Using HealthTouch for N5 Patients Allison McNulty Sodexo Dietetic - PowerPoint PPT Presentation

Using HealthTouch for N5 Patients Allison McNulty Sodexo Dietetic Intern Diet Office Employee Since May 2016

New Ordering Process for N5 Patients • Your staff will be acquiring the skill and technology to order meals for the patients • Paper menus will be eliminated • Communication with the diet office will be increased to ease transition

The goal of this project • Improve patient satisfaction and autonomy • Give departments a more direct line of communication and collaboration • Remove paper menu process • Reduce food waste • Allow your staff to see status of diet orders in HealthTouch

The current process • Menu collection in the afternoon by diet office staff • Organize by meal and patient • Enter breakfast menus for following morning (approx. 20 minutes) • Correct menus to fit diets and tray limits • File lunch and dinner menus *Next morning at 6am* • Staff enter lunch and dinner for that day based on filed menus (approx. 45- 60 minutes) – Often, new menus were faxed overnight, leading to confusion and disorganization if patient already had a menu • House meals entered or copied and pasted from previous order for patients without a menu or new admits.

Issues with this process • Multiple levels of order communication and transformation from patient to tray delivery – Orders can lose accuracy through the process • Patient responsible for completing all three menus by a certain time, or may be dissatisfied with meal • Patients feel that they are receiving the wrong tray or want to change their mind

Before we get into the details… Any questions or concerns with starting this new process?

HealthTouch • A point of service program used for meal ordering • N5 received 3 licenses that are available on workstation computers to use HT • Meals can be placed in advance – All day to enter Breakfast, Lunch, and Dinner for following day – Have until 2 hours before meal to make edits – Always able to call diet office for special requests or adjustments • Filters patient selections based on their diet and/or allergies

Patient Diets • Cardiac • Low Fat • Low Sodium • No Added Salt (NAS) • Carbohydrate Counting • Renal • Low Fiber • GI Recovery • Low Tyramine (not often, but does occur on N5) • Altered textures (Soft, Ground, Pureed, Thickened Liquids)

Cardiac Diet • For patients with heart disease or at risk for heart disease • <60 g fat per day • <20 g of Saturated Fat per day • <4500 mg sodium/day Low Fat • Used for various digestive disorders. – Ex: Pancreatitis • Limits high fat foods – Cookies, cakes, sausage – whole milk, cheese, mayonnaise replaced with lower fat option • <50 g fat/day

Low Sodium • For patients with high blood pressure, CHF, and/or edema • Limit potato chips, bacon, soups, gravies, and cheeses • < 2400 mg sodium/day No Added Salt (NAS) • Same as Low Sodium, but more liberal • < 4500 mg sodium/day

Carbohydrate Counting • For patients with diabetes or high blood sugar • Limits foods high in carbohydrates and encourages inclusion of other food groups • Four levels based on patients needs: – 135 g CHO: 45 g/meal, 15 g 8pm snack – 180 g CHO: 60 g/meal, 15 g 8pm snack – 225 g CHO: 75 g/meal, 15 g 2pm snack, 15 g 8pm snack – 270 g CHO: 90 g/meal, 15 g 2pm snack, 15 g 8pm snack • Carbohydrates monitored by HealthTouch • Allowed to be over or under 15 g/meal • Snacks handled by SRC Staff

Renal • For patients with kidney disease • Limits sodium, potassium, and phosphorous. – Milk limited due to phosphorous content – Oranges, bananas, tomatoes, and potatoes are limited due to potassium – Items prepared with minimal salt • Levels are monitored by HealthTouch, if unsure of the levels in certain foods, can click through options Low Fiber • For patients with digestive disorders – Ex: Diverticulitis or diarrhea • Avoid whole grains, nuts, seeds, and raw fruits & vegetables – Banana, melon, and lettuce is ok • <13-15 g fiber/day

