The effect of organizational level and practice area on managerial work in hospital dietetic services

All areas of practice in hospital dietetic services include a management component; however, the nature of the managerial role in various areas of dietetic practice has not been identified clearly. The definition of dietetic practice in the Conceptual Framework for the Profession of Dietetics supports the importance of managerial skills. The effect of organizational level and practice area on managerial activities and roles of professional staff in hospital dietetic services was examined in this study. The nationwide sample included professionals in hospitals with 300+ beds. A total of 3,280 dietetic professionals participated. Five groups were defined: low administrative, low clinical, middle administrative, middle clinical, and upper administrative. Mintzberg identified 10 managerial roles and categorized them as interpersonal, informational, or decisional. The 10 roles were used as the basis for developing an 80-item instrument on which respondents rated each item for importance and time demand. Perceived importance of managerial activities tended to be greater at higher organizational levels. The managerial aspects of the lower clinical and upper administrative position were the most clearly defined. The lower clinical group tended to rate all of the managerial roles as significantly less important than did those in other positions; however, the middle clinical position included a substantial managerial responsibility.     

Clinical nutrition and foodservice personnel in teaching hospitals have different perceptions of total quality management performance

OBJECTIVE: To investigate the perceived total quality management (TQM) performance of their department by clinical nutrition managers and dietitians, and foodservice managers and supervisors, in hospital food and nutrition service departments. DESIGN: Using a 2-part questionnaire containing items about 3 constructs of TQM performance and demographic characteristics, participants rated their perceptions of TQM performance. SUBJECTS: Employees in 7 Council of Teaching Hospitals. Of the 128 possible respondents, 73 (57%) completed the study. STATISTICAL ANALYSES PERFORMED: Correlation analysis to identify relationships between demographic characteristics and TQM performance. Analysis of variance to investigate statistical differences among hospitals and between subject groups and types of employment positions. RESULTS: Three TQM constructs--organization, information, and quality management--were evaluated. The clinical nutrition manager and dietitian group had mean ratings between 3.1 and 4.7 (5-point Likert scale); the foodservice manager and supervisor group had mean ratings from 2.7 to 4.0. Education level was significantly correlated (r = 0.44) to performance of employee training in the clinical nutrition group. The number of employees directly supervised was negatively correlated (r = -0.21) to the performance of employee training in the foodservice group. APPLICATIONS: As the dynamic roles of dietitians change, many dietitians will occupy management positions in organizations such as restaurants, health food stores, food processing/distribution companies, and schools. This study demonstrates how a TQM survey instrument could be applied to clinical nutrition and foodservice settings. Dietitians will need to assess TQM in their workplace facilities, especially because of the direct links of TQM to productivity and client satisfaction.     

Consumer evaluation of hospital foodservice quality: an empirical investigation

PURPOSE: The purpose of this article is to estimate the relationship between acute care consumers' satisfaction with hospital foodservices, foodservice characteristics, demographic and contextual variables. DDESIGN/METHODOLOGY/APPROACH: The acute care hospital foodservice patient satisfaction questionnaire was administered to 2347 patients in Queensland, Australia from 1996-2001. Regression analysis was conducted to measure the influence of 21 foodservice attributes and seven contextual/demographic items on overall foodservice satisfaction. FFINDINGS: Foodservice satisfaction was strongly associated with variety, flavour, meat texture, temperature, meal taste, and menu staff (p < 0.01). Consumers aged 70 years or more rated their overall satisfaction significantly lower than younger consumers (p < 0.01), but no statistically significant differences in overall ratings existed for other contextual or demographic groups. RESEARCH LIMITATIONS/IMPLICATIONS: This new foodservice instrument and the methods of analysis may be generalisable, but application is likely to be context-specific. Further applications of the instrument are required to produce greater confidence in its validity and reliability across different foodservice settings. PRACTICAL IMPLICATIONS: Global statements often used in health service satisfaction surveys (e.g. a single rating of "food quality") provide insufficient information to allow managers to adapt foodservices to suit consumers' preferences. ORIGINALITY/VALUE: Detailed information of the kind produced here is required for the formulation of managerial and sectoral policies to improve the quality of health and consumer nutrition care. The findings are noteworthy and, as far as the literature review showed, no previously published study has produced this level of detail on consumer preferences across foodservice attributes or their relationship to overall foodservice satisfaction.     

