit food waste, contribute to the enhancement
of patients health and well-being and furthermore, enhance the quality of life, comfort and care for
patients that reside in the hospital on a long-term or short-term basis.
In preparation for these new menus, there is an anticipated need for additional staff to facilitate
the cohesiveness and functionality of this proposed transition of menus. The change from non-selective to
selective menus will allow for the incorporation of 37 additional menu items of all meals served on a
daily basis. Conclusively, offering to patients an estimated 70 menu items to select from during each meal
will increase the demand for late trayline preparation, additional preparation of salad items and cooking,
evaluation of accuracy of each selection per patient and additional maintenance for dishwashing.

Table 2. The following are the proposed positions, hours, days worked, and hourly rate when
implementing the Selective Menu.

Position Hours Days Pay Rate

Late Tray line 11:00 am 7:30 pm 3.5 $11.00/ hr

PM Cook 11:00 am 7:30 pm 3.5 $11.00/ hr

Salad Room 9:30 am 6:00 pm 3.5 $11.00/ hr

Worker

Diet Clerk 9:00 am 5:30 pm 3.5 $11.00/ hr

Dishwasher Various 3.5 $11.00/ hr

Lunch ~ 11:00 am 7:30 pm
Breakfast ~ 6:00 am 2:30 pm
 Karina Almanza, CSUN 2017-2018 Dietetic Intern
R.D., Deborah Lomax, Pacifica Hospital of the Valley
Proposed Staff
Late Tray Line (1)
There would be a need for an additional late tray line employee to assemble a late tray for
admissions. Having this position fulfilled will further allow for possible advanced preparation for the
following days tray line. Preparation of tray line items for the following day is currently occurring on
Sunday evenings, to accommodate heavier than usual workload on Mondays BHU meals/snacks.

PM Cook (1)
In response to employment of a late tray line cook, there will need for a PM Cook to prepare the
additional food items on the tray line. Incorporating the selective menu into the Pacifica Hospital of the
Valley will increase the number of items that will be prepared and/ or cooked from 37 to 69 items;
doubling the food options that are currently being offered on a daily basis. This change would demand an
additional cook to take on the increased workload anticipated with the selective menu.

Salad Room Worker (also referred to as the Food Service Worker) (1)
Several of the items that will be offered on the selective menu will be in the form of fresh food
ingredients (fruits, vegetables, etc). These ingredients will be incorporated into entrees that require
additional meal preparation time. With the additional use of fresh ingredients requiring preparation, a
Salad Room Worker/ Food service worker would be needed for the additional workload that the selective
menu would entail. The current Salad Room Worker prepares each of the 37 items on the non-selective
menu. The current staff has expressed that at times (especially Mondays) there is a need for additional
help to prepare all of the food for each meal by a specific time of day. Occasionally, the Cafeteria Food
service worker steps out of her position to help the Tray Line Food Service Worker. That being said, the
implementation of the estimated 69 menu items offered from the Selective Menu will demand an
additional Salad Room Worker.

Diet Clerk (1)

The role of a Diet Clerk, will be to consult with each patient regarding their choices for the
selective menus on a daily basis. An additional Diet Clerk will be responsible for passing and retrieving
the menus.When menus are collected by the extra clerk, a tally will be prepared for the following days
meals. The compilation of the tally will be a shared task among the early and late clerks. Breakfast and
lunch will be completed by the extra clerk with the help of the PM clerk. The PM clerk will be
responsible for compiling the dinner tally.

Dishwashers (2)
With the implementation of the selective menu, the use of new plastic dishware will be instituted.
The selective menu will create a higher workload on the dishwashers, thus requiring additional staff.
 Karina Almanza, CSUN 2017-2018 Dietetic Intern
R.D., Deborah Lomax, Pacifica Hospital of the Valley
Table 3. The table below depicts the proposed budget plan for the additional 6 positions that would be
needed to implement the selective menu options; mentioning position, desired pay rate, and total
payments in terms of a weekly, bi-weekly and monthly basis. The total amount of money to employ the 6
positions would be an estimated $13,090.00 on a monthly basis and $157,080.00 per fiscal year.

Position Pay Rate Weekly Bi-Weekly Monthly

$11.00/ hr $327.25 $654.50 $1,309.00

2 Late Tray Line
$11.00/ hr $327.25 $654.50 $1,309.00

$11.00/ hr $327.25 $654.50 $1,309.00

2 PM Cook
$11.00/ hr $327.25 $654.50 $1,309.00

$11.00/ hr $327.25 $654.50 $1,309.00

2 Salad Room
$11.00/ hr $327.25 $654.50 $1,309.00
Worker

$11.00/ hr $327.25 $654.50 $1,309.00

2 Diet Clerk
$11.00/ hr $327.25 $654.50 $1,309.00

$11.00/ hr $327.25 $654.50 $1,309.00

2 Dishwashers
$11.00/ hr $327.25 $654.50 $1,309.00

TOTAL $13,090.00
 Karina Almanza, CSUN 2017-2018 Dietetic Intern
R.D., Deborah Lomax, Pacifica Hospital of the Valley

Supporting Research
The following research was collected when investigating scientific-based evidence that a
well-nourished patient with a personalized menu plan such as the selective menu will benefit significantly
in health outcomes.

Studies have shown that raising the awareness of the dangers of malnutrition and enabling nurses to
improve the standard of nutritional care has resulted in improved recovery time and shortened length of
stay. 1

Individualized dietary treatment leads to improved food intake and other positive outcomes. 2

Citations
1. Rodriguez, L. (2004, December). Nutritional status: assessing and understanding its value in the
critical care setting. Retrieved August 24, 2017, from
https://www.ncbi.nlm.nih.gov/pubmed/15571939
2. Cheung, G., Pizzola, L., & Keller, H. (2013). Dietary, Food Service, and Mealtime Interventions
to Promote Food Intake in Acute Care Adult Patients. Journal of Nutrition in Gerontology and
Geriatrics, 32(3), 175-212.
3. Bogden, B. J. (2013, September 27). Clinical skills: importance of nutrition for acutely ill hospital
patients. Retrieved August 24, 2017, from
http://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2004.13.15.15532?url_ver=Z39.88-200
3&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
4. Bradley, Lindsey, & Rees, Colin. (2003). Reducing nutritional risk in hospital: The red tray.
(audit). Nursing Standard, 17(26), 33-7.
 Karina Almanza, CSUN 2017-2018 Dietetic Intern
R.D., Deborah Lomax, Pacifica Hospital of the Valley
Appendix A