This study was performed to improve the hospital food service in quality and customer satisfaction by using 6-sigma strategy which was processed by DMAIC methods. The research procedure was as follows; analyzing the main causes of customer dissatisfaction of food service by using numerical method, and then finding out the standardized problem solving methods, and finally reforming food service process. The effectiveness of 6-sigma activity was measured by 'food service quality index', 'customer satisfaction index' and 'total food service satisfaction index'. Food service quality index was calculated by adding grade of soup temperature, food service, delivery time, and setting accuracy. Statistical data analyses were completed by using the Minitab Ver. 14. By performing 6 sigma activity, food service quality index was increased from 67 to 79 points (p<0.05) and customer satisfaction index also rise from 73 to 79points (p<0.05). Satisfaction of meals' taste, diverse menu, food setting accuracy, remove of food service, overall food service were significantly improved(p<0.05). The results of capability analysis in food service quality index, customer satisfaction index, and total food service satisfaction index were improved 2.11sigma to 2.49sigma , 1.88sigma to 2.43sigma, and 2.04sigma to 2.47sigma respectively (p<0.05). Therefore this study showed that subjective food service improving process could be measured by objective numerical value which might be used for financial value in hospital management.
Data Interpretation, Statistical ; Food Service, Hospital* ; Food Services ; Problem Solving

The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, chi-square -test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.
Diet ; Food Service, Hospital ; Meals ; National Health Programs ; Postal Service ; Surveys and Questionnaires

The purposes of this study were to : a) investigate the current status of contracted hospital food services, b) analyze and clarify various perspectives of contractors and hospitals. Thirty six hospitals and their contractors which were having more than 100 beds located in Seoul, Inchon and Kyungkido, were the subjects of this study. Data were collected through surveys. The survey was conducted during March to April in 2002. Questionnaires were mailed to the 36 directors of dietetic departments of hospitals and 36 managers of contract foodservice management company. Statistical analysis was completed using SPSS Win(11.0) for descriptive analysis, t-test and chi-square-test. The results of the study can be summarized ; 1. The type of contract considered adequate by directors of dietetic departments and managers of contractors was fee-contract, combined type, followed by profit-and-loss contract. 2. According to the results from analysis on the contract cost per meal considered adequate by directors of dietetic departments and managers, the directors of dietetic department indicated that showing no difference with the current contract cost per meal. However, the managers of contractor indicated that showing significant differences compared with the current contract cost per meal(regular diet p<0.01, therapeutic diet p<0.001). 3. In the composition of contract cost per meal considered adequate, the managers of contracting businesses accounted labor cost (p<0.01) as a major cost, whereas the chiefs of nutrition departments accounted miscellaneous or controllable expense (p<0.001) and VAT (p<0.01) as major costs. 4. The directors of dietetic departments and managers thought that the hospital should be responsible for utility costs. On the other hand, directors of dietetic departments regarded that the contractor and managers thought that the hospital should pay for facility investment cost.
Commerce ; Diet ; Food Service, Hospital ; Gyeonggi-do ; Hand ; Incheon ; Investments ; Meals ; Postal Service ; Surveys and Questionnaires ; Seoul

The purpose of this study was to assess how the changes in the food services environment on patients satisfaction with the hospital food service. Statistical data analyses were completed using the SPSS 11.0 program. The results can be summarized as follows: The flow line and environment of the food services in the hospital were improved through remodeling, which included the replacement of all cooking utensils, ventilation facilities and material storages, the purchase of a combi steamer, and the change of meal carts and trays. After the remodeling, the hospital food service was improved so that it provided spoons at each meal, diversified the menu utilizing the combi steamer, served event meals three times a week as well as water boiled with burned rice in the morning twice a week. In addition, various types of tableware were used in the table settings to produce attractive visual effects. Among the 10 items included on the patient satisfaction questionnaire, "satisfaction with offered menus" (p<0.01) showed significantly higher scores before the remodeling. "cooking/seasoning of food", "amount of meals" and "taste of meals" were not statistically significant, but showed increased satisfaction after the remodeling. However "temperature of food", "cleanliness of clothes and features" and "satisfaction with meal times" were not statistically significant, but showed decreased satisfaction after the remodeling.
Burns ; Cooking and Eating Utensils ; Data Interpretation, Statistical ; Food Service, Hospital* ; Food Services* ; Humans ; Meals ; Patient Satisfaction ; Ventilation ; Water ; Surveys and Questionnaires

