The kid almost died! He’s a diabetic! How did that patient get the wrong food tray?” said Bonnie Blaine, director of hospital operations, to Drew Owensboro, the director of dietary services. Bonnie Blaine, a woman in her early fifties, had worked in almost every area of the hospital. By going to school in the evenings for three years, she had earned a Master’s in business administration. Owensboro had worked in the hospital for 19 years and had a high school education. “Bonnie, I don’t know! I’ll try to find out but it may be impossible. The dietary department is really a very complex operation and it’s very difficult to audit or trace anything,” Owensboro said in frustration. “Drew, I’ve got enough problems trying to contain hospital costs without having to worry about patient lawsuits due to poor quality control on our part,” Blaine continued. “The kid’s family and family doctor are furious! Your employees are all blaming one another, but no one is really doing anything about it. Now fix it or maybe I’ll have to get someone else in here to do the job,” Blaine said as she turned to answer the telephone. The Hospital’s Dietary Department The dietary department provides food services to three basic groups: patients, employees, and visitors. The greatest demand for food services comes from the patients, and because of the many different diet requirements which must be fulfilled, this can be rather complex. Each day the patient fills out their required dietetic menu for all three meals for the following day and chooses from several different food items in each food group (entree, vegetable, fruit, dessert, beverage). Since the average patient stay is five days, the dietary department offers different daily menus for two weeks and then repeats the menu selection.

1. What are the problems facing the hospital’s dietary food service?

2. What is the cost to the hospital of a minor versus major service upset or failure?

3. What does the value chain look like? Describe features of each area. Provide examples of opportunities for errors at each stage of the value chain.

4. Who is responsible for quality?

5. Select a process and discuss how to mistake proof it and improve process performance. 

6. How do we turn this dietary food service around? What are your recommendations?