Tray Line Observation

The clinical nutrition manager at Mercy General Hospital (MGH) who oversees tray line was interested to see how long it takes for carts to be delivered to the units throughout the hospital, and if the actual delivery times match their current tray line/cart delivery schedule. She identified a need for this data in response to the Diabetes Task Force at MGH requesting a more consistent schedule of cart delivery, so nurses will know what time they should be administering insulin to patients before meals. The clinical manager was also curious to evaluate the efficiency of tray line and accuracy of their current tray line/cart delivery schedule.

Methods:

I created a form in order to record when carts left the kitchen and what time they were

Delivery times typically took longer at lunch due to the employee who is responsible for delivering carts to the units having to retrieve special request items from the grill or café before the carts could be delivered, which consistently occurred more frequently at lunch compared to breakfast. Departure to delivery time also depended on how many carts were needed for specific units, and the distance of the unit from the kitchen. If a unit required two carts, the employee would sometimes have to make two trips in order to deliver all of the trays. This delayed the delivery process, and resulted in carts being delivered later than the set delivery schedule. At breakfast all carts were delivered within 3 minutes of the scheduled delivery time, with the exception of the 2N unit that was delivered 5 minutes early. At lunch there were 5 units whose average actual delivery times averaged 7- 9 minutes later than the scheduled delivery

The data I collected helped evaluate the efficiency of cart delivery times, the accuracy of the current cart delivery schedule, and was used to make adjustments to the current schedule. Based on the data, I recommend delaying lunch cart delivery times by 5 minutes for the PCU, ASU, 4W, 4M, and 2S units to reflect a more accurate representation of when carts are actually being delivered. I also recommend assigning another employee to help with retrieving special request items from the grill/café in order to reduce the workload of the employee working the “zoner” position. The zoner is responsible for delivering all of the carts to the units expect for 4W and 4M, which the kitchen 12 position helps with. During busy times on tray line carts frequently become backed up in the kitchen, which delays the cart delivery when the zoner does not have enough help. I believe that having kitchen 12 continue to help deliver carts and retrieving special items throughout the duration of tray line would help the process run smoother and more efficiently. It may also be beneficial to designate a cart for late trays, opposed to sending them on the last card that goes to the MSNICU unit. This would allow the MSNICU cart to be delivered sooner, as the zoner takes