The purposes of this study were to investigate the current status of contracted hospital food services and to find out the difference in accordance with the number of beds in hospitals. Thirty six hospitals having more than 100beds in Seoul, Inchon and Kyungkido were the subjects of this study. Data was collected through surveys. The survey was conducted during March and April in 2002. The Questionnaires were mailed to the 36 directors of dietetic departments of the hospitals and 36 managers of contracting patient food services. Statistical analysis was completed using SPSS Win(11.0) for descriptive analysis and t-test. The results of the study are summerized as follows; I. Hospital perspective : The range covered by contract food service was 63.3% and 36.7% in hospital food services, and medical nutrition services. The patient and employee food services were in 83.3%, and patient food services were in 6.7%. The methods selecting contractors are general, limited, selected and competitive biddings, and private contracts. The responsibility for supervision of contract food services was the dietetic department (51.7%) in most cases. Hospitals having personnel responsible for contracting affairs were in 75.9% of the cases and 24.1% did not have personnel. The biggest reason for contracting was facilitation of personnel management. The most important criteria on selecting food services contractors was the professionality of the contractor. II. Contractor's perspective : The cost per meal in the year 2001 was composed of 1,905 won for food cost, 1,081 won for labor cost, 222 won for expenses, 114 won for VAT, 14 won for rent and 146 won for miscellaneous or controllable expense, representing 109 won loss per meal. The profit-and-loss contract cost is higher than the fee-contract cost. The ratios of food cost, labor cost and expenses are higher and the ratios of miscellaneous or controllable expense, VAT, rent and profit are lower in hospitals with more than 400 beds compared with those less than 400 beds. However, no significant differences are present between these two groups of hospitals. The actual contract period was 2.2 years upon initial contract and 1.2 years upon renewal. The initial investment cost was 53 million won and the cost of renovation and repair was 8.5 million won. Significant differences were present between two groups of hospitals. The conditions of employment and number of personnel hired by contractors for contract patient food services were significantly different according to the number of beds.
Competitive Bidding ; Employment ; Food Service, Hospital* ; Food Services ; Gyeonggi-do ; Humans ; Incheon ; Investments ; Meals ; Organization and Administration ; Personnel Management ; Postal Service ; Surveys and Questionnaires ; Seoul

The purposes of this study were to investigate the current status of contracted hospital food services and to find out the difference in accordance with the number of beds in hospitals. Thirty six hospitals having more than 100beds in Seoul, Inchon and Kyungkido were the subjects of this study. Data was collected through surveys. The survey was conducted during March and April in 2002. The Questionnaires were mailed to the 36 directors of dietetic departments of the hospitals and 36 managers of contracting patient food services. Statistical analysis was completed using SPSS Win(11.0) for descriptive analysis and t-test. The results of the study are summerized as follows; I. Hospital perspective : The range covered by contract food service was 63.3% and 36.7% in hospital food services, and medical nutrition services. The patient and employee food services were in 83.3%, and patient food services were in 6.7%. The methods selecting contractors are general, limited, selected and competitive biddings, and private contracts. The responsibility for supervision of contract food services was the dietetic department (51.7%) in most cases. Hospitals having personnel responsible for contracting affairs were in 75.9% of the cases and 24.1% did not have personnel. The biggest reason for contracting was facilitation of personnel management. The most important criteria on selecting food services contractors was the professionality of the contractor. II. Contractor's perspective : The cost per meal in the year 2001 was composed of 1,905 won for food cost, 1,081 won for labor cost, 222 won for expenses, 114 won for VAT, 14 won for rent and 146 won for miscellaneous or controllable expense, representing 109 won loss per meal. The profit-and-loss contract cost is higher than the fee-contract cost. The ratios of food cost, labor cost and expenses are higher and the ratios of miscellaneous or controllable expense, VAT, rent and profit are lower in hospitals with more than 400 beds compared with those less than 400 beds. However, no significant differences are present between these two groups of hospitals. The actual contract period was 2.2 years upon initial contract and 1.2 years upon renewal. The initial investment cost was 53 million won and the cost of renovation and repair was 8.5 million won. Significant differences were present between two groups of hospitals. The conditions of employment and number of personnel hired by contractors for contract patient food services were significantly different according to the number of beds.
Competitive Bidding ; Employment ; Food Service, Hospital* ; Food Services ; Gyeonggi-do ; Humans ; Incheon ; Investments ; Meals ; Organization and Administration ; Personnel Management ; Postal Service ; Surveys and Questionnaires ; Seoul