Management development: a study of nurse managerial activities and skills

This study discusses an activity competency model that may be used to investigate the perceived importance of managerial activities and skills required by three levels of nurse managers (top, middle, and supervisory management). Our findings indicate that the importance of nurse managerial activities differs significantly according to the level of nurse management. A set of critical managerial activities and skills/knowledge needs for each level of nurse managers was identified in the study. These findings provide guidelines for nursing-management development programs, training, and career planning. They also can serve as a guideline for recruiting and selecting an effective nurse manager.     

A research model for relating job characteristics to job satisfaction of university foodservice employees

The purpose of this study was to determine the relationship between job characteristics and job satisfaction and between demographic variables and job satisfaction for university foodservice employees. A three-part survey was developed which included the 30-item Job Characteristics Inventory, 6 items related to job satisfaction, and 7 demographic items. Separate written questionnaires were administered to 32 managerial and 147 non-managerial employees of a large state university foodservice department. The response rate was 98% (32 managers and 143 non-managers). The reliability for the instrument, as determined by Cronbach's alpha, was 0.88 for employees and 0.91 for supervisors. Multiple linear regression analyses were used to test research hypotheses at a significance level of p less than or equal to .05. There was a positive relationship between job characteristics (autonomy, task identity, feedback, variety, dealing with others, and friendship opportunities) and job satisfaction for both employees and supervisors. Feedback and dealing with others were the individual job characteristics that were significant. Only one job characteristic, dealing with others, was rated higher by managerial than by non-managerial employees. There was no difference in job satisfaction by role (managerial vs. non-managerial) or demographic variables, except age for non-managerial employees. Older, non-managerial employees tended to be more satisfied with their jobs than did younger employees. Dietitians and foodservice managers can use the findings for implementing job design strategies, such as job enrichment and job rotation, to improve employee satisfaction.     

Computer technology in institutional foodservice

A survey research study profiled foodservices and foodservice managers in health care and educational institutions that applied computer technology to their operations. The survey also examined the extent to which computers were applied to management and client service functions. Both the size and the type of institution were found to be significantly related to computer usage. The larger the institution, the greater the extent of indicated usage. Educational institutions used computers more than all types of health care institutions. Mainframe systems (time shared internally or externally) were the predominant computers used. Internal mainframe systems and minicomputers were used significantly more by educational institutions than by health care institutions. The manager most likely to use computers was a man of any age with at least a bachelor's degree who was employed full-time within the institution. He had taken at least six business management courses and had at least some understanding of and ability to apply systems management concepts to his daily management practices. Applications were categorized into five functional areas: menu, purchasing/storage, production, client service, and managerial information. Managerial information applications were most frequently reported by all respondents, with large institutions and elementary/secondary schools reporting the greatest usage for those applications. Several purchase/storage and production applications were significantly related to type or to size or to both, with large institutions and college/university foodservices reporting the greatest usage. Menu precosting was the only significant menu function, and that was significant only relative to institutional type. No client service functions were significantly related to either type or size.     

Comparison of foodservice management performance level between dietitians and non-dietitians in senior centers using IPA

This study investigated the management importance and performance level of foodservice managers at senior centers. Using the survey, perceived importance and performance levels of seven foodservice management areas were evaluated and analyzed. Data showed the foodservice facilities were being managed by dietitians (61.6%) or non-dietitians (38.9%). The result indicated that overall importance level (3.43) was higher than performance level (3.02) (p<.01). As of the IPA result, dietitians and non-dietitians had different perspectives in terms of managing the eight categories of foodservice areas. The differences in the IPA results between the two groups may reflect bias attributable to the respondents'' degrees of knowledge and professional preparation. The research findings could enhance our understanding of importance of hiring professional dietitians to operate foodservice at senior centers and find out which management area should be concentrated for more effective foodservice management.     

