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

Any questions or concerns with starting this new process?

Before we get into the details…

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
• 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 Fat

• For patients with high blood pressure, CHF, and/or edema
• Limit potato chips, bacon, soups, gravies, and cheeses
• < 2400 mg sodium/day
• Same as Low Sodium, but more liberal
• < 4500 mg sodium/day

Low Sodium No Added Salt (NAS)

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

• 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

Low Fiber

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
• 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

Low Tyramine

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

• f 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 # Date of Birth Diet *diet can be changed for patients preference to vegetarian, vegan,

• r gluten free by

clicking on their current diet*

To order a new meal, click green “new meal” button Clicking in this box will bring you to a screen to see which meals have been ordered

Adding a preference diet

After clicking

• n their diet,

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

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

• rders

Copying orders for patient with no menu

Choosing “copy

• rder” 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

• rder in the

meal zones. Will need to place a “Ready @ Order” Call SRC #2233

Breakfast selection

Patients can select

• ne 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

• rder 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

• rder. 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

• r 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

Highlight the soda in the

• rder, and

click “Modify” While modifying soda, choose “in a cup”

Desserts: May choose 2

Condiments: Unlimited Within Reason

*Do not send peanut butter

• n 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

• rder and diet
• ffice staff enter

supplements. The only thing you will need on this screen is the house tray.

Completing meal order

Review order in this “Current

• rder”

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

• rder, 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

• ften used

feature will be “tray messages”

Can choose various messages here

Plastic utensils will always be pre-selected for you. This patient requires several special messages

Patients on Carb Counting Diets

Other Therapeutic Diets

Low sodium, no added salt (NAS), low fat, cardiac, renal, low fiber

Do not override the program!

Do not select/override things that are grayed out! These are not allowed on the particular diet.

Another important observation about this patient…

Allergies!

Egg allergy for example

No eggs, pancakes, or French toast show up for this patient. DO NOT “Free text” an item to give them anything not showing up, unless specified in diet order.

How to Free Text When Necessary

Here, it is specified that the patient can choose products with egg, so toast may be modified to French toast. Begin by clicking “more functions”

Click “Free Text instructional Modifier”

Type in the item the patient would like *if* it fits into their diet Then, it will appear like this

Never send anything disallowed due to an allergy!

• Do not Free Text

anything in that isn’t showing up and not specified to be allowed

• Unless the diet order

specifies “Patient may choose”

– Ex: Lactose intolerant patients often have that note included

• If unsure of what is in

the recipe or checking nutritionals, click on “Item Info” the “Item recipe”

Seeing who has ordered

Choose the day and meal

Then Click “North 5”

All rooms will populate

All of these patients have

• rdered! If

there is no

• rder, then

the icon will be a little face.

Tray limits and restrictions

Breakfast:

• Patient’s may order:
• 1 breakfast

entrée

• 1 breakfast side
• 1 hot cereal
• 1 cold cereal
• 1 yogurt
• 2 beverages
• Unlimited

condiments Lunch & Dinner:

• Patient’s may order:
• 2 entrees
• 2 sides
• 2 desserts
• 3 beverages
• Unlimited

condiments

Any questions about using HealthTouch?

What is on the menu

• The general hospital menu includes

many choices including hot meals, soups, sandwiches, salads, and various sides.

• North 5 patients are offered special

items on the Balance Cohort, which can be accessed on the breakfast and main item screen.

Balance Cohort

• Strawberry Pancake Wrap: Thin pancake with fresh strawberries and cream

cheese, rolled into a wrap and garnished wit more berries

• Trail Mix Parfait: Small container of Greek yogurt with dark cherry compote,

almonds, walnuts, flax & sesame seeds

• Crispy Chicken Slider: Baked chicken breast patty with lettuce and tomato
• Greek Chicken Taco: Two tacos with grilled chicken, hummus, cucumber, tomato,

feta cheese, and tzatziki sauce

• Strawberry Spinach Salad: Spinach with Craisins and fresh strawberries
• Tomato Mozzarella Caprese Sandwich: Ciabatta with balsamic, mozzarella,

tomato, roasted red pepper, and basil

• Ranch Chicken Slider: Baked Chicken patty with bacon, lettuce, tomato, and ranch

dressing

86 Items

• When we run out of items, kitchen may replace what is ordered with a

similar item

– After checking with the diet in the diet office

• Some items run low on the weekends

– Bananas and Stoneyfield Smoothies are common

• If you ever need to check with the kitchen about something, call diet office or

kitchen directly:

– SRC: #2233 – Kitchen: #3780

We are always here to help you!

• It is a learning opportunity for all of us
• Getting adjusted may take time but it will all become familiar!

Any final questions?

Thank you! I will be here for several weeks to help with the process J