GI Recovery • For patients with diarrhea, GI ailments, reflux, or heartburn • Avoid a variety of foods that may cause gastric or intestinal distress – High fat, high fiber, spicy, caffeine, chocolate, and lactose-rich foods to be avoided. • HealthTouch has menu items filtered for this Low Tyramine • For patients on MAOI’s (antidepressants) • Limits caffeine and Tyramine • Tyramine containing foods: – Aged and processed food, aged cheeses and meats, smoked or pickled foods, soy, miso, tofu, meat, fish, poultry – On the menu: Broths, gravies, pepperoni, bacon, turkey bacon, cheddar cheese, Swiss cheese, mac & cheese, Greek taco, tofu, meatballs – Limit to 16 oz/day: Coffee, cola, and root beer

Altered Textures • HealthTouch will provide which foods are allowed on each diet. • Do not override • Soft: No crackers, chips, cookies, or raw vegetables. All soft consistency • Cut-up: must be cut-up, ground, flaked, no raw vegetables. • Ground: Meats ground with extra sauces and gravies, soup pureed, vegetables cooked extra • Pureed: All foods pureed consistency with extra moisture from sauces, gravies, syrups, etc. • Thickened Liquids: Honey and nectar thick for swallowing difficulties.

Any questions about any of the diets, or diets you have previously seen?

Log in Type in Username and password, then hit green login button.

After logging in choose North 5 Enter into North 5 zone

Viewing the entire floor Choose appropriate room # to enter a meal for a patient

Ordering a meal for the selected patient Name Room # Clicking in this box will bring you to a screen Date of Birth to see which meals have been ordered Diet *diet can be changed for patients preference to To order a new vegetarian, vegan, or gluten free by meal, click clicking on their green “new current diet* meal” button

Adding a preference diet Then you will After clicking be brought to this screen, on their diet, where you can you are brought select their to this screen. preference and Choose the most current save it diet

Checking order history Clicking in this box will bring you to a screen to see which meals have been ordered

You can see which meals have been placed Here you can see that meals have been placed up to breakfast. This screen is where you can modify, copy, or delete orders

Copying orders for patient with no menu Choosing “copy order” allows you to place the identical order for the desired meal time.

House trays If a patient doesn’t have a current or previous menu, they will receive a house tray. This can be found under the supplements page and will automatically fill in a full meal.

After choosing to order a new meal, you are brought to this screen, where you can choose the meal to order *IMPORTANT: If the meal period already printed, do not place a meal order in the meal zones. Will need to place a “Ready @ Order” Call SRC #2233

Breakfast selection Patients can select one item per breakfast section (1 entrée, hot cereal, yogurt, breakfast sides, cold cereal, and fruit. (Fruit can be found in the “Desserts” tab) 3 beverages)

Lunch & Dinner Entrée Screen Patients may order 2 entrees for Lunch and Dinner

Lunch and Dinner Options Some options bring you to a customization screen and have several things to remember (See next slide)

You can modify grill and deli items These are the modifier screens. Clicking on them will add a “CYO Deli Sandwich” or “CYO Grill Sandwich” to the order. Please delete that if you did not end up creating a sandwich.

Grill items Grilled cheeses are made under CYO from the grill . Choose the bread and cheese they would like. If the patients would like tomato, choose “Grilled tomato” If the patient does not want bread for any sandwich (grill or deli), please choose “no bread/bun”

Side/bread & Soup/salad *May order 2 items from each

Beverages: May choose 3 Important: We do not send cans to N5, when choosing soda, modify the item and choose “in a cup” (next slide) Do not need to send coffee for breakfast, we send up coffee each morning on the cart

Putting soda in a cup While modifying soda, choose “in a cup” Highlight the soda in the order, and click “Modify”

Desserts: May choose 2

Condiments: Unlimited Within Reason *Do not send peanut butter on patient trays* (due to potential allergies)

Supplements: Taken care of in the SRC Do not send anything from this screen. It will be entered into the diet order and diet office staff enter supplements. The only thing you will need on this screen is the house tray.

Completing meal order Review order in this “Current order” section When finished, select “order finished”

Important observation for this patient… The comments specify that they need a paper tray. This needs to be entered into the order, which can be seen under “Tray messages” This is done under the “GO” screen.

“Go” Screen For Tray Messages The Go screen also includes several special diets, but the most often used feature will be “tray messages”