Managerial work behavior and hierarchical level: implications for the managerial training of first-line supervisors

Mintzberg proposed that managers at all levels enact ten roles. There is, however, a relative importance ascribed to the various roles given the manager's location in the hierarchy. Like Mintzberg's ideas on the utility of ten roles, we found that managers at all levels, to varying degrees, need the three skills proposed by Katz. We have argued that a variety of roles and skills describe what managers do. At the same time, the predominance of one role or skill over another may be influenced by the location of the manager in the hierarchy. The question is not whether roles would be enacted at different levels or whether skills will be required, but whether one role or skill or a set of roles and skills will be predominant for the first-line supervisor. The first-line supervisor's work requires that he or she be predominantly proficient in the areas of human and technical skills in order to fulfill supervisory responsibilities. Current empirical research supports this assertion; however, the continuing study of managerial roles and skills and other variables such as functional specialty will offer other opportunities for the study of first-line supervisors. For example, will the predominance of the roles and skills that we have discussed vary if the supervisor is a line or staff manager or if the supervisor works in a production or service related organization? Organizations adapt to change to meet the expectations of those within and outside the organization with something at stake. Organizations need managers to facilitate the realization of organizational goals, so organizations need to continuously train managers, targeting appropriate roles and skills given each manager's location in the hierarchy. The preceding pages should provide resource materials to individuals and organizations interested in evaluating and designing the training and development of first-line supervisors. This roles-and-skills information can be productively utilized to assist the organization with its management training, particularly of first-line supervisors.     

Dimensions of managerial work in hospital dietetic services

The objective of this study was to identify underlying dimensions of the managerial work of hospital dietetic services professional staff. A survey instrument was developed on the basis of Mintzberg's role theory of management. Respondents were asked to rate 80 activity statements on the relative importance and time demand of each. Principal component analysis was used to determine whether items could be conceptualized meaningfully by a smaller number of components capable of accounting for interrelationships. Reliabilities and correlations were computed for the resulting managerial factor scores. Six factors were identified from the importance ratings: Upper Management, Interaction with Subordinates, Outside Activities, Quality Assurance, Communication Activities, and Personnel Activities. Similar dimensions were identified from the time-demand ratings. Findings from this analysis suggest that managers in different functional specialties and at various organizational levels tend to vary in their allocation of time and to stress different roles. As a person rises on the administrative ladder of responsibility, concentration on extramural affairs and involvement in planning are greater, and concern with specific operational problems decreases. The importance of conceptual skills was especially evident in upper administrative positions, as was the critical need for intergroup skills.     

Food production relationships between entrée combinations and forecasted demand

Macro elements and values for associated Time Measurement Units were applied to three classifications of entrées to synthesize production time for 100, 300, and 500 portions. Average handling and process time for each classification and time per portion were calculated. Data revealed that roast and single-item entrées required greater average handling time than combination entrées, because more individual handling of portions was required as forecasted demand increased. Process time for combination and single-item entrées increased as forecasted demand increased. The time for the single-item classification doubled for 300 and 500 portions, because oven capacity was exceeded. Production time data were applied to six combinations (menu mixes) and quantity levels of entrée classifications to determine production feasibility in a simulated foodservice system. Production problems were encountered in five of the six menu mixes because of system constraints. This study indicated that total production time estimates would be useful to foodservice managers when planning a menu mix, scheduling production personnel, and forecasting labor costs.     

Manager beliefs regarding worksite health promotion: findings from the Working Healthy Project 2

PURPOSE: To explore differences in manager beliefs about worksite health promotion programs (HPPs). DESIGN: Cross-sectional written survey. SETTING: Twenty-four manufacturing worksites, with 11,811 employees and 1719 eligible managers. SUBJECTS: Sixty-six percent (1133/1719) of managers completed the survey; 1047 managers were categorized by level (169 senior, 567 middle, and 311 line supervisors). ANALYSIS: Results are reported on overall manager beliefs (and by manager level) about importance, efficacy, barriers, and benefits of HPPs. Multilevel analysis modeled the influence of manager level, age, and experience with HPPs on beliefs about HPPs, while accounting for worksite-level effects. RESULTS: Seventy-five percent of managers believed that offering HPPs is highly important. Eighty percent believed that HPPs improved employee health, 68% believed that they reduced health care costs, and 67% believed that they improved employee morale. Few significant differences by manager level were observed on the perceived importance of health promotion, employer responsibilities for health promotion and protection, and efficacy of health promotion strategies or perceived benefits. Senior managers (vs. line supervisors) were significantly less likely to believe that space or cost was a barrier to offering HPPs and were less likely than middle managers or line supervisors to believe that production conflicts were barriers to offering HPPs. CONCLUSION: Targeted interventions to address manager beliefs, including differences by age, experience, and manager level, are worth consideration when planning worksite HPPs.     