The purposes of this study were to evaluate the quality of hospital food services in view of patients in orthopedic wards and accomplish the quality improvement in hospital foodservice operations. Quantitative questionnaires for patients containing foodservice satisfaction and demographic information were developed. A survey of 8 general hospitals was undertaken and detailed information was collected from 290 patients in orthopedic wards. The collected data were processed using the SAS PC 6.12 for descriptive analysis, t-test. In demographic information of patients, 32.6% was over 50 years old and 31% was hospitalized over 30 days. 80% of patients was taking normal diet. 47.7% and 47.9% of patients showed moderate appetite and moderate pain respectively. The overall satisfaction score for patients was 3.24 out of 5, showing slightly higher level than the average score(3.00). According to foodservice involvement scores of patients, they were divided into two groups which were high involved group and low involved group. Two groups showed significant differences in taste of meals, variety of menu, punctuality of meal times, temperature of meals and portion size. The foodservice involvement factor which affected significantly patient foodservice satisfaction was 'kindness of foodservice staff'.
Appetite ; Diet ; Food Service, Hospital ; Hospitals, General ; Humans ; Meals ; Middle Aged ; Orthopedics* ; Portion Size ; Quality Improvement ; Surveys and Questionnaires

The purposes of this study were to evaluate the quality of hospital food services in view of patients in orthopedic wards and accomplish the quality improvement in hospital foodservice operations. Quantitative questionnaires for patients containing foodservice satisfaction and demographic information were developed. A survey of 8 general hospitals was undertaken and detailed information was collected from 290 patients in orthopedic wards. The collected data were processed using the SAS PC 6.12 for descriptive analysis, t-test. In demographic information of patients, 32.6% was over 50 years old and 31% was hospitalized over 30 days. 80% of patients was taking normal diet. 47.7% and 47.9% of patients showed moderate appetite and moderate pain respectively. The overall satisfaction score for patients was 3.24 out of 5, showing slightly higher level than the average score(3.00). According to foodservice involvement scores of patients, they were divided into two groups which were high involved group and low involved group. Two groups showed significant differences in taste of meals, variety of menu, punctuality of meal times, temperature of meals and portion size. The foodservice involvement factor which affected significantly patient foodservice satisfaction was 'kindness of foodservice staff'.
Appetite ; Diet ; Food Service, Hospital ; Hospitals, General ; Humans ; Meals ; Middle Aged ; Orthopedics* ; Portion Size ; Quality Improvement ; Surveys and Questionnaires

The aims of this study are to evaluate the quality of hospital food services and the evaluate the quality in selected hospitals trough the use of the questionnaires. A survey of 30 hospital food and nutrition service department was undertaken and detailed information was collected from each, including, surveys of 1,016 patient. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis, t-test chi2-test ANOVA principal component analysis, and cluster analysis and cluster analysis. In the case of patient satisfaction with hospital food and food services, overall satisfaction scores of male and female were 3.54 and 3.45 showing higher levels than the average score(3.00) The aspect of the food and food service which received the lowest ratings by patients was 'meal rounding while dining'. After conduction of factor analysis of variables affecting the patients meal satisfaction 3 groups including the 'menu satisfaction factor', 'service satisfaction factor' and 'nutrition management satisfaction factor' were selected. 3 clusters were categorized by the 'service cluster' 'nutrition management cluster', 'men cluster', and 'menu nutrition service cluster' after conducting a cluster analysis with influencing variables affecting patients meal satisfaction. The overview results of patient satisfaction by cluster were : in the case of the service group, such factors as taste, portion size, dealing with complaints while dining meal rounding while dining should be managed with caution In case of the nutrition management group, such factors as taste, portion size, temperature of the food intake, and dependence on hospital food should be managed with care, In the case of the menu groups, such factors as punctuality of meal times, contaminated substances in meals and serving mistakes, cleanliness of dishes, kindness of the server meal rounding while dining should by particularly managed with importance.
Data Interpretation, Statistical ; Eating ; Female ; Food Service, Hospital ; Food Services* ; Humans ; Male ; Meals ; Patient Satisfaction* ; Portion Size ; Principal Component Analysis ; Surveys and Questionnaires

Young radish (Raphanus sativus L), a member of the mustard family (Cruciferae), is a common ingredient of Kimchi. Although few reports have described anaphylaxis to cruciferous vegetables, we report the case of anaphylaxis induced by contact with young radish. A 46-year-old female with a history of contact allergy to metal presented to our emergency room (ER) with dizziness, generalized eruption and gastrointestinal upset. Her symptoms developed after re-exposure to young radish while chopping it. Hypotensive blood pressures were noted. Three days prior, the patient had experienced generalized urticaria with pruritus immediately after chopping the fresh young radish, which resolved spontaneously. In the ER, her symptoms improved by the administration of epinephrine (0.3 mL), antihistamine (chlorpheniramine) and isotonic saline hydration. A skin prick test with young radish extract showed positive reactivity. The same skin test was negative in five adult controls. IgE-mediated hypersensitivity could be an important immunologic mechanism in the development of young radish-induced anaphylaxis.
Adult ; Anaphylaxis* ; Dizziness ; Emergency Service, Hospital ; Epinephrine ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Middle Aged ; Mustard Plant ; Pruritus ; Raphanus* ; Skin ; Skin Tests ; Urticaria ; Vegetables