Are registered dietitians adequately prepared to be hospital foodservice directors?

OBJECTIVE: To determine perceived importance of selected competencies for the role of hospital foodservice director and explore whether registered dietitians (RDs) are perceived competent in these areas. DESIGN: Data were collected through a mailed questionnaire. SUBJECTS: A random sample of 500 hospital foodservice directors and 500 hospital executives to whom the directors report. ANALYSIS: Chi2, Mann-Whitney, and Kruskall-Wallis tests were used to examine differences among ratings by and demographic characteristics of foodservice directors and the executives with whom they work. RESULTS: All competencies were perceived to be important for someone in the role of hospital foodservice director. RDs were perceived to be somewhat competent in all areas studied but were only perceived to be competent to expert in a few of the areas. Directors who were RDs and hospital executives who had worked with RDs rated the competence level of RDs higher than did non-RD directors and hospital executives who had not worked with RDs. CONCLUSIONS: Unique competencies appear to be important for those aspiring to become hospital foodservice directors. Hospital executives who had worked with RDs perceived the competency level of RDs to be higher than did executives who had not worked with RDs. Often, areas rated as most important for the role of hospital foodservice director were not areas in which RDs were perceived to be highly competent. Additional competency development may be needed to better prepare RDs to assume the role of hospital foodservice director.     

Development of financial management competencies for entry-level and advanced-level dietitians.

The major purposes in this study were to develop a list of financial management competencies for entry- and advanced-level dietitians, determine hospital foodservice directors'/chief dietitians' (practitioners) perceived importance of these competencies at both levels of practice, and determine educators' perceived importance of these competencies at the entry level. Drawing from the literature and the judgment of eight experts, we developed a list of 50 financial management competencies. Written questionnaires that included importance scales for the competencies were mailed to (a) practitioners in a random sample of 1,500 member hospitals of the American Hospital Association and (b) directors of Plan IV/V, Approved Preprofessional Practice, and Dietetic Internship programs. Response rates were 34% for the practitioners and 47% for the educators. Practitioners rated 8 competencies as important or very important for entry-level dietitians and 26 as important or very important for advanced-level dietitians. Practitioners rated all competencies higher for advanced-level dietitians than for those at the entry level, and educators rated all competencies higher than did practitioners. Content areas, identified by factor analysis, were similar for both levels of practice. Our findings indicate that emphasis in undergraduate and practice programs should be given to the eight competencies identified by practitioners and educators as most important. Our results also may be used for development and evaluation of graduate and continuing education programs and for specialty certification in foodservice management.     

Use of the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire to monitor trends in patient satisfaction with foodservice at an acute care private hospital

Aim:  To demonstrate how the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire can be used to monitor trends in foodservice satisfaction.
Methods:  Three one-day surveys of foodservice satisfaction were conducted in 2003–05. All adult hospital inpatients with the exception of intensive care, cardiac post-operative care, labour ward and day surgery patients were eligible. The response rate was 48% (2003), 42% (2004) and 60% (2005). This took place in an acute care 440-bed private hospital. Overall foodservice satisfaction, dimensions of foodservice satisfaction (food quality, meal service quality, staff/service issues and the physical environment) and two independent statements (temperature of the hot foods, ability to choose different sized meals); satisfaction by gender, length of stay, age, diet type and appetite for 2005. Scores were calculated for overall satisfaction, four dimensions of satisfaction and two independent statements. Chi-squared analysis was used to determine the effect of gender, age, diet type and appetite on overall satisfaction. Correlation analysis was used to assess the association between overall foodservice satisfaction and length of stay.
Results:  Ratings of overall foodservice satisfaction, four dimensions of foodservice and two independent foodservice items were high, consistent with previous findings. Of the foodservice dimensions, the staff/service issues were the most positively rated and food quality the least positively rated. Patients' expectations of the foodservice were significantly associated with overall satisfaction. Quality improvement activities focused on the lowest scoring components of the questionnaire.
Conclusion:  The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire can be used to determine trends in foodservice satisfaction and identify areas to target for quality improvement initiatives.     

The effect of education on foodservice manager job satisfaction

We conducted a study to determine whether educational background (field of study and level of education) was related to the job satisfaction of foodservice managers. The Index of Organizational Reactions Questionnaire was used to measure specific components of job satisfaction based on a five-point Likert-style scale (1 = low satisfaction, 3 = moderate satisfaction, and 5 = high satisfaction). Questionnaires were mailed to the entire population of 256 foodservice managers employed in college and university dining facilities of a regional division of a major foodservice company in the northeastern United States. Names, titles, positions, and addresses of the managers were obtained from the company's human resources department. Analysis of data was done through computation of the point-biserial correlation coefficient and the rank order correlation coefficient. Managers who responded to the questionnaire (74.6%) indicated moderate overall job satisfaction (mean = 3.42 on a 5-point scale). Of the respondents, 44% had an educational background in foodservice; these respondents had lower overall job satisfaction than did those having no education/training in foodservice. Both groups were most satisfied with the job components of supervision, type of work, and relationship with coworkers. Both groups were least satisfied with pay and benefits, company identification, and amount of work. A significant (p less than .01) positive relationship was found between educational field of study and job satisfaction, and a significant (p less than .001) negative relationship was found between educational level (i.e., degree[s] earned) and job satisfaction.(ABSTRACT TRUNCATED AT 250 WORDS)     

The seven S's for successful management

Becoming a successful manager in a health care agency is, for most new managers, an awesome goal. Successful management is more than knowledge of leadership roles and management functions that can be learned in school or educational workshops. Successful management involves effective use of both the manager's affective and cognitive domains. Mentoring and apprenticeship with a successful nurse leader is for many novice managers a highly valuable way to learn management skills since this allows for techniques with a successful nurse manager to be visualized and then modeled. "Seven S's" that provide a framework for managerial success are discussed.     

The Use and Value of Information Systems as Evaluated by Dairy and Specialty Crop Farm Managers

ABSTRACT

Little recent research is available about where specific types of farm managers search for information about better production practices. The objective of this study was to investigate what information sources managers used and how they rated the usefulness of each source. The authors administered mail questionnaires to probability samples from sampling frames they developed for four groups: dairy and fresh market vegetable producers from Wisconsin and berry and nursery producers from a multistate region. Questionnaire items asked operation managers to check off, from a list of information sources, those that they used in the last year to learn about new equipment or procedures to improve their operations and then to rate the usefulness of each source. In the last year, nursery, dairy, and berry managers most often used information from print media (63% to 84%), followed by other farmers (50% to 80%). Fresh market vegetable growers used conferences (60%) most often, followed by print media (41%). The information source rated most useful was “other farmers” for the nursery, dairy, and fresh market vegetable managers. Nursery and fresh market vegetable managers rated conferences as second most useful, whereas dairy managers rated print media second. Berry managers were not asked about usefulness. Farm manager information behavior exhibits some common features but is also specific to their operation type. Research and outreach efforts intending to communicate information to farm managers may be able to be more efficient at reaching and persuading their intended audience if they first investigate manager information behavior.     

The affective domain: behaviors important in entry-level practice

Affective behaviors, those associated with attitudes, beliefs, and values, were identified by a Delphi panel of dietetic experts. Statements converged through four rounds into a set of behaviors categorized into five components: human, technical, conceptual, personal, and professional. One group of registered dietitians rated each of these statements from most to least important within each component. Another group rated each statement using the scale 1 = absolutely essential to 4 = not of concern. Mean rankings within each of the five components tended to have a small range. Mean ratings of the statements indicated respondents considered all of the behaviors to be essential or at least important. For an additional analysis, ratings of statements were subjected to principal components analysis. Inspection of the varimax-rotated factor matrix revealed that all but 1 of the 41 behavior statements could be grouped in an additional way to yield six internally consistent scales: initiative/flexibility, professional commitment, interpersonal, personal responsibility, leadership, and personal commitment. Additional research should be done to determine the practicality of utilizing these behavior statements to evaluate the performance of dietitians both at the entry level and at more advanced levels.     

Practitioners' opinions on Food and Nutrition Care Indicators in assisted living facilities for older adults

This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults.