33

 

THE HOSPITAL FOOD SERVICE DIRECTOR:  - .5 7'1 i ' ’
- ESSENTIAL'QUALIFICATIQNS   : .

Thesis for the Degree of MS} ' f i .
MICHIGAN STATE UNNERSITY
GATHA ANN. WILUAMS
1974 5 .

ABSTRACT

THE HOSPITAL FOOD SERVICE DIRECTOR:
ESSENTIAL QUALIFICATIONS

BY
Gatha Ann Williams

This study was concerned with determining the
essential job qualifications that hospital dietary depart-
ment directors must possess in order to operate the depart-
ment effectively. Opinions were sought from two sources--
hospital administrators and officials of contract food
management companies. It was believed that (a) the
opinions of these two main types of employers of hospital
dietary directors would serve as a realistic basis for
determining the specialized knowledge and skills needed by
the competent hospital food service director, and (b) such
knowledge would provide valuable insight for educators in
the modification of professional training programs in
administrative dietetics and would be useful in designing
career ladders for practicing dietitians with interest in
administrative dietetics.

The data gathering technique used for Part A of

the survey was the mail questionnaire which consisted of

if!” Gatha Ann Williams

open-ended and fixed alternative questions. This research
instrument solicited opinions from the administrators of
one hundred non-governmental hospitals, located in the
Lower Peninsula of Michigan, with a bed capacity of one
hundred or more.

For Part B of the study the opinions of officials
of four contract food management companies Operating in
Michigan were obtained through personal interviews con-
ducted by the researcher. A standardized interview guide
consisting of both Open-end and fixed alternative questions
comparable to those presented to the hospital administrators
contacted in Part A of the study was used.

Findings from this study indicate that the role of
administrative leadership in dietary departments of Michi-
gan hospitals is no longer the exclusive domain of pro-
fessionally-trained dietitians. Hospital administrators
and officials of contract food management companies, the
two main employers of hospital dietary directors, are search-
ing for and selecting individuals to direct their dietary
departments primarily on the basis of experience and
potential ability to manage the food service demands of
the institution. As a result, nearly half of the persons
who currently direct the food service activities of the
hospital-Operated departments of the institutions repre-
sented in this study are not professionally-trained

dietitians certified by the American Dietetic Association.

Gatha Ann Williams

In Michigan hospitals serviced by contract food manage-
ment companies the percentage of individuals employed as
food service directors who are not certified members of
the American Dietetic Association is even higher.

Particular areas of competence that these Michigan
employers feel professionally—trained dietitians lack
which tend to disqualify them for administrative positions
in hospital food service departments suggest the need for
additional training in administrative-technical skills and
in communication effectiveness. Since the majority of the
survey respondents indicated a preference for ADA-certified
dietitians as directors of their hospital food service
departments, and since professionally-trained dietitians
currently have many of the other qualifications essential
for administrative success in food service operations, it
is likely that improved competence in the areas of lack
identified by these employers would measurably increase
the chances for ADA certified dietitians to compete

successfully for administrative positions in hospital

dietary departments.

THE HOSPITAL FOOD SERVICE DIRECTOR:

ESSENTIAL QUALIFICATIONS

BY

Gatha Ann Williams

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF SCIENCE

Department of Food Science and Human Nutrition

1974

ACKNOWLEDGMENTS

The author wishes to extend her most sincere
appreciation to Dr. Grace A. Miller for her kindness,
valuable guidance and generous assistance throughout the
author's graduate program. Grateful acknowledgment is
also extended to Dr. Gilbert A. Leveille for encourage-
ment, interest and financial assistance.

The author is also indebted to Miss Burness
Wenberg, Miss Jean McFadden and Dr. William Sweetland
for serving on my guidance committee and for their help-
ful comments and suggestions.

Sincere thanks are extended to Miss Verda Scheifley
and Mrs. Judy Pfaff for generous assistance with the many

computer related problems.

ii

TABLE OF CONTENTS

Page
LIST OF TABLES . . . . . . . . . s . . . V
Chapter
I. INTRODUCTION . . . . . . . . . . . 1
Statement and Significance of the Problem . 2
Assumptions . . . . . . . . . . . 3
Objectives 0 o ‘ o o o o o o o o o o 3
Definition of Terms . . . . . . 4
Organization of the Study Report . . . . 6
II. REVIEW OF LITERATURE . . . . . . . . . 8
Employment Trends . . . . . 8
Responsibilities of the Hospital Food
Service Director . . . . . . . . . 13
Employment Disqualification Factors . . . 15
Essential Qualifications for a Hospital
Food Service Director . . . . . . . 22
Recruitment . . . . . . . . . . . 27
III. METHOD OF INVESTIGATION . . . . . . . . 29

Part A: The Mail Survey . . . . . . . 29
The Population . . . . . . . . . . 29

Survey Instrument . . . . . . . . . 30
Review of Instrument . . . . . . . . 33
Distribution . . . . . . . . . . 33

Part B: The Personal Interview . . . . . 34
The Population . . . . . . . . . . 34
Interview Guide . . . . . . . . . 34
The Interview Procedure . . . . . . . 36

Analysis of the Data . . . . . . . . 37
Part A: Mail Survey Responses . . . . 37
Part B: Personal Interview Data . . . . 38

iii

Chapter

IV. ANALYSIS OF THE SURVEY DATA . . . . . .

Part A: Hospital Administrators . . . .

Assessment of Response Representation .
The Study Participants . . . . . .
Hospital and Dietary Department:
Operational Characteristics . . . .
Contract Food Management Company Services
The Hospital Food Service Director:
Essential Qualifications . . . . .
Recruitment of a Hospital Food Service
Director (Manager) . . . . . . . .

Part B: Contract Food Management Company

Officials . . . . . . . . . . .
The Study Participants . . . . . .
Operational Characteristics . . . . .
The Hospital Food Service Director:
Essential Qualifications . . . . .
Recruitment of Hospital Food Service
Directors . . . . . . . . . .

V. SUMMARY, CONCLUSIONS AND IMPLICATIONS . . .

Summary of Mail Questionnaire Findings . .

Summary of Personal Interview Findings

Assessment of Response Representation .
The Study Participants . . . . . .
Hospital and Dietary Department Opera-
tional Characteristics . . . . . .
Contract Food Management Company Service
The Hospital Food Service Director:
Essential Qualifications . . .
Recruitment Means . . . . . .

The Study Participants . . . .
Operational Characteristics . . .
The Hospital Food Service Director:
Essential Qualifications . . . . .
Recruitment of a Hospital Food Service
Director . . . . . . . . . .

Conclusions and Implications . . . . .

LITERATURE CITED 0 O O O O O O O O O O O
APPENDICES O O O O O O O O O O O O O O
A. HOSPITAL ADMINISTRATORS. . . . . . . .

B. CONTRACT FOOD MANAGEMENT COMPANY OFFICIALS .

iv

Page
39
39
44

52
69

71
81
86
90
98
101
104
105
105
105

106
107

108
108
109
109
110
111

111
112

114
119
120
128

 

 

 

mill II

LIST OF TABLES

Table Page
1. Survey Response by Hospital-Community Class . . 40
2. Questionnaire Response Based on Community Size . 41
3. Questionnaire Response Based on Hospital Size . 42

4. Questionnaire Response Based on Counties and
Regions 0 O O O O O O O O O O O O 43

5. Administrative Titles of Survey Respondents:
Frequency Distribution in Relationship to
HOSpital Size . . . . . . . . . . . 45

6. Highest Degree Earned by Survey Respondents:
Frequency Distribution in Relation to
Hospital 8126 0' o o o o o o o o o o 47

7. Professional Specialization of Survey Respond-
ents: Frequency Distribution in Relationship
to Hospital Size . . . . . . . . . . 48

8. Total Number of Years in the Field for Survey
Respondents: Frequency Distribution in
Relation to Hospital Size . . . . . . . 50

9. Total Number of Years in Present Position for
Survey Respondents: Frequency Distribution
in Relation to Hospital Size . . . . . . 50

10. Ranges Among Facilities Within Hospital Size:
Patient Census, Total Hospital Staff, and
Total Dietary Staff . . . . . . . . . 53

ll. Ranges Among Facilities Within Hospital Size:
Total Dietary Staff . . . . . . . . . 55

12. Types of Meal Service Provided by Hospitals
Surveyed . . . . . . . . . . . . . 57

Table

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

Page

Position Titles of Dietary Directors of Survey
Respondents: Frequency Distribution in
Relationship to Hospital Size . . . . . . 59

Educational Attainment Levels of Hospital Food
Service Manager. Frequency Distribution in
Relationship to Hospital Size . . . . . . 60

Area of Specialization for Directors of Food
Service: Frequency Distribution in Relation-
ship to Hospital Size . . . . . . . . . 61

Total Years in the Field for Directors of Food
Service: Frequency Distribution in Relation-
ship to Hospital Size . . . . . . . . . 62

Total Number of Years in Present Position for
Directors of Food Service: Frequency
Distribution in Relationship to Hospital Size . 63

Professional Classification of Directors of
Food Service: Frequency Distribution in
Relationship to Hospital Size . . . . . . 65

Attainment of Present Position for Director of
Food Service: Frequency Distribution in
Relationship to Hospital Size . . . . . . 65

Managerial Competence Rating of Directors of
Food Service: Frequency Distribution in
Relationship to Hospital Size . . . . . . 66

Present Director of Food Service: Professional
Classification XE- Competence Ratings by
Hospital Administrators .. . . . . . . . 67

Managerial Competences Essential for the
Hospital Food Service Director as Perceived
by Hospital Administrators: Frequency
Distribution in Relationship to Hospital
Size . . . . . . . . . . . . . . 73

Personal Traits and Skills Essential for the
Hospital Food Service Director as Perceived
by Hospital Administrators: Frequency Dis-
tribution in Relation to Hospital Size . . . 74

vi

Table Page

24. Most Desirable Professional Background for a
Director (Manager) of a HOSpital Food Service
Department as Perceived by Hospital Adminis-
trators: Frequency Distribution in Relation-
ship to Hospital Size . . . . . . . . . 76

25. Most Desirable Minimum Level of Academic
Training for a Hospital Food Service Director
(Manager) as Perceived by Hospital Administra-
tors: Frequency Distribution in Relationship
to Hospital Size . . . . . . . . . . 77

26. Minimum Amount of Work Experience Considered
Essential for Employment as Director
(Manager) of a Hospital Dietary Department as
Perceived by Hospital Administrators:
Frequency Distribution in Relationship to
Hospital Size . . . . . . . . . . . 79

27. Areas of Competence that Most Professionally-
Trained Dietitians Lack as Perceived by
Hospital Administrators: Frequency Distribu-
tion in Relationship to HOSpital Size . . . 80

28. Recruitment Means Used by Hospital Administra-
tors: Frequency Distribution in Relationship
to Hospital Size . . . . . . . . . . 82

29. Recruitment Means Effectiveness: Opinions of
Hospital Administrators (Rank Order--Most
to Least--According to Frequency of Mention) . 84

30. Recruitment Problems Encountered by Hospital

Administrators: Frequency Distribution in

Relation to Hospital Size . . . . . . . 85
31. Professional Profiles of Interviewees from

Four Contract Food Management Companies

with Michigan Hospital Accounts . . . . . 88
32. Types of Michigan Establishments Served . . . 91

33. Number of Michigan Hospital Food Service
Accounts . . . . . . . . . . . . .. 92

34. Employment of Hospital Dietary Employees by
Contract Food Management Companies . . . . 95

vii

Table Page

35. Managerial Skills and Personal Traits Essential
for the Hospital Food Service Director as
Perceived by Interviewees from Four Contract
Food Management Companies . . . . . . . . 100

36. Recruitment Means Used by Contract Food
Management Company Officials Surveyed . . . . 103

viii

CHAPTER I

INTRODUCTION

The supplantation of professionally—trained adminis-
trative dietitians by contract food management companies, or
by independent food service managers, as directors of hos-
pital dietary departments is a problem of growing concern to
the profession of dietetics. Even though the employment of
contract food management companies and independent food
service managers by hospitals did not begin until the early
1950's, during the last twenty—five years the practice has
become alarmingly wideSpread.

Recent studies conducted by Spangler (33) for the
State of Michigan and by Hofto and Brush (14) for the State
of New Jersey revealed that, of the hospitals they contacted,
less than half employed professionally-trained dietitians as
directors/managers of their dietary departments. According
to Lipscomb and Donaldson (17) and Hofto and Brush (14), the
reason most often given for hospitals turning to outside
management firms and independent managers is their dissatis-
faction with the managerial competence levels of most pro-

fessionally trained dietitians. Thus, the challenge to

administrative ADAl dietitians has been made: master the
latest skills and techniques of management in order to
effectively operate hospital dietary departments or relin-
quish this position to persons other than professionally-
trained dietitians (19, 21, 24, 29).

If administrative dietitians are to attain and main-
tain competitive status, it is imperative that the essential
job qualifications and the present shortcomings of their

academic and experiential training be identified.

Statement and Significance of the Problem

This thesis is concerned with determining the
essential job qualifications that hospital dietary depart-
ment directors must possess in order to operate the depart-
ment effectively.

Administrators from one hundred non-governmental
hospitals, located in the lower peninsula of Michigan and
with a bed capacity of one hundred or more, and officials of
six contract food management companies operating in Michigan
were asked to give their perceptions concerning the essential
job qualifications of the hospital dietary director. It was
believed that the opinions of these two major employers of
hospital dietary directors, each steming from a different
frame of reference, would serve as a realistic basis for

determining the specialized knowledge and skills needed by

 

1American Dietetic Association.

the competent hospital food service director. Such knowl—

edge would provide valuable insight for educators in the

modification of professional training programs in adminis-

trative
ladders

trative

dietetics and would be useful in designing career

for practicing dietitians with interest in adminis-

advancement.

Assumptions

 

The basic assumptions for this study were:

1.

The

1.

Administrative dietitians are being increasingly
supplanted by employees of contract food manage-
ment companies and/or independent managers to
direct the activities of hospital dietary depart-
ments of Michigan hospitals.

Lack of professional managerial skills is the
major factor contributing to the loss of competi-
tive status of professionally—trained dietitians
with interest in top-level administrative posi-

tions in the field of hospital dietetics.

Objectives

 

objectives of this research study were threefold:
To survey selected Michigan non-governmental
hospitals of one hundred or more beds to
ascertain: I

a. the current professional manpower needs for
Operating the dietary department,

b. the extent to which dietary departments are
being operated by hospitals,

c. the extent to which hospitals are employing
outside firms and/or individuals to operate
their dietary services, and

d. the essential job qualifications for
directors/managers of hospital dietary
departments, as perceived by hospital
administrators.

2. To survey selected contract food management
companies operating in Michigan to ascertain:

a. the types of dietary management services
currently available to Michigan hospitals,

b. the current professional manpower needs to
service hospital dietary accounts, and

c. the essential job qualifications for
directors/managers of hospital dietary
services as perceived by contract food
management company officials.

3. To identify the academic and experiential areas
which tend to disqualify professionally-trained
dietitians in the selection of directors/

managers for hospital dietary departments in

Michigan.

Definition of Terms

 

For the purpose of this study the following defini-

tions were adopted:

1. Hospital Administrator: The hospital adminis-

 

trator is the executive director of the hospital and the

deputy of the Board of Trustees. His functions consist of

all activities necessary to effectively direct and manage

the affairs of the hospital (20).

2. Director of Hospital Dietary Department: The

 

person who administers, plans, and directs activities of

the department providing quantity food service. Establishes
policies and procedures. Provides administrative direction
to menu formulation, purchasing, food preparation and
service, sanitation standards, safety, and personnel
utilization. Is responsible for financial management;
maintains a system of records for planning and control.
Selects the professional dietary staff. Directs departmental
programs of education. Coordinates interdepartmental pro-
fessional activities and relationships. Serves as a con-
sultant to management in matters relating to dietetics (44).

3. Independent Food Service Manager: A person who

 

performs all the activities of the hospital dietary depart-
ment director. The dietary manager's status of employment
differs from that of other hospital employees in that the
manager has a personal contract with the hospital.

4. Contract Food Management Company: Outside
management firm that is employed by the hospital to operate
the dietary department. The company provides total manage-
ment for the department, but the hospital retains the right
to establish dietary policy. Three common types of contract

food management companies are:

a. Management firms that provide supervisory
personnel to work in the dietary departments
and introduce specific management policies
that are approved by the hospital administra-
tor.g All food is prepared by dietary
personnel within the hospital.

b. Management-Commissary firms place super-
visory personnel to work in the dietary
department and employ certain management
practices with the approval of the hospital
administrator. Food is supplied to the
hospital from their own commissary. Most
foods are delivered in a semi-prepared or
ready-to-eat form.

c. Management-Consultant firms may provide
total management, but also specialize in
contracting for specific problems and selling
or leasing certain parts of their management
systems (40).

Organization of the Study Report

 

The remaining report sections are organized as
follows:

Chapter II: Review of Literature: Aspects of

 

employment trends, responsibilities of the hospital food
service director, employment disqualifications factors,
essential qualifications for a hospital food service direc-
tor and recruitment sources are reviewed.

Chapter III: Methodology: A detailed description

 

of the two survey populations, survey instruments, data
collection procedures, and methods of data analysis.

Chapter IV: Analysis of the Survey Data: Educa-

 

tional achievement and professional experience of the

respondents and of the hospital dietary directors are

reported. The operational characteristics of hospitals and
contract food management companies are described. Opinions
of hospital administrators and contract food management
company officials concerning essential job qualifications
for the director/manager of hospital dietary departments
are compared within and between survey groups to determine
the types of managerial skills which professionally-trained
dietitians need to receive consideration for administrative
advancement in the field of hospital dietetics. Other com-
parisons between and within the groups include recruitment
means used in searching for hospital dietary directors and
areas of competency that administrative dietitians lack.
Opinions of hospital administrators concerning the use of
contract food management companies are also included.
Chapter V: Summary, Conclusions and Implications

of the Study: In this chapter, the study is summarized,

 

conclusions and implications are drawn.

CHAPTER II

REVIEW OF LITERATURE

Due to the technological, social, and economic
developments of the past twenty years the health care
industry has grown at a tremendous rate and is now con-
sidered big business (13, 15). At all levels of adminis—
tration it has been necessary to adopt new concepts and
methods of management in order to cope with increased
patient load, inflation, personnel problems, governmental
regulations, and new technology. One of the areas of
major concern to the hospital administrator is financial
management. Cost consciousness has led him to concentrate
his efforts on producing high quality service at the lowest
possible price (34). As a result, hospitals are now seeking
highly qualified managers to oversee the operation of their

many functions.

Employment Trends

 

The need for operational leadership ability has
led to employment of business-oriented persons to direct
the activities of the hospital instead of members of the

medical profession. The 1973 Hospital Guide Issue of the

American Hospital Association (43) revealed that of the 271
Michigan hospitals reported in the Issue only 30 (11%) have a
member of the medical profession as administrator of the hos-
pital compared to 80 (33%) of 240 in 1958 (41).

The trend of employing management personnel more on
the basis of administrative skills and less on the basis of
technical abilities also is evident in middle management
positions. In hospital dietary departments the trend is to
make use of trained personnel other than ADA dietitians to
handle the administrative functions of the department and
leave the nutritional aspects of the job to the clinical ADA
dietitian (21, 24).

In a 1964 nation-wide survey (40) conducted by ADA
concerning food service in hospitals it was revealed that
employment of ADA members as dietitians and directors of
dietary departments out-numbered that of professionally
trained food service managers but, when compared to all non—
ADA members (food service supervisors, cook managers, food
service managers, etc.) the situation was reversed. Of the
3838 usable responses received in the study, ADA dietitians
managed 1808 (47%) of the food service departments where as
2030 (53%) departments were directed-by non-ADA members.

ADA members were food service directors in 67% of the
smaller hospitals (100 to 500 beds) but as hospital size
increased the number of ADA dietitians employed to direct

food service operations decreased.

10

The ratio of ADA dietitians to non-ADA food service
managers was reversed in the 1972 findings of Hofto and
Brush (14). Their study of New Jersey hospitals revealed
that ADA dietitians were directors of dietary departments
in only 33% (24 of 72) of the general short term hospitals
with 100-500 beds.

In many of the hospitals where dietitians are not
employed as food service directors contract food management
companies or independent managers are engaged to direct the
departments. The use of contract food management companies
began in the 1950's and has been steadily increasing (9,
37). By 1960 there were 191 hospitals in the United States
with dietary services provided by outside firms and this
number increased to 380 by 1966, the last year that the
American Hospital Association requested such information
from the hospitals they survey annually. In Michigan the
number of hospital contract accounts increased from four
in 1961 to 24 in 1966. The management companies operating
in Michigan, collectively lost only four of the contracted
accounts over this six year period.

More than one-fourth of all hospital contract
accounts were in small facilities, less than 100 beds (38%
for Michigan in 1966 [42] and 27% nationally in 1964 [40]).
The sizable number of contract accounts in hospitals of less

than 100 beds was not expected since a 1968 survey of 20

11

contract management companies (9) pointed out that, at the
time of the survey, five of these companies did not contract
with small facilities and six companies discouraged con-
tracts with hospitals of less than 100 beds because it

would be economically infeasible for both parties.

The literature contains several references (23, 34,
37) concerning the advantages for using contract food
management companies. The five reasons most often empha-
sized are: (a) availability of a centralized personnel
pool, (b) minimized involvement of the hospital administra-
tor in the daily operation of the department, (c) savings
based on quantity purchases, improved quality and portion
control, and increased efficiency and reduction in total
man-hours of labor, (d) employee recruitment and training
at all levels of the department, and (e) centralized
accounting that reports on dietary costs monthly.

After reviewing the advantages listed in the
literature for employing contract food management companies
Rainier (26) concluded that these same results could be pro-
vided by a competent administrative dietitian and management
staff at a much lower cost to the hospital. Rainier accused
the hospital administrator of failing to accept his job
responsibilities by farming out many of the hospital
services.

The types of services that hospitals may purchase

are numerous: food service, laundry service, window washing,

12

housekeeping, public relations, legal advice, fund raising
counsel, consulting services in administrative management
and organization, business and accounting practices, aseptic
techniques, and employee relations, as well as outside
pathology and radiology services. Hospital administrators
justify the use of these outside firms on the basis of
operating economics (34).

The case for the use of hospital staff to direct
the dietary department was given by Zugich (38). It is
interesting to note that the advantages of a hospital—
operated department listed by him were all patient-oriented,
whereas advantages for contract management companies were
always related to economics. Zugich's defense for hospital-
operated dietary departments included:

1. The nutritional knowledge and counsel from
trained professionals is apt to be maintained
in greater continuity, quantity, and influence
in residence under a hOSpital-operated depart—
ment.

2. The scope of food interests for patients and
services to the hospital organization will tend
to be broader under a hospital-operated
department.

3. Hospital-Operated services should provide
greater flexibility to meet medical staff or
ill patient needs.

4. Direct management control is insurance against
conflict of objectives and promotes optimum

coordination with medical and nursing standards
of care programs of the specific hospital.

13

5. Safety factors affecting some patients' welfare
are more apt to be observed in a hospital-
operated department.

6. The hOSpital's appreciation of nutrition for
the sick will not tend to remain static or
depreciate.

ReSponsibilities of the Hospital
Food Service Director

 

 

Regardless of the type of department management the

hospital selects or the professional background of the

director, the major role and responsibilities of the person

who heads the dietary department are the same. These

responsibilities and activities were outlined in a 1965 ADA

report (39) on the duties and re8ponsibilities of the

Dietary Director.

A. Planning, organizing, and directing activities of the
department.

1.

Establishing both long- and short-range objectives
for the department which are consistent with the
goals of the institution.

Recommending policies and standards for the
department to administration.

Interpreting objectives, accomplishments, and
needs of the department to administration.

Planning for effective budget management and
personnel utilization.

Planning, organizing, evaluating, and directing
the total food service, including: normal and
therapeutic food service to patients and personnel,
purchasing specifications for facilities and
materials, food production, and sanitation and
safety standards.

10.

11.

12.

13.

14

Participating in conferences of department heads.

Attending general medical staff meetings and
clinical conferences in accordance with the
hospital policy.

Establishing and maintaining effective intra- and
interdepartmental communication patterns.

Coordinating and integrating departmental services
with those of other departments.

DevelOping and maintaining an organization chart
of the department showing responsibilities and
authority of all personnel.

Delegating responsibilities to all professional
staff members and supervising their work.

Supervising maintenance of cost control and
personnel records and reports, without duplicating
information kept in other departments.

Participating in professional and community
activities.

Planning, organizing, and directing educational programs
of the department.

1.

2.

DevelOping and maintaining an active and effective
staff development program.

Planning, advising, and/or participating in the
development and execution of educational programs
for: nursing students; medical and dental students;
interns and residents; dietetic interns; and other
groups in the institution.

Participating in formulation and maintenance of an
effective and continuous program for the orienta-
tion, training, and supervision of personnel.

Planning, organizing, and directing research programs of
the department.

1.

Developing and implementing research programs in
administration, food production, normal and
therapeutic nutrition, and education.

Cooperating and assisting with medical research
related to nutrition.

15

Employment Disqualification Factors

A wide variety of educational backgrounds and pro-
fessional experience are held by persons presently directing
the activities of hospital dietary departments. A review of
the duties and responsibilities of the dietary director
causes one to wonder which types of work experience and/or
education would be most useful to the successful director.
The literature contains several opinions regarding these
points but the preference is for the employment of a
director on the basis of his ability to perform the job
regardless of his background or professional affiliation
(16, 31). Therefore, applicants are usually selected for
employment on the basis of their past performance and not
on the basis of who traditionally held the position.

It is felt by some authors (18, 26) that if the
administrative dietitian has adequately learned the skills
of management along with a basic knowledge of nutrition
then she would be the best qualified person for the job.
These writers further point out that knowledge of nutrition
is not enough since the activities of a hospital dietary
department are quite varied.

Traditionally, professionally qualified dietitians
have been employed as directors of hospital dietary depart-
ments but, as was pointed out by the ADA survey (40) and
by Hofto and Brush (14), many of these positions are

presently held by non-ADA members. The reason most often

16

given for employing non—ADA members is that hospital
administrators are dissatisfied with the managerial per-
formance of most professionally-trained dietitians.
Lipscomb and Donaldson (17) surveyed hospital administra-
tors in the East-North Central Region of the United States
and reported that ADA dietitians that served as dietary
directors were fulfilling the technical aspects of their
position to a greater extent than the managerial.

The writings of Vanderwarker (36) substantiate the
findings of Lipscomb and Donaldson (17) with regard to ADA
directors effectively performing the technical aspects of
their jobs while neglecting the administrative functions--
planning, organizing, directing, and controlling. He com-
mented that executive dietitians as well as other administra-
tive personnel with professional backgroundstend to continue
their pre-occupation with the technical aspects of their
work and warned that dietitians must be on constant guard
against being drawn into this trap, since the position of
dietary director requires managerial skills as well as
technical knowledge. Data reported by the Study Commission
on Dietetics (45) also indicate that many ADA hospital
dietary directors lack management skills and are particu-
larly weak in the areas of financial management and pur—
chasing.

Hofto and Brush (14) reported contradictory informa-

tion regarding the managerial performance of ADA dietitians.

17

In their New Jersey study the administrators of twenty-four,
short term hospitals with 100-500 beds were asked to rate
the managerial performance of their ADA dietary directors.
Responses were received from nineteen hospital administra-
tors and, of these, sixteen administrators rated the
managerial performance of their dietitians as gggd to

excellent with the three remaining dietitians rated as

 

pggr. A good to excellent rating by 84 percent of the
respondents appears to be quite encouraging until it is
noted that only twenty-four out of seventy-five hospitals
(32%) had ADA dietitians as directors of their dietary
departments. Hofto and Brush hypothesized that dissatis-
faction with the managerial performance of the ADA dieti-
tians was one reason for the employment of the larger
percentage of food service managers to direct hospital
dietary departments.

One might question whether administrative dietitians
who serve as hospital dietary directors are actually per-
forming their duties as poorly as the literature indicates
or if additional factors may be partially influencing their
competence ratings by employers--sexual bias, different
expectations of business-oriented hospital administrators,
and/or inadequate and ineffective communcation regarding
the professional abilities and demonstrated accomplishments

of administrative dietitians.

18

Benson and Thomas (2) reported the findings from a
1974 survey of Harvard Business Review subscribers in
management positions designed to determine if sexual bias
was a factor in management personnel decisions. This
study revealed that selection, promotion and career develop-
ment decisions are biased in favor of males and that when
valuable employees have personal problems, management will
make a greater effort to retain males than females. This
research substantiated the views of Dr. Wolf (1) presented
at the 1973 ADA Annual Meeting where she stated that women
are discriminated against in terms of jobs, salaries, pro-
motions, training, etc.

The attitude that females are incapable of handling
complex jobs is also reflected by women. As reported by .
Fritz and Hayman (10), their research revealed that companies
that conduct Equal Employment Opportunity programs have a
difficult time in convincing promotable females that they
are, indeed, equally as competent and promotable as their
male counterparts.

An example of a woman feeling that men are more
capable of c0ping in positions was shown in an article
authored in 1972 by an ADA dietitian“ Cabot (5), a food
service consultant in St. Louis, advocated that dietitians
should not compete with capable food service managers, but

should perform the "role that dietitians are best trained

19

for and legally qualified to fill." Cabot stated that
dietitians are best equipped to: (a) handle therapeutic
diets; (b) serve as nutritional consultants to physicians,
nurses, patients and their families; (c) serve as nutri-
tional instructors to the medical staff and community;
and (d) set the specifications for food purchasing and
evaluate new products based on the needs of special diet
patients. A fifth role was given to the consulting dieti-
tian--to provide price audits by comparing prices from the
different accounts or institutions served by the consultant.
Even the findings of the Study Commission on

Dietetics (45) seem to encourage dietitians to become
specialists in nutrition and leave the job of food service
management to persons other than ADA dietitians:

Although the dietitian may not be essential for all

food service management, the field does involve the

science of nutrition for the objective of optimum

nourishment. Perhaps the need can best be met by

the dietitian as a consultant concerned directly

with nutrition and not bogged down in the day to

day minutiae of operating a very complex system.
This conclusion seems to imply that the American Dietetic
Association might even subscribe to the belief that dieti—
tians are not capable of handling complex management situa-
tions and, therefore should concentrate their professional
efforts on becoming nutritionists. It is also interesting
to note that the Commission's Report did not project an

increased need for administrative dietitians by 1980. In

their estimation, the current level of administrative

20

dietitians will be sufficient since persons other than ADA
dietitians will also fill food service management positions.

The Foodservice Systems Management Education Council
(35) also accused the Report of the Study Commission on
Dietetics of neglecting the administrative dietitian. The
Council states that, if the findings and recommendations
of the Commission are endorsed, the American Dietetic
Association's goal would require redefinition and a profes-
sional society of nutritionists would be created.

If such observations regarding administrative
dietitians and their future role both from outside and
within the Association are due to sexual bias or are the
result of cultural and business tradition, then members of
the American Dietetic Association as a whole must strive to
overcome this Opinion by making the public, the buSiness
community, and professional colleagues aware of the capa—
bilities and contributions of administrative dietitians.

If administrative dietitians are to survive in this very
competitive field then they must strive to promote the
usefulness of the administrative dietitian (15). On the
other hand, if the Observation about the administrative
dietitian's performance are correct, then they must strive
to determine their weaknesses and redesign the pre-
professional curricula in a manner that will provide them
with the necessary management skills and techniques to

manage a hospital dietary department successfully.

21

Two major studies have been conducted to determine
the adequacy of academic preparation in the field of
dietetics. Although conducted a decade apart, the findings
of Miller (22) and Of Sanford, McKinley and Scruggs (30)
revealed that graduates were not sufficiently prepared in
two important areas of management-—human skills and concep-
tual skills. Miller's survey concerned the adequacy of
undergraduate academic preparation as perceived by graduates
and by employers. Seventy-one administrative elements were
submitted to both groups for evaluation and at least 25%
of each group felt there was inadequate management prepara-
tion in approximately two—thirds of these elements (67.6%
fOr graduates and 66.2% for employers). Sanford, McKinley
and Scruggs' study dealt with graduates of dietetic intern-
ship programs and these researchers reported that at least
25% of their respondents felt that they had received less
than adequate preparation for 62.7% of the 59 administrative
elements submitted to them for evaluation.

The creditability of literature reports (17, 36)
concerning administrative dietitianS' inability to ade-
quately perform management functions is enhanced by the
admittance of surveyed dietitians that they were insuffi-
ciently prepared to perform at least 60% of the administra-
tive elements submitted for their evaluation (22, 30).

This strongly indicates that colleges, universities, and

22

internships are graduating dietetic students that are not
amply prepared to perform many of management's functions
in an effective manner.

It appears that neither the American Dietetic
Association nor the education institutions responsible for
preparing dietetic students for a career in food service
administration have taken positive steps to correct these
inadequacies in the educational preparation and training Of
future dietitians.

Essential Qualifications for a
Hospital Food Service Director

 

 

The literature contains not only references as to
the best type of educational background and experiential
training for the person who directs the activities of a
hospital dietary department but also numerous references as
to the ideal characteristics and traits that hospital
dietary directors should possess.

In 1958 George Cartmill, the Director of Harper
Hospital in Detroit, Michigan, wrote an article (6) on the
traits that are essential for a successful career as a
hospital food service director. He believes that the food
service director must possess effective communication skills,
good imagination, an open mind, a high degree Of objectivity,
personal desire to advance in his field, and sensitivity to
change. He further indicated that the director must have

attained a formal education that has prepared him with the

23

tools Of his trade: a knowledge of basic nutrition, equip-
ment, food production, and human relation skills.

The managerial skills and tools needed by an effec-
tive director as expressed by Puckett (25) include human
relation skills, communication skills, ability to develop
administrative personnel, self-motivation to advance in the
field and develOp oneself to the fullest potential, and self-
confidence.

Human relation skills were emphasized by Bussart
(4) as being essential for the manager since the ability to
get along with people is critical in getting the job done.
Other qualities cited by Bussart were: self motivation;
emotional stability; intelligence; ability to lead and
direct and establish personal and department goals; ability
to recognize talents in others and the ability to develop
these talents; and effective communication skills. Even
though Bussart stresses the acquisition Of human skills,
she also recognizes the importance of technical skills at
all levels of management and the usefulness of constructive
criticism Of oneself as well as employees.

Creative and analytical thinking, judgment, initia-
tive, confidence, and vision were the main qualities identi-
fied by Gleiser (11) as essential for an executive in order
to carry out his main functions-—forecasting, planning,-
organizing, coordinating, controlling and personnel

directives.

24

Austin.Ross,Jrn, an Associate Administrator in a
Seattle Washington hospital, wrote two articles in the late
1960's that outlined his expectations of a director of
dietetics. His first article (28) listed four major areas
of administrative expectation--technical competency, human
relations skills, problem solving ability and communication
skills. In the second article (29) he recommended four
steps to be used in evaluating the management of the dietary
department. Two of the four steps given concerned the per-
sonal traits and managerial skills essential for the dietary
director. The seven personal characteristics pointed out
were: (a) honesty, (b) identification with institutional
objectives, (c) judgment and intelligence, (d) emotional
balance, (e) technical knowledge and competence, (f) com-
munication ability, and (g) a unique leadership style. The
five managerial skills cited were: (a) ability to plan
time well, (b) sets an example, (c) possesses political
and organizational ability, (d) possesses communication
skills, and (e) sets priorities and achieves the desired
end result.

A high degree of enthusiasm, ability to delegate
work in a systematic manner and the ability to handle human
relations problems effectively were three traits emphasized
by Schwartz (32).

Clark and Knickrehm (7) from the University of

Nebraska conducted a study of 350 facilities to discover

25

how hospital administrators and administrative dietitians
perceive the importance of different aspects of the
managerial skills and personal characteristics of the food
service director. The findings from this research revealed
that the ranking of supplied statements on managerial skills
and personal characteristics by administrators and by
dietitians showed a close positive correlation between the
two groups, but some characteristics were ranked differently
by the administrators and dietitians.

In 1974 Puckett (25) wrote a letter to the editor
cflEJADA in response to statements from the Food Service
System Management Education Council that strongly expressed
her views on the managerial skills and personal traits that
are essential for the hospital food service director:

It is the "manager dietitian" who is out working in
the profession who must become a member Of the
management team, who must sell her abilities to the
high level manager. She must be able to plan,
organize, control, direct, coordinate, set obtain-
able short-, immediate-, and long-range goals, and
communicate her abilities; she must develop a phi-
losophy and style of management; she must act with
:nowledge, authority, and responsibility. She must
be willing to spend long hours in developing reports
and budgets. She must be people-oriented, concerned
for mankind, have a sense of integrity and honesty;
and for many, she must be a teacher, an empathiser,
a leader, and above all, a knowledgeable individual
in the field of management.

This twenty-year review of the literature (1955-1974)
on essential qualifications Of the hospital dietary director

revealed numerous qualities that people with different frames

of reference felt were essential. Since only one skill, the

 

1Journal of the American Dietetic Assoication.

26

ability to communicate effectively, was mentioned by all of
the authors cited it appears the essential skills may not
be the same for all hospitals. Moreover, the expectations
for the hospital dietary director may vary depending on the
educational and professional background of the employer.

HoftO and Brush (14) conducted research on the
managerial performance of the director and discovered that
there was a direct relationship between the performance
rating of the director and the educational attainment and
years of experience of the hospital administrator. It was
revealed that the performance rating of the administrative
dietitian was lower from administrators that had been in
the field for a short period of time (six months to eight
years) and had a master's degree in some area of administra-
tion than the rating of the administrator who had been in
the field for a longer period of time (nine to twenty—
four years) and did not have an advanced degree.

The younger and better educated administrator has a
business background and is more familiar and concerned with
financial management. These are the areas that professional
dietitians are weak in. The administrator's knowledge and
use of the latest techniques of management with emphasis on
accountability of supplies, equipment and personnel may
cause him to evaluate the director of dietary services
differently than the administrator who may still view the
hospital as a charitable organization and not as a big

business that is service oriented.

27

Recruitment

 

In order for dietitians or any employee to be con-
sidered for a managerial position, the availability of that
job must be made known to him. Therefore, information con-
cerning the recruitment means used by hospital and contract
food management officials and the sources of job oppor-
tunities used by prospective employees will be useful in
determining (a) if ADA dietitians are actually passed over
in favor of non-ADA members, or (b) if professional dieti~
tians are using the most productive employment Opportunity
sources.

Internal recruitment is the means used first by most
organizations to fill vacancies. Almost all of the business-
men interviewed by Benis gp_al. (3) stated that they have a
policy of promoting from within but each could state
instances when they recruited executives from other compan-
ies. These executives did not think that there was any one
best method of recruitment, but stated that many methods
must be used to find the most qualified applicant for each
vacancy.

One recruitment method company personnel departments
use quite frequently is press advertising (8). The media
most Often used are national newspapers, local newspapers

and specialist journals.

28

In 1960 Benis gp_al. (3) conducted a survey of
business executives to determine the recruitment means
used by them to find suitable applicants. These researchers
discovered that the five most frequently mentioned sources
were: (a) personal contacts, 76 percent; (b) executive
recruitment firms, 46 percent; (c) management consulting
firms, 39 percent; (d) newspaper advertising, 24 percent;
and (e) universities, 18 percent.

Richards (27) in 1974 reported on job lead sources
used by 160 professionally trained dietitians when search-
ing for employment. The five most frequently used methods
were: (a) telephoned or sent letters of inquiry to
potential employers; (b) inquired among former classmates
and/or professional colleagues; (c) answered jobs listed in
newspapers; (d) consulted a private employment agency; and
(e) contacted former or current professors.

A comparison of methods used by executives and
dietitians revealed that dietitians are basically using the
same recruitment sources that company officials are using.
The major difference is the low percentage of dietitians
that make use of private employment agencies. Therefore, a
lack of knowledge about available jobs would appear not to
be a major factor in the supplantation Of professionally-

trained dietitians as directors of dietary departments.

CHAPTER III

METHOD OF INVESTIGATION

For this exploratory study two data collection
techniques were used to investigate the essential job
qualifications Of hospital food service directors as per-
ceived by hospital administrators and by administrative
officials of contract food management companies that have
food service accounts in Michigan hospitals. The methods
used to gather the information were: (a) direct mail
questionnaires to hospital administrators; and (b) personal
interviews with administrative Officials of contract food

management companies.

Part A: The Mail Survey

The Population

The sample population used for Part A consisted of
100 hospital administrators selected on the basis of the
following institutional criteria: (a) the hospital was
located in the lower peninsula of Michigan; (b) the hospital
had a bed capacity of 100 or more; and (c) Operational con-
trol was non-governmental. The list for initial contacts

was assembled from two Official directories, the American

29

30

Hospital Association (Guide Issue, 1971) and the Michigan

 

Hospitals (Statistical and Directory Issue, 1973).

 

Survey Instrument

 

A five—page questionnaire was designed to ascertain
information from the hospital administrators. The informa-
tion sought was divided into five major segments: (1) per-
sonal data of the reSpondent; (2) Operational character-
istics of the hospital and the dietary department; (3)
contract food management company services; (4) essential
qualifications for a hospital food service director; and
(5) recruitment of a hospital food service director. A
copy of the cover letter and questionnaire is included in
Appendix A .

The first part of the questionnaire consisted of
five questions which served to identify the respondent by
administrative title, educational background, professional
specialization, and experience in the field of hospital
administration.

The second part, operational characteristics Of the
hospital and the dietary department, included fifteen items
Of inquiry. The first three were related to hospital size
with respect to inpatient and outpatient census and total
staff for the hospital and for the dietary department.
Items four and five sought information on the types Of meal
service offered and the type of managerial service provided

for the food service component of the dietary department.

31

The next eight items solicited descriptive informa-
tion about the person currently responsible for managing the
food services of the hospital. Types of data requested
included position title, employment status, academic back-
ground and area(s) of specialization, experience in food
service operation, professional classification, how present
position was attained, and the respondent's assessment of
the managerial competence of the present food service
director (manager) of his hospital. The last two items
pertained to the current and projected manpower needs for
professionally trained employees for administrative staff
assignments in the food service area of the dietary depart-
ment.

Three items concerning the use of contract food
management cOmpany services comprised part three of the
questionnaire.' Reasons were solicited as to why contract
food management companies were employed or why contract
services had been employed and their services discontinued.
The administrators were also asked to express their Opinions
about the services generally provided by contract food
management companies.

Part four, essential qualifications for a hospital
food service director, contained five items of inquiry.
Respondents were asked to express their Opinions concerning
(a) the five most important managerial competences and the

five most important personal skills for a hospital food

32

service director; (b) the most desirable professional back-
ground for this position; (c) the minimum level of formal
academic training needed; (d) the minimum amount Of work
experience needed; and (e) the areas of competence that

most professionally-trained dietitians lack that tend to
disqualify them for administrative positions in most hospital
dietary departments.

The fifth and final part of the questionnaire con-
tained two items which focused on practices and problems
related to the recruitment of administrative dietary per-
sonnel. The first requested the respondent to designate
the means he would most likely use in searching for a food
service director and to indicate those which he considers
most useful. In the second question the administrators
were asked to identify the most usual and most difficult
problems they have encountered in locating qualified
applicants.

The questionnaire was designed to take not more
than fifteen minutes for completion. To facilitate data
processing all fixed alternative questions were pre-coded
and responses to open ended questions were organized and
coded after the questionnaires were returned. To minimize
postal expenses the questionnaires were printed on both

sides of heavy 8% x 11" white paper.

33

Review Of Instrument

The survey instrument was reviewed by three dif—
ferent groups: (a) members of the investigator's guidance
committee; (b) graduate students majoring in business
administration, nutrition, food service management, and
hospital administration; and (c) registered hospital
dietitians. The cover letter and questionnaire were
evaluated for format, clarity, adequacy of content, and
required time for completion. They were revised in accord-
ance with the comments and suggestions received. A list of
definitions of terms used in the questionnaire was also
developed for inclusion in the mailing. A copy of this

list is included in Appendix AC.

Distribution

 

-Questionnaire packets were mailed January 15, 1974
to the administrators of the 100 hospitals selected for
study. Each packet included: (a) a cover letter explaining
the purpose of the study and requesting the cooperation of
the administrator in completing the questionnaire; (b) the
revised questionnaire; (c) list of terms; and (d) pre-
addressed return envelope. Administrators who preferred
not to participate in the study were requested to return
the blank questionnaire. Hospital administrators who did
not return the questionnaire by the stated deadline were
sent a follow up letter (Appendix A7), duplicate question-

naire, list of terms, and a pre-addressed return envelope.

34

Part B: The Personal Interview

The Population

 

A list of contract food management companies
Operating in Michigan was established with the assistance
of the Michigan Public Health Department, the Michigan
Restaurant Association, executives of contract food manage-
ment companies, and Michigan telephone directories. Since
contract food management companies are not licensed in
Michigan, no single Official listing of these companies was
available.

The sample population for Part B of this study was
limited to six contract food management companies selected
on the basis that they were providing total food management
service to hospital food service departments in Michigan.
The six administrative officials contacted for interview
were central office staff members responsible for establish-
ing employment policies and/or procuring food service

directors (managers) for their Michigan hosPital accounts.

Interview Guide

A nine-page standardized interview guide was
developed to assure collection of comparable information
about the six food management companies selected for the
study. The guide contained fixed alternative and open ended
questions comparable to those included in the mail question-

naire addressed to the hospital administrators surveyed in

35

Part A of this study. The Faculty Guidance Committee of
the investigator reviewed the interview guide for organiza-
tion and completeness of questions and effectiveness of
approach. Recommendations of the reviewers were incorporated
into the final revision of the guide. A copy of the inter-
view guide is included in Appendix B .

Information in four major areas was sought:

(a) executive title and professional background Of the
respondent; (b) operational characteristics of the food
management company; (c) essential job qualifications for
the hospital food service director; and (d) recruitment of
a hospital food service director.

Part one, the respondent, contained five items to
identify the respondent by administrative title, formal
educational background and specialization, and professional
experience in the field of food service.

Part two contained twenty-six items of inquiry con-
cerning the Operational characteristics of the management
companies. Item one requested information on the number of
years that the management company had operated hospital
food Service departments. The next twelve items sought
information on the types of establishments served, number of
Michigan hospital accounts, and types of services provided
to Michigan hospital accounts. Purchasing and delivery
policies were covered in items fourteen through seventeen.

The nine remaining items sought descriptive information Of

36

the dietary personnel employed by the company, and present
and projected manpower needs for administrative positions
for their Michigan hospital accounts.

Part three, essential qualifications of the hospital
food service director, contained five questions. Four of
the five items concerned the essential job qualifications
for a successful food service director as perceived by the
interviewees: (a) the five mOSt important managerial
competences and the five most important personal skills;

(b) most desirable professional background and experience
needed; (c) minimum level of formal academic training
required; and (d) minimum amount of work experience needed.
The fifth item solicited the Officials' opinions concerning
areas of competence which most professionallyétrained
dietitians lack that tend to disqualify them for administra-
tive positions in hospital food service departments.

The fourth and final part requested information on
the means of recruitment used by the companies and the most
usual problems encountered in searching for directors

(managers) of their hospital food service departments.

The Interview Procedure

Administrative officials of the six contract
management companies were initially contacted by telephone
for an appointment. During the telephone conversation a

brief explanation of the project was given and the

37

individual's consent to participate in the study was
requested. An appointment for the interview was scheduled
at the convenience of the interviewee.

All personal interviews were conducted by the
researcher between January 15 and February 25, 1974. At
the beginning Of each scheduled interview a more detailed
explanation of the problem under study was given. The
administrative officials were assured that the names of
the organization and the respondent would be held in con-
fidence in reporting the study results. During the inter-
view session, the administrative officials' responses were
recorded on the interview form. At the conclusion of the
interview, the researcher offered to send a summary of the
results of the study to the interviewee and thanked him

for participating in the research project.

Analysis of the Data

 

Part A: Mail Survey Responses

The questionnaire returns were hand coded and key
punched on cards for computer processing. Frequency
counts and percentages of total response for each question-
naire item were calculated using the Control Data Corpora-
tion 6500 Computer at Michigan State University. The data
were summarized and examined for response similarities and

differences among survey participants.

38

Part B: Personal Interview Data

 

The interview guide data were hand tabulated. Fre-
quency counts and percentages of total responses for each
interview item were calculated, summarized and examined for
similarities and differences among the food management
company officials interviewed. These data were then com-
pared with the matching item data received from the

hospital administrators.

CHAPTER IV

ANALYSIS OF THE SURVEY DATA

A study to determine the essential qualifications
of the hospital food service director was conducted in
Michigan. The investigation consisted of two parts: Part A,
a survey of hospital administrators selected from non-
governmental hospitals located in the lower peninsula of
Michigan and Part B, a survey of contract food management

companies operating in Michigan.

Part A: Hospital Administrators

Questionnaires were mailed to one hundred hospital
administrators in Michigan selected on the following criteria:
(a) the hospital was located in the lower peninsula of
Michigan; (b) the hospital had a bed capacity of 100 or more;
and (c) operational control was non-governmental. Of the one
hundred administrators contacted, fifty returned the question-
naire.
Assessment of Response
Representation

The returned questionnaires were sorted on the basis

of hospital and community size. Twenty-one categories were

39

40

designed to accommodate the source of responses (see Table
l). Eighty percent of the returns were from administrators
of hospitals of less than 400 beds and represented six

different community size ranges.

TABLE l.--Survey Response by Hospital-Community Class.

 

 

 

Class Hospital Size Community Size Returns
(beds) (pOpulat1on) No. %

1 100-199 less than 10,000 5 10
2 100-199 10,000 - 29,999 4 8
3 100-199 30,000 - 49,999 5 10
4 100-199 100,000 - 199,999 3 6
5 100-199 1,000,000 + 3 6
6 200-299 10,000 - 29,999 4 8
7 200-299 30,000 - 49,999 3 6
8 200-299 50,000 - 99,999 3 6
9 200-299 100,000 - 199,999 1 2
10 200-299 1,000,000 + 2 4
11 300-399 30,000 - 49,999 1 2
12 300-399 50,000 - 99,999 3 6
13 300-399 100,000 - 199,999 2 4
14 300—399 1,000,000 + 1 2
15 400-499 100,000 - 199,999 4 8
16 400-499 1,000,000 + 1 2
17 500-599 50,000 - 99,999 1 2
18 500-599 100,000 - 199,999 1 2
19 1000 + 50,000 — 99,999 1 2
20 10003+ 1,000,000 + 1 2
21 not indicated not indicated _1 2

TOTAL 50 100

 

41.

When returned questionnaires were looked at in
relationship to community size gply (Table 2) the response
was greatest (64.3%) from hospitals in the 50,000-99,999
range and least (30.7%) from communities with a population
of 1,000,000 and over. The percentages Of returns reported
are based on the initial mailing for each community size

range.

TABLE 2.--Questionnaire Response Based on Community Size.

 

 

 

Initial Returns
Community Size Mailing
(No.) NO. % per Range
Less than 10,000 11 5 45.5
10,000 - 29,999 14 8 57.1
30,000 - 49,999 18 9 50.0
50,000 - 99,999 14 9 64.3
100,000 - 199,999 17 10 58.8
1,000,000 and over 26 8 30.7
Not indicated _:_ _l -
TOTAL 100 50

 

As shown in Table 3, based on hospital size gply,
percent of response was greatest (100.0%) for hospitals in
the 1000+ bed range, but the larger numbers of returns were
from hospitals in the 100 to 199 bed range (20) and in the
200-299 bed range (13). None of the administrators in
hospitals with a bed capacity between 600 and 999 beds

returned the questionnaire.

42

TABLE 3.--Questionnaire Response Based on Hospital Size.

 

 

 

Initial Returns
Beds Mailing
(No.) No. % per Range
100-199 45 20 44.4
200-299 26 13 50.0
300-399 13 7 53.8
400-499 7 5 71.4
500-599 4 2 50.0
600-699 1 0 -
700-799 1 o -
800-899 1 0 -
1000 and over 2 2 100.0
not indicated __: _l -
TOTAL 100 50

 

Survey participation was also looked at on the
basis of responses by county and region. For this analysis,
the Lower Peninsula of Michigan was horizontally divided
into three regions, the southern third (21 counties), the
middle third (26 counties) and the northern third (21
counties). Because this investigation was limited to
administrators of non-governmental hospitals of 100 beds
or more, only 29 of the 68 Lower Peninsula counties were
represented in the initial mailing list (see Table 4). The
actual number of counties represented by the survey returns
was 22 or 75.9 percent of the counties of the initial
mailing list. As expected, the highest number of returns
(30) was received from the southern region which repre-

sented 43.5 percent of the initial mailing for that region.

43

TABLE 4.--Questionnaire Response Based on Counties and

 

 

 

 

Regions.
Lower Initial Returns
Peninsula County Mailing
Region (No.) NO. Percentage
Southern Barry 1 l 100.0a
Th1rd Berrien 3 1 33.3
Calhoun 4 1 25.0
Ingham 4 3 75.0
Jackson 2 1 50.0
Kalamazoo 2 2 100.0
Lenawee l 1 100.0
Livingston l - -
Macomb 4 1 25.0
Monroe 1 1 100.0
Oakland 7 2 28.6
St. Clair 2 1 50.0
Washtenaw 4 3 75.0
Wayne _33 _12 36.4
TOTAL 69 3o 43.5b
Middle Bay 3 1 33.3a
Third Genesee 4 4 100.0
Gratiot l 1 100.0
Isabella 1 0 -
Kent 6 3 50.0
Midland l 0 -
Montcalm 2 1 50.0
Muskegon 3 3 100.0
Saginaw 4 4 100.0
Shiawasee __l __: -
TOTAL 26 17 65.4b
Northern Cheboygan 1 1 100.0a
Third Crawford 1 0 -
Emmet l 0 -
Grand Traverse l 1 100.0
Wexford __1 __Q -
TOTAL 5 2 40.0b
Not indicated - l -

 

aPercentage initial mailing for county.

bPercentage initial mailing for region.

44

Seventeen responses (65.6%) were received from the middle
region and only two (40%) questionnaires were returned by
hospital administrators in the northern region.

From these analyses it appears that, despite a
survey response rate of only 50 percent, the returns
received are fairly representative of the initial group
contacted with respect to hospital size, community size

and region within the Lower Peninsula.

The Study Participants

Part I of the questionnaire was designed to
ascertain information concerning the respondent's adminis-
trative title, educational background, and professional
experience in the field of hospital administration. It
was felt that such descriptive information concerning the

respondents would be useful in evaluating their Opinions.

Administrative title.--Thirteen different adminis-

 

trative titles were held by the fifty respondents (Table 5).
Twenty-one (42%) have the title of Assistant Administrator
and comprise the largest protion of the group. The second
highest percentage of respondents (32%) have the title of
either administrator or director. The remaining ten

titles are each held by only one or two respondents and,
collectively, represent 24 percent of the respondents.

One participant failed to indicate his title.

45

TABLE 5.—-Administrative Titles of Survey Respondents:
Frequency Distribution in Relationship to
Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

 

Titles
100-400 400+ No. %
Top Level
Administrator 12 - 12 24
Director 2 2 4 8
Executive Vice President 1 - l 2
Chief Executive Officer 1 - 1 2
President & Administrator 1 - 1 2
Corporative Executive 1 - l 2

Secondary Level

 

Assistant Administratorb 18
Assistant Director 1
Vice President 2
Assistant Vice President -
Vice President of

Operations & Planning -
Director of Services -

hw- H IF‘N
PH HNNH
mm anm

Other

Administrative Assistant - l 1

TOTAL 39 9 49 98

NO response given 1 - 1 2

 

aN=50

bOne respondent did not give hospital size.

46

Based on the hospital-community size classes
adopted for this study, the pattern of response is:
(a) in hospitals of 400 beds or more, regardless of com—
munity size, the questionnaires were completed by persons
at a secondary administrative level three times as fre-
quently as by those at the top level; (b) in hospitals Of
less than 400 beds, regardless of community size, the
questionnaires were completed by administrators at the top
level and the secondary level on a nearly equal basis

(19 top level, 21 secondary level).

Educational background.--Inquiries were made into

 

two aspects of the educational background of each partici-
pant--highest degree earned and the area(s) of specializa-
tion. As shown in Table 6, 73 percent of the respondents
had earned an advanced degree; 24 (48%) in hospital
administration, 8 (16%) in business administration, 3 (6%)
in liberal arts, and one (2%) in law. Eleven (22%) of the
respondents had attained only a bachelor's degree and one
(2%) reported that he had no earned degree. Two (4%)
respondents did not answer the question.

In hospitals of 400 beds or more, all located in
communities of 50,000 or more, 8 of the 9 respondents had
earned advanced degrees, and one had only a bachelors

degree. In hospitals of less than 400 beds 28 of the 38

47

TABLE 6.--Highest Degree Earned by Survey Respondents:
Frequency Distribution in Relation to HOSpital
Size.

 

Hospital Size (beds) Total Groupa

 

Educational Level

 

 

100-400 400+ NO. %
Master's Hospital
Administration 16 8 24 48
Master's Business
Administration 8 - 8 16
Master of Arts 3 - 3 6
Law 1 - l 2
Bachelor'sb 9 1 ll 22
High School _1. _: _l _2
TOTAL 38 9 48 96
No response given 2 - 4
aN=50

bOne respondent did not give hospital size.

respondents (73.6%) had advanced degrees, 9 (23.6%) had
only a bachelors degree and one (2.6%) had only completed
high school.

The administrators listed eight different areas of
professional specialization (see Table 7). Hospital
administration was the area mentioned most frequently (54%),
with the areas of business administration and hospital plus
business administration next in frequency of mention (16%

each). Nursing, finance, dietetics, hospital administration

48

TABLE 7.--Professional Specialization of Survey Respondents:
Frequency Distribution in Relationship to
Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Area of Specialization

 

100-400 400+ -No. %
Hospital Administration 23 4 27 54
Business Administration 6 l 8 16
Hospital & Business Adm. 6 2 8 16
Nursing 1 - 1 2
Finance 1 - l 2
Dietetics - l l 2
Hospital Administration
and Economics 1 - l 2
Hospital Administration
and Pharmacy _: +1 _1 _2
TOTAL 38 9 48 96
No response given 2 - 2 4

 

aN=50

bOne respondent did not give hospital size.

plus economics and hospital administration plus pharmacy
were each mentioned by one respondent. There was a 96 per-
cent response to the question by the administrators.

(The number of respondents who had received
specialized formal training in the field of administration
was high regardless of hospital size--8 of the 9 respondents
(88.9%) in hospitals of 400 or more beds and 36 of 38
respondents (94.7%) in hospitals of 100-400 beds. Only
three of the respondents had achieved an hospital administra-

tion position through specialization in a field other than

49

administration (one in dietetics in larger hospitals and one

in nursing and one in finance in smaller hospitals).

Employment history.--Information regarding the

 

administrator's experience in the field of hospital adminis-
tration focused on two factors--the number of years each has
been employed in the field and the total number Of years
each has been in his present position. These data are sum-
marized in Tables 8 and 9.

The length of time that the administrators have been
in the field of hOSpital administration varied from one to
over twenty-five years. Twenty—seven (54%) of the adminis-
tratOrs have been in the field for ten years or less with the
highest number, 16 (32%), found in the 6-10 year range.

Only one of the administrators failed to respond to this
question.

In hospitals with less than 400 beds, 24 (61.5%) of
the 39 respondents have had 10 years or less experience in
the field of hospital administration. Of these, nearly half
(11) have been in the field five years or less. Of the
remaining reSpondents from 100 to 400 bed hospitals, 12
(30.8%) have 11 to 20 years experience and three (7.7%) have
been in the field for over 20 years.

Parallel comparisons for respondents employed in
hospitals with more than 400 beds revealed that seven

(77.7%) of the nine respondents have 10 years or less

50

TABLE 8.--Total Number of Years in the Field for Survey
Respondents: Frequency Distribution in Relation
to Hospital Size.

 

 

 

 

 

Total Years Hospital Size (beds) Total Groupa
1n F1eld 100-400 400+ No. %
1' 3b 5 l 1 12
4‘ 5 6 3 1o 20
6-10 13 3 16 32
16-20 4 1 5 10
over 25 *2 _£ _; _9
TOTAL 39 9 49 98
No response given 1 - l 2

aN = 50

bOne respondent did not give hospital size.

TABLE 9.--Tota1 Number Of Years in Present Position for
Survey Respondents: Frequency Distribution in
Relation to Hospital Size.

 

 

 

 

 

. . a

Years in Present Hosp1tal S1ze (beds) Total Group
POSlth“ 100-400 400+ NO. %
Less than 1 6 1 7 l4
1- 3b 15 4 20 4o
4- 5 7 3 10 20
6-10 9 - 9 18
11-15 - l l 2
16-20 - - O -
21-25 2 - 0 -
over 25 _: _: _0 _:
TOTAL 39 9 49 98
No response given 1 - l ' 2

aN = 50

One respondent did not give hospital size.

51

experience in the field and, of these, more than half (four)
have been in the field five years or less. Of the two
remaining respondents from these larger hospitals, one has
had more than 16 but less than 21 years experience and one
has been in the field for over 25 years. Within the limi-
tations of these data it appears that irrespective Of
hospital size, administrators of Michigan hospitals with
100 or more beds are apt to have relatively few years of
experience in the field.

The total number of years that respondents have been
in their present positions ranged from less than one year to
25 years. Forty-six (92%) of the respondents have been in
their present positions for ten years or less; 27 (54%) have
served three years or less. The largest number of adminis-
trators were in the one to three year service range, 20 (40%).

Based on hospital size, the percentage of administra-
tors who have been in their present position for 10 years or
less was slightly higher (95%) for hospitals with less than
400 beds than for hospitals with 400 or more beds (89%).
Within hospital size ranges, respondents with three years
or less service comprised over half of their respective
reporting groups: 21 (54%) for hospitals with less than

400 beds and five (56%) for hospitals with 400 or more beds.

52

Hospital and Dietary Department:
Operational Characteristics

 

 

The second part of the questionnaire included five
areas of inquiry concerning the operational characteristics
of the hospital and dietary department: (a) hospital
census, (b) types of meal service, (c) type of food service
management, (d) descriptive information about the current
food service director, and (e) current and projected pro-

fessional manpower needs Of the dietary department.

Hospital census. Information regarding hospital

 

size was solicited with respect to average daily inpatient
and outpatient census and total staff employed for the
hospital and for the dietary department. These data are
summarized and reported in Table 10 according to hospital
size. Comparisons both within and among hospital sizes
indicated considerable variation for each of these Opera-
tional characteristics. .

The number of total dietary staff for the hospitals
surveyed ranged from 17-355. However, there was considerable
variation in the number Of total dietary staff within and
between hospital bed capacity ranges. The greatest dif-
ference in the number of total dietary staff was among
hospitals in the 100-199 bed range--a difference of 70
employees.

Percentages for total dietary staff in relationship

to total hospital staff ranged from 4.5 to 14.2 percent.

.mNHm Hmuwmmon m>wm no: can pampsommmu mso

 

53

 

 

 

m
.muflm mmmum Hmuflmmos m>flm DOG OHU pampsommmn OGOU
.muflm mmmpm humumflc m>wm no: cap uswpsommmu wcoo
.mmmum Hmuwmmon Hmuou mo mmmuswoummn
.msfiuuommu mwfluflaflomm HOQEOZM
v.m me oom omm om omH H muonuo
v.m mmmnmmm comm omvmuooma commuoooa ommloom N U+oooa
m.» me mum own Immm oom use onvummm m ommmloom
m.m uv.n moaamoa womanooma mam Imam Ohm INH mmmuomm m mmvloov
o.m um.v moanso oowauoom new amvm mam no omelovm n mmmlocm
m.HH:n.o mm :mw ooaaloam Ohm nova oom Io mnmnmma ma mmmIoom
m.ea|m.e mm Ina mmm IomH mvm Iom cow no smauoa om mmHIooa
w .02 . Hmuoe usmflummuso DGOADMQCH
n oz.Hmuoe .oz memm
wwmbm Hmuflmmom m Hmuflmmom

wwgpm humu0flo mamsmo waflma mmmum><

 

.mmmum sumumflo ethos tam .mmmum Hmufldmom
Hobos .msmcmo ucmflumm "swam Hmuwmmom sflnuflz mmfiufiawomm ms06¢ mmmsmmln.oa mamfla

54

These high and low percentages were found within the same
hospital bed capacity range, 100-199 beds. As the hospital
bed capacity increased (up to 400 beds) the spread between
the lower and upper percentages for dietary staff decreased
(a percentage difference of 9.7 in the 100-199 bed capacity
range to a percentage difference of 2.4 for the 400-499 bed
capacity range). Within the limits of these data, it seems
likely that as bed capacity increases facility design, types
of meal service provided, numbers of persons served, and the
Opportunity to optimize worker productivity may be influ-
encing factors with respect to the total number Of dietary
staff needed to provide the required dietary services.

Data pertaining to total dietary staff size were
examined with respect to professional staff (full and part
time), and employees (full and part time). Ranges within
and between hospital size ranges are summarized in Table 11.
All responding hospitals had at least one full-time
administrative professional, with the maximum number being
45. Some hospitals of less than 300 beds did not have a
full-time therapeutic dietitian on staff. This may be
attributed to the fact that some hospitals in these size
ranges may have only one dietitian who performs both the
administrative and the therapeutic services required by the
hospital. The number of part-time professional staff was

relatively small within all hospital size ranges.

.mNHm HmuHmmo: m>Hm no: OHU usmpcommmn msoo

.mumw mumpm humume m>Hm no: UHU usmpsommwn econ
.msHuHommH mmHuHHHOMM Hmnfiszm

 

mm m mm o o o w H m we H Cheapo
momlomm omlmm ommlomH mIH MIH ono owlmv mHImH mvlom mmmlmmm N +OOOH
HO mH mm o o o N H .H va N mmmloom
”w omHIHOH ovaH omHlmo mlo mlo Olo mmlv O IN omlm meImOH m mmvloov
MOHIoo mwlm mm va Mlo Hlo Nlo m Im m IN N IH mOleo b mmmloom
mm low omlo mm IHN Hio Hlo Hlo NHIN v Io m IH mm Imv mH mmNIoom
Hm ImH omlo Ho IOH @Io Nlo mlo m IH m to o IH mm IhH om mmHIOOH

 

OEHB OEHB H309 6.858 39:94 H1309 855. 53.364

 

 

 

 

m 0
H u e unmm Hess
s
mEHB puma OEHB HHsm %WWDWMQ .oz mpom
. s mHmuamwom
mommonEm Hmuoe .

mwmum HMQOHmmmwomm

 

.mmsum >HMDOHQ HMDOB "mNHm HTDHmmom CHQDHB mmHDHHHosm 0:084 momsmmll.HH mqmde

56

The number of full-time employees varied from 10-280.
The considerable degree of variation in numbers of staff
employees within and between hospital size ranges may be
due to: (a) the number and types of meal services Offered,
(b) facility design and equipment, (c) facility employment
policies, (d) department scheduling, (e) budget, and
(f) manpower availability with respect to number and job-
readiness of available job seekers. In some hOSpitals of

100-299 beds no part-time employees were on staff.

Types of meal service.--Twelve different types of

 

meal service were reported by the respondents (see Table 12).
Four types of services were provided by more than 50% Of the
hospitals: patient trays (100%); cafeteria, open to the
public (82%); vending machines operated by an outside con-
tract firm (68%); and cafeteria for hospital personnel only
(54%).

When types of meal service Offered were compared on
the basis of hospital size, it was revealed that the smaller
hospitals (less than 400 beds) provided as wide a variety of
meal services as the larger hospitals (400 beds or more).
The largest number of different services Offered by a single
hospital was seven; this hospital had a bed capacity of over
1000. In all other cases the variety of meal services pro-
vided ranged from three to six in all hospital size classi-

fications.

57

TABLE 12.--Types of Meal Service Provided by Hospitals
Surveyed.

 

Hospital Size (beds) Total Groupa

 

 

Types Of Service

 

100-400 400+ T No. %

patient trayb 4o 9 so 100
Cafeteria (open to public)b 34 6 41 82
Vending machine (outside

contract firm)b 27 6 34 68
Cafeteria (hospital

personnel only)b 21 5 27 54
Coffee shop or snack bar 8 4 12 24
Dining room, table service

(hospital personnel) 8 4 12 24
Vending machines

(hospital operated) ll - ll 22
In-hospital cateringb 7 l 9 l8
Off-Premise Meal Service 3 l 4 8
Dining room, table service

(Open to public) 2 l 3 6
Employee lounge 1 - l 2
Family style (patient) - l l 2

 

an = 50
One respondent did not give hospital size.

Type of food service management.--In 36 (72%) of the

 

hospitals surveyed the dietary departments are hospital-
operated. Fourteen (28%) are operated by contract food
management companies, and, of these, none are in hospitals

of more than 400 beds.

58

The current director Of food services.--Eight items
solicited descriptive information about the person currently
responsible for managing the food services of the hospital.
Types Of data requested included position title, employment
status, academic background and area Of specialization,
experience in food service Operation, professional classi-
fication, how present position was filled, and the respond-
ent's assessment of the managerial competence Of the
present director (manager) of his hospital food service
department.

As detailed in Table 13, the directors of food
service in the 50 reporting hospitals held nine different
position titles. Food Service Director or Manager was the
title held by the largest number of persons who direct the
activities of these dietary departments, 23 (46%). The
second most frequently reported title was Director or
Manager of Dietary Services, 11 (22%). The seven remaining
position titles were reported with far less frequency:

(a) Chief Dietitian and Food Service Supervisor, three (6%)
each; (b) Director of Dietetics, Director of Food Services
and Dietetics or Nutrition, and Administrative Dietitian,
two (4%) each; and (c) Executive Director and Dietitian,
one (2%) each. Two (4%) of the respondents did not answer

this question.

59

TABLE l3.--Position Titles of Dietary Directors of Survey
ReSpondents: Frequency Distribution in Relation-
ship tO Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Position Title

 

 

100-400 400+ No. %
Food Service Director/
Manager 21 2 23 46
Director/Manager
Dietary Services 8 3 ll 22
Chief Dietitian 3 -
Food Service Supervisorb 2 - 6
Director of Dietetics - 2
Director of Food Services
and Dietetics/Nutrition 2 - 2 4
Administrative Dietitian 2 '-
Executive Director - l
Dietitian _l _:_ _l __
TOTAL . 39 8 48 96
No response given 1 l 2 4
aN = 50

bOne respondent did not give hospital size.

The employment status of 48 (96%) of the 50 food
service department directors was full time. The employment
status for two of the directors was not reported.

As shown in Table 14 the highest level of educational
attainment for the majority of dietary department managers
was a bachelor degree, 32 (64%). The remaining earned

degrees reported were: Master of Science, two (4%); and

60

TABLE l4.--Educationa1 Attainment Levels of Hospital Food
Service Manager. Frequency Distribution in
Relationship to HOSPital Size.

 

HOSpital Size (beds) Total Groupa

 

 

Educational Level

 

loo-400 400+ No. %

Bachelor Degree 25 7 32 64
High School Diplomab 3 1 5 10
M.S. Degree 1 1 2 4
M.A. Degree 2 - 2 4
Associate Degree 2 - 2 4
Hotel, Motel Certificate _1 _: _l' _2
TOTAL 34 9 44 88

NO response given 6 - 6 12

 

aN = 50

bOne reSpondent did not give hOSpital size.

Associate Degree, two (4%). One manager (2%) had attained
a certificate in hotel and motel management and five (10%)
managers had earned only a high school diploma. Six
respondents (12%) did not complete this question.

With respect to hospital size, the percentages of
bachelor degrees and master degrees for both small and
large hospitals were 25 (74%) and seven (78%) respectively
for bachelor degrees and three (8.8%) and one (11%)
respectively for master degrees.

Ten different areas Of specialization were identified

for the directors of the food service departments (Table 15).

61

TABLE 15.--Area of Specialization for Directors of Food
Service: Frequency Distribution in Relationship
to Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Area of Specialization

 

 

100-400 400+ No. %
Dietetics, General 11 3 14 28
Hotel, Restaurant and
Institutional Management 8 10 20
Dietetics, Administrative 3 6 12
Dietetics, Therapeutic 3 - 3 6
Business Administration 2 - 2 4
Food Service Supervisor 1 l 2 4
Army Food Service 2 - 2 4
Psychology 1 - 1 2
Institution Management 1 - l 2
Economics and Political
Science _1 _:. _1 _2
TOTAL 33 9 42 84
No response givenb 7. - 8 16
aN=50

bOne respondent did not give hospital size

Three areas of specialization were reported for 60 percent
of the directors under study: general dietetics, 14 (28%);
hotel, restaurant and institution management, 10 (20%); and
administrative dietetics, six (12%). The remaining seven
areas of specialization in descending order of frequency of
mention were: therapeutic dietetics, three (6%); business

administration, two (4%); food service supervisor, two (4%);

62

army food service, two (4%); psychology, one (2%); institu-
tion management, one (2%); and economics and political
science, one (2%). Eight respondents failed to complete
this question.

Persons specializing in dietetics composed the
highest percentage of dietary department managers regard-
less of hospital size--67 percent for 400 beds or more and
51 percent for hospitals with less than 400 beds.

Professional experience of the managers of food
service was examined in two areas: total number of years in
the field (Table 16), and total number of years in their

present position (Table 17). The total number of years that

TABLE l6.--Tota1 Years in the Field for Directors Of Food
Service: Frequency Distribution in Relation-
ship to Hospital Size.

 

 

 

 

 

. . a

Total Years in Hospltal Slze (beds) Total Group
Field 100-400 400+ No, %
Less than 1 year 1 - l 2
l- 3 years 4 — 4 8
4- 5 years 7 - 7 14
6-10 years 2 - 2 4
11-15 years 5 l 6 12
16-20 years 7 3 10 20
21-25b years 5 2 9 18
over 25 years _£ _3 _Z 13
TOTAL 36 9 46 92
No response given 4 - 4 8

aN=50

bOne respondent did not give hospital size.

63

TABLE l7.--Total Number of Years in Present Position for
Directors of Food Service: Frequency Distribu-
tion in Relationship to Hospital Size.

 

 

 

 

. . a

Years in Present Hospital Slze (beds) Total Group
P°Slt1°n 100-400 400+ NO. %
Less than 1 year 6 - 6 12
l-‘3 years 11 - ll 22
4- 5 years 4 3 7 l4
6-10byears 9 4 13 26
11-15 jyears 4 2 7 14
16-20 years 1 - l 2
21-25 years 2 - 2 4
over 25 years __—_ _: _-1 -:
TOTAL 37 9 47 94
No response given 3 - 3 6

 

an = so

bOnerespondent did not give hospital size.

the managers had been in the field of food service ranged
from less than one year to over 25 years. In hospitals of
less than 400 beds 22 (61%) of 36 managers had been in the
field for 11 years or more. The largest number in the 11
years and over group was in the 16-20 year range, seven (32%).
The largest number of managers in the 10 years or less group
was in the 4-5 year range, seven (50%). All of the managers
in the nine larger hospitals had been in the field of food
service for 11 years or more. Of the 50 hospitals partici-
pating in the study, only five (10%) of the dietary depart-
ment managers were relatively new in the field (three years

or less).

64

As shown in Table 17, data pertaining to the number
Of years the managers have been in their present positions
revealed that 37 (74%) have been in their present position
for ten years or less. Among smaller hospitals (100-400
beds) 17 (46%) of the managers have been in their present
positions for only three years or less, 17 (46%) had service
records of 4 to 15 years and three (8%) had been employed
for 16 years to 25 years. In larger hospitals (400+ beds)
none of the food service managers had service records of
less than four years or more than 15 years. Three respon-
dents did not reply to this question.

Twenty-two (44%) of the directors of food service
were members of the American Dietetic Association. Of the
22 ADA members 21 were registered dietitians. Non-ADA
members comprised 19 (38%) Of the directors. In relation-
ship tO hospital size the smaller hospitals had a nearly
equal number of ADA registered members and non-ADA members,
15 and 16 respectively. In the larger hospitals ADA registered
dietitians outnumbered non-ADA members by 3 to 1. Nine of the
respondents failed to answer this question (see Table 18).

Only 11 (22%) of the directors of food service
studied were promoted to their present position from within
their respective dietary departments (see Table 19). The
36 (72%) remaining managers were employed for the position
from outside the hospital staff. Within hospital size, only

five (14%) of the directors of food service in the smaller

65

TABLE 18.--Professional Classification of Directors of
Food Service: Frequency Distribution in
Relationship to Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

 

 

Professional

Classification 100-400 400+ No. %

ADA Registered 15 6 21 42

ADA Not Registered - l 1 2

Non-ADAb 1g .3 _1_9_ _§_
TOTAL 31 9 41 82

No response given 9 - 9 18

a

N = 50

bOne respondent did not give hospital size.

TABLE 19.--Attainment of Present Position for Director of
Food Service: Frequency Distribution in Relation-
ship tO Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Employment Procedure

 

100-400 400+ NO. .%

Promoted from withinb 5 5 ll 22
Obtained from outside 32 _4 36 12
TOTAL 37 9 47 94
No response given 3 - 3 6

 

aN=50

bOne respondent did not give hospital size.

66

hospitals were promoted from within whereas in the larger
hOSpitals over half (56%) attained their position through
promotion.

Ninety percent of respondents gave the manager Of
their food service a competency rating of average or better.
As shown in Table 20 the ratings were: 14 (28%) excellent,

18 (36%) above average, 13 (26%) average, and one (2%)

 

below average. Four respondents declined to commit them-

 

selves On this point.

TABLE 20.--Managerial Competence Rating of Directors of
Food Service: Frequency Distribution in
Relationship to Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Competence Rating

 

100—400 400+ No. %

Excellent 10 4 14 28
Above Averageb l4 3 18 36
Average 11 2 13 26
Below Average 1 - l 2
Poor _: _; _: _‘_
TOTAL 36 9 46 92
No response given 4 - 4 8

 

bOne respondent did not give hospital size.

67

When the competence ratings were compared to pro-
fessional classification, nonMNIXmembers had an excellent
rating for seven (17%) compared to five (12%) for registered
ADA dietitians. The one non-registered ADA member also had

a rating of excellent. In the above average group, ADA

 

 

registered dietitians outnumbered non ADA members by four
(10% of the total group). The average rating was shared
nearly equally by non ADA members and ADA members, seven
and six respectively. These comparatives are summarized in
Table 21, and were available for only 42 (84%) Of the

responding hospitals.

TABLE 21.--Present Director of Food Service: Professional
Classification yg. Competence Ratings by Hospital
Administrators.

 

Competence Rating

 

 

 

 

Idoflfifihmmd a
. . . No. Abome Behmv
ClaSSlflcatlon Excellent Average Average Average Poor
No. % It» % No. % .NO. ‘No.
ADAIEgnmxned
* Dietitian 21 5 12 10 24 6 l4 - -
ADAhkmber,rrm
IkgisUarfl. l l 2 - - - - - -
Non-ADA “fiber Q .1 ll _5_ 1i .1 3.1.7. _-_ _:
TOTAL 42 13 31 16 38 13 31 - -

 

5‘N = 42 (data incomplete for eight respondents).

68

A ninety-six percent response was received on the
question of current vacancies. Of these, eight (17%) of the
hospitals reported a total of 11 vacancies for full-time
dietary administrative staff. Two of these vacancies were
in hospitals of less than 400 beds. No vacancies for part-
time dietary administrative staff were reported.

The 1975 projected needs for additional dietary
administrative staff, as reported by the 48 (96%) hospital
administrators who did respond to this question, totaled 28
full-time and seven part-time positions. Of the estimates

for full-time positions, four (14%) would be needed in large

 

hospitals (400 beds or more) and 24 (86%) would be available
in smaller hOSpitals (less than 400 beds). For the EEEE‘
Eime positions, only one (14%) would be needed in a large
hospital whereas six (86%) would be available in smaller
hospitals.

Although these data are extremely limited, it
appears likely that, for the next year or two at least,
individuals seeking employment in the field of hospital
food service administration in Michigan will find more job
Opportunities in hospitals of less than 400 beds than in

hospitals of 400 or more beds.

69

Contract Food Management
Company Services

 

The Opinions of hospital administrators regarding
contract food management services were sought. Three

questions were posed:

a. If your food service department is now
operated by a contract food management company,
why were the services of an outside firm
employed?

b. If your hospital formerly employed a contract
food management company but your food service
department is now hospital-Operated, why were
the services of the outside firm discontinued?

 

c. From your experience as a hospital administrator
how would you rate the services generally pro-
vided by contract food management companies?

The survey participants were given a variety of response
options for each question and asked to indicate as many as
applied to their respective institutions. The Options pro-

vided are shown in Part III of the questionnaire, page 124

in Appendix A.

Employment of contract food management companies.--
Only 15 (31%) Of the 50 administrators answered the
question requesting information as to why the services of a
contract food management company had been employed. All
respondents were administrators of hospitals of less than
400 beds. The reasons most often given were: (a) to reduce
department operating costs, nine (60%); (b) dissatisfied
with the managerial competence of the former director,

eight (53%); (c) unable to employ a qualified person to

70

manage the department, four (26.6%); and (d) to minimize
the responsibility and involvement Of the hospital adminis-
trator in the daily operational problems of the food
service department, four (26.6%). Four other reasons were
each given by one administrator: (a) to improve quality of
service; (b) support personnel; (c) continuity in service;

and (d) expansion Of department.

Discontinuation of contract food management company

 

services.--Of the 12 administrators (24%) that responded to
the question concerning discontinuation of contract food
management company services, five (42%) reported that the
services were too expensive and the contracts were not
renewed by the hospital. Four (33%) of the respondents felt
that the contract firms did not provide adequate nutritional
services. The next most frequently mentioned reasons were:
(a) the quality of food service was sub-standard, three (25%)
and (b) the firm employed did not fulfill the terms of the
contract, three (25%). One administrator reported that the
contract company excelled in only one area--purchasing--
therefore their services were discontinued. All Of the
responding administrators were from hospitals of less than

400 beds.

Rating of services provided by contract food manage-

ment companies.--Forty (80%) administrators responded to the

 

question requesting their overall rating of contract food

71

management company services. Eighteen (45%) of those
reporting indicated that, in general, the services of such
firms were either comparable to or significantly better
than hospital-operated services: four (10%) felt that the
services were comparable to most hospital-operated depart-
ments and significantly less costly; nine (22.5%) reported
that the services were comparable to most hospital-Operated
departments, but more costly; and five (12.5%) believed
that the services were significantly better than most
hospital-operated departments. Eight (20%) of those com-
pleting this question indicated that qualitatively the
services of contract companies were inferior to most
hospital-operated departments (seven administrators of
hospitals of less than 400 beds and one administration of
400 or more beds). Since 14 (35%) of the respondents had
had no experience with contract food management companies,
they felt they were unable to make the assessment requested.
Ten (20%) of the survey participants were not willing to
express their Opinions on this topic.

The Hospital Food Service Director:
Essential QualifiEations

 

 

Opinions of survey respondents regarding the essential
qualifications for a hospital food service director were
sought in the following five areas: (a) the five most

important managerial competences and the five most import-

 

ant personal traits and skills for a hospital food

 

service director; (b) the most desirable professional

72

background and experience; (0) the minimum level of formal
academic training needed; (d) the minimum amount of work
experience essential for this position; and (e) the areas
of competence that most professionally-trained dietitians
lack that tend to disqualify them for administrative posi-

tions in most hospital dietary departments.

Managerial competences and personal skills.--

 

Responses to the open-end questions that requested the
respondents' opinions concerning the five most important
managerial competences and the five most important personal
traits and skills are detailed in Tables 22 and 23. For
ease in reporting,managerial competences (Table 22) have
been divided into two groups--administrative skills and
technical knowledge and skills.

In the area of administrative skills, the one most
frequently mentioned was organization and coordination
(30 or 60%). The remaining administrative skills in
descending order of frequency of mention were: planning,
21 (42%); motivation and leadership, 15 (30%); problem
solving and decision making, 14 (28%); delegation, 10 (20%);
follow through, six (12%); controlling, six (12%); and
directing, four (8%). Only two aspects of technical
knowledge and skills were listed by more than 50 percent of
the respondents--financial management, 27 (54%) and human

relations skills, 26 (52%). Six other areas of

73

TABLE 22.--Managerial Competences Essential for the
Hospital Food Service Director as Perceived
by Hospital Administrators: Frequency Distribu-
tion in Relationship to Hospital Size.

 

- . a
Managerial ,Hospltal size (beds) Total Group

Competences 100_400 400+ NO. %

 

 

 

Administrative Skills

 

Organization and

Coordinationb 22 7 30 60
Planning 15 6 21 42
Motivation and

Leadership 11 4 15 30

Problem Solving and

 

 

Decision Makingb 9 14 28
Delegationb 7 2 10 20
Follow through 6 - 6 12
Controlling 5 1 6 12
Directing 3 1 4 8
Techpigal Knowledge
and Skills
Financial Management 23 4 27 54
Human Relations 23 3 26 52
Purchasing and Storeroom 13 1 14 28
Personnel Managementb 10 l 12 24
Diet Therapyb 7 l 9 18
Production Management 7 l 8 16
Labor Relations 4 2 6 12
Teaching and Training 3 - 3 6

 

an = 50 (100-400 beds = 41; 400+ beds = 9).

bOne respondent did not give hospital size.

74

TABLE 23.--Personal Traits and Skills Essential for the
Hospital Food Service Director as Perceived by
Hospital Administrators: Frequency Distribution
in Relation to Hospital Size.

 

. . a
personal Traits Hospltal Slze (beds) Total Group

 

and Skills 100-400 400+ No. %

 

Communication (written

and oral)b 22 5 28 56
Creative balance 7 2 9 18
Congenialb 5 3 9 18
Good appearance 7 l 8 16
Loyalty and honesty 4 4 8 16
Sense of fairness 6 l 7 l4
Self-confidenceb 4 1 6 12
Self-actualizing 5 l 6 12
Initiative 6 - 6 12
Integrity 2 3 5 10
Tactfulness 3 1 4 8
Stability 4 - 4 8
Professional in manner 3 l 4 8
Objective 2 2 4 8
Detail-oriented 3 - 3 6
Good health 2 1 3 6
Intelligence 1 2 3 6
Industrious l 1 2 4
Dependable l l 2 4
Desire to serve 2 - 2 4
Consistency l l 2 4
Goal oriented l l 2 4
Humility 1 1 2 4
Willingness to accept

criticism 2 - 2 4

 

an = so (100-400 beds = 41; 400+ beds = 9).

bOne respondent did not give hospital size.

75

technical knowledge and skills were listed by 28 percent
or less of those reporting. The range of response fre-
quency for these was from 14 (28%) to three (6%) (see
Table 22).

The administrators Offered 24 personal traits and
skills they felt were essential for a director of hospital
food services. Only one trait was listed by more than 50
percent of the respondents--communication, written and
oral, 28 (56%). The remaining 23 traits reported by 18
percent or less of the survey respondents had a range of
response frequency from nine (18%) to two (4%) (see Table

23).

Professional background and experience.--A
registered ADA dietitian with a general background was con-
sidered by 18 (36%) of the administrators to be the most
desirable professional background for a director of
hospital food services (Table 24). Formal academic train-
ing and experience in hotel, restaurant and institutional
management or a registered ADA dietitian with an administra-
tive background were each considered by 12 (24%) of the
respondents to be the most desirable professional background.
Four other types of professional background were thought
to be most desirable by eight (16%) of the administrators.
The frequency of mention for each of these is detailed in

Table 24.

76

TABLE 24.--Most Desirable Professional Background for a
Director (Manager) of a HOSpital Food Service
Department as Perceived by Hospital Administra--
'tors: Frequency Distribution in Relationship
to Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Professional Background
100-400 400+ No. %

 

Registered ADA dietitian,
generalb 15 2 18 36

Formal academic training
and experience in
hotel, restaurant and
institutional manage-
ment 10 2 12 24

Registered ADA dietitian,
administration 8 4 12 24

Hotel, Restaurant and
Institutional Manage-
ment degree plus
Nutrition 2 l 3 6

Certificate from a food
service administration
program and experience
in the field ' 2 - 2 4

Business administration 2 - 2 4
Food service administra-

tion in the armed
services 1

ole
U'l
OH

TOTAL 40 100

 

aN=50

bOne respondent did not give hospital size.

77

'Minimum level of academic training.--As shown in
Table 25, the bachelor degree was considered the most
desirable minimum level of academic training for the
director of the food service department by 37 (74%) of the
administrators reporting. This was the overwhelming choice
regardless of hospital size (76% of the administrators of
hospitals of less than 400 beds; 78% of the administrators
of hospitals of 400 or more beds). The reSponse frequencies
of the remaining preferences were: more than a high school

diploma but less than a college degree, six (12%);

TABLE 25.--Most Desirable Minimum Level of Academic Train-
ing for a Hospital Food Service Director
(Manager) as Perceived by Hospital Administra-
tors: Frequency Distribution in Relationship
to Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Academic Level

 

100-400 400+ No. %

Experience only 1 - l 2
High school diploma plus

special training 3 - 3 6

More than high school

diploma but less than

a college degree 5 l 6 12

Bachelor degreeb 29 7 37 74

Advanced degree _: _l. __ _2

TOTAL 38 9 4 96

- 4

NO response given

 

aN=50

bOne respondent did not give hospital size.

78

experience only one (2%) and advanced degree, one (2%). Two
respondents (4%) declined to Offer their opinions on this

question.

Minimum amount of work experience.--As shown in
Table 26, the minimum amount of work experience considered
essential for the hospital food service director by 34 (68%)
of the administrators ranged from three to five years or
more. Based on hospital size, administrators of smaller
hospitals (less than 400 beds) favored three to four years
(42%) whereas administrators of larger hospitals (400 beds
or more) preferred five years or more (67%). Thirteen (26%)
indicated one to two years as minimum. One respondent
was unwilling to set a minimum. Ninety-six percent of the

survey participants answered the question.

Areas of competence dietitians 1ack.--Only 43 (86%)
Of the administrators answered this question and, of these,
two indicated they were unable to answer the question
adequately. Seven survey participants declined to express
their opinions on this subject. According to the hospital
administrators reporting, to manage hospital dietary depart-
ments successfully, professionally-trained dietitians need
(a) additional training in six areas of administrative skill
and eight areas of technical knowledge and skill, and (b)

must improve three personal traits and skills (see Table 27).

79

TABLE 26.--Minimum Amount Of Work Experience Considered
Essential for Employment as Director (Manager)of
a Hospital Dietary Department as Perceived by
Hospital Administrators: Frequency Distribution
in Relationship to Hospital Size.

 

Hospital Size (beds) (Total Groupa

 

 

 

Years of
EXperlence 100-400 400+ No. %
5 years and over 11 6 17 34
3-4 years 16 1 17 34
1-2 yearsb 10 2 13 26
No set minimum 1 - l 2
TOTAL 38 9 48 96
No response given 2 - 2 4
aN=50 -

bOne respondent did not give hospital size.

In administrative skills, the following areas of incompetence
were cited: ability to relate to other departments and
professionals (8, 16%), ability to motivate and lead (5, 10%),
ability to organize and coordinate (4, 8%), ability to
delegate (3, 6%), willingness to accept administrative
responsibilities (3, 6%), and ability to make decisions and
solve problems.

Financial management, human relations, personnel
management, purchasing, and production management were the
five areas of technical knowledge and skills that a high
proportion of the survey respondents felt professionally-

trained dietitians frequently lack. Three other areas that

80

TABLE 27. Areas of Competence that Most Professionally-
Trained Dietetians Lack as Perceived by Hospital
Administrators: Frequency Distribution in
Relationship to Hospital Size.

 

. . a
Areas of Hospital Slze (beds) Total Group

 

 

Incompetence 100-400 400+ NO. %

 

Administrative Skills

 

Ability to relate to
other departments

 

 

 

and professionals 6 2 8 16
Motivation and

leadership 4 l 5 10
Organization and

coordination 3 l
Delegation 3 -
Willingness to accept

administrative

responsibilities 3 - 3 6
Decision making and

problem solving 2 l 3 6
Technical Knowledge
and Skills
Financial Managementb l3 2 16 32
Human Relations 11 2 13 26
Personal Management 9 2 11 22
Purchasing 8 2 10 20
Production Management 7 2 9 18
Labor Relations 1 l 2
Data Processingb l - 2
Department Sanitation l - 1
Personal Traits and Skills
Communication (written and

oral) 2 - 2 4
Creativity l - l 2
Aggressiveness l - l 2

 

aN = 50 (100-400 beds = 41; 400+ beds = 9).
bOne respondent did not give hospital size.

81

were reported by a few administrators were labor relations,
data processing, and department sanitation.

The hospital administrators reported only three
personal traits that professionally-trained dietitians lack:
oral and written communication, creativity and aggressive-
ness. Incompetence in these areas were cited only by
survey respondents in hospitals of 400 beds or less.

Recruitment of a Hospital
Food Service Director (Manager)

 

 

Hospital administrators were requested to provide
information regarding two facets of recruitment: (a) the
means they would most likely use in searching for a director
(manager) of their hospital food service department, and (b)
the most usual problems they have encountered when searching

for such a person.

Recruitment means.--The recruitment means used by

 

the hospital administrators surveyed in searching for a
director (manager) for their food service department are
summarized in Table 28. Fourteen means were reported and,
of these, four were used by more than 50 percent of the
respondents: college and university placement Offices,

26 (52%); post a position-available announcement in pro-
fessional journals, 30 (60%); poll professional colleagues
for potential leads, 31 (62%); and professional journal

advertisements (situation wanted), 34 (68%).

82

TABLE 28.--Recruitment Means Used by Hospital Administrators:
Frequency Distribution in Relationship to Hospital
Size.

Hospital Size (beds) Total Groupa

 

Recruitment Means
100-400 400+ No. %

 

College and University
Placement Officeb 22 3 26 52

Post a Position-
Available Announcement
in Professional Journal 25 5 30 60

Poll Professional
Colleagues for

Potential Leads 26 5 31 62
Professional Journal

Advertisement b

(situation-wanted) 27 6 34 68

Poll Current Hospital
Dietary Staff for

Potential Applicants 11 5 16 32
Area Newspaper

Advertisement

(situation-wanted) l4 3 17 34

Post a Position-Available
Anouncement in Area

Newspaper l3 5 18 36
Private Employment

Agencyb 18 2 21 42
College and University

Professors 7 2 9 18
Public Employment Agency 4 - 4 8

Area Dietetic
Association

Other Dietary Managers
Sales Representative

Area Hospital Council

H r4 H F4 H
I

r- Hir- H-r-

N no N thv

NO response given

 

aN=50

One respondent did not give hospital size.~

83

Thirty-two to 42 percent of the respondents indi-
cated that they would be apt to poll current hospital
dietary staff for potential leads, 16 (32%); to use
"situation-wanted" advertisements in area newspapers, 17
(34%); to post a "position-available" announcement in the
area newspaper(s), 18 (36%) and/or contact a private
employment agency, 21 (42%). Only nine (18%) indicated
they would contact College/University professors to find
potential candidates. Only a few administrators reported
they would contact public employment agencies, four (8%);
the area dietetic association, one (2%); other dietary
managers, one (2%); sales representatives, one (2%); and
the area hospital council, one (2%).

The administrators were also asked to indicate
which of these means they felt were most apt to help them
find qualified applicants. Opinions on this point varied
among respondents and some were reluctant to express their
views on this matter. Responses from those who were willing
to reveal their judgments are reported in rank order (most

to least) according to frequency of mention (Table 29).

Problems encountered.--Eight recruitment problems

 

were listed by hospital administrators and are detailed in
Table 30. Only one problem was reported by more than 50
percent of the respondents--finding professionally qualified

applicants. Nine (18%) of the respondents had had no

 

84

TABLE 29.--Recruitment Means Effectiveness: Opinions of
Hospital Administrators (Rank Order-Most to
Least-According to Frequency of Mention).

 

Frequency of Total Groupa

 

Recruitment Means Mention
(%)
(No.)
Private Employment Agencies 10 20

Post a Position-Available
Announcement in Professional
Journal 8 16

Post a Position-Available
Announcement in Area
Newspaper 7 14

Poll Professional Colleagues

for Potential Leads 7 14
Professional Journal

Advertisements

(situation-wanted) 6 12

College and University
Placement Offices 5 10

Area Newspaper Advertisements
(situation-wanted) 4 8

Poll Current Hospital Dietary
Staff for Potential
Applicants 4 8

College and University

 

Professors 2 2
Public Employment Agencies 1 l
a

N = 50

85

TABLE 30.--Recruitment Problems Encountered by Hospital
Administrators: Frequency Distribution in
Relation to Hospital Size.

 

Hospital Size (beds) Total Groupa

 

 

Recruitment Problems

 

100-400 400+ No. %

Finding professionally

qualified applicants 24 4 29 58
Finding qualified appli-

cants willing to

assume the extent of

responsibility

inherent in the

positionb 12 4 17 24
Meeting salary level

requirement of

applicantb 7 1 9 18
Geographic location 6 2 8 16
Meeting work hour demands

of applicants 2 4 6 16
Employee fringe benefits

which are Offered by

the hospital are some-

what less than avail-

able from competitors 3 2 5 10
Supplied by Management

Company 1 - l 2
Physical Structure Of

Building 1 - l 2
No experience 6 3 9 18
No problems - 2 2 4
No response given 2 - 2 4

 

aN = 50 (100-400 beds = 41; 400+ beds = 9).

bOne respondent did not give hospital size.

86

experience in searching for a director Of hospital food
service and two (4%) stated they had had no problem in
this regard. Two (4%) did not respond to this question.
Responses received regarding which of the problems
cited are or have been the most difficult were very
limited. Among the 13 (26%) who were willing to answer
this part of the question, eight indicated finding pro-

fessionally qualified applicants, four stated geographic

 

location of the hospital, and one mentioned meeting the

salary level requirements of the applicants.

Part B: Contract Food Management
Company Officials

 

 

Personal interviews were conducted with administra-
tive officials of six contract food management companies
with accounts in Michigan. However, the data herein
reported cover only four of'flramanagement companies
selected for study because one company did not have
hospital accounts in Michigan and the interview with the
administrative Official of a second company was abruptly
discontinued due to unforeseen company activities requir-
ing immediate attention by the interviewee.

The findings from the four food contract management
companies are presented in the sequence used in the design
of the interview guide (Appendix B). For consistency in

reporting, individual companies and their respective

87

administrative officials are referred to by the same alpha-

betical code, A, B, C, and D.

The Study Participants

Descriptively, the present position titles of the
four executives interviewed are Personnel Manager, Market
Personnel Director, Manager of Operations, and Executive
Vice President. The Personnel Manager and the Market Per-
sonnel Director have similar assignments in that they are
directly responsible for the selection, placement and
administrative development of hOSpital food service direc-
tors. The other two company Officials--the Manager of
Operations and the Executive Vice President--are responsible
for a broader range of Operational activities. In each
case, however, the management of personnel for their
hospital accounts is one of their designated administrative
responsibilties.

The professional profiles of the interviewees are
detailed in Table 31. Current position titles have been
excluded in order to maintain anonymity of the respondents.
Three basic characteristics are included: (a) educational
background; (b) area of professional specialization; and
(c) professional employment history.

Inquiries were made into two aspects of the educa-
tional background of each participant-~the highest formal

educational level attained and the area(s) of specialization.

88

TABLE 31.--Professional Profiles of Interviewees from Four

Contract Food Management Companies with Michigan

Hospital Accounts.

 

Characteristics

Food Management Company

 

A

B

C

D

 

Educational Background

 

Degree Earned (highest)
Bachelor Degree
Post Graduate Courses not
ending in Master Degree

Area OfASpecialization

 

Economics

Personnel Management

Pre-medicine

Hotel, Restaurant and
Institution Management

Emplgyment History

 

Years in Present Position
Years in Food Service Field

Previous Food Service Experience

College Accounts
AsSistant Food Service Dir.
Food Service Director

 

Hospital Accounts
Assistant Food Service Dir.
Food Service Director

 

Central Office
Personnel Manager
Director of Hospital and
Nursing Home Accounts
Vice President

 

><

>4

 

89

As shown in Table 31, all had earned a bachelor's degree
but, in each case, the area of specialization differed.
Courses beyond the bachelor's degree, but not ending in a
master's degree, had been completed by only one of the
interviewees.

Information regarding the employment history of
the administrative officials focused on three aspects--the
number Of years each has been in his present position, the
total number of years each has been employed in the food
service field, and the types of food service positions
previously held.

The length of time these administrative Officials
have been in their present positions varied from six months
to seven years. Executives A, C, and D have been in the
food service field for 16, 12, and 18 years, respectively,
and each has held either three or four other positions in
the field previOus to his present position. Former field
positions held by these executives included Assistant
Director and/or Director of Food Service in college and/or
hospital accounts. Previous central office positions
included Personnel Manager, Director of Hospital and
Nursing Home Accounts, and Vice President f0: executives
A, C, and D respectively. The administrative Official from
company B has been in the field of food service for three
years as Personnel Manager. This position is his only

area of experience in the food service field.

90

Operational Characteristics

Operational characteristics Of the four contract
food management companies surveyed included: (a) types of
Michigan establishments for which they currently provide
food management services; (b) number of years that the
company has been in the hospital contract food management
business; (c) number of hospital accounts and approximate
facility sizes; (d) types of management services provided;
(e) commissary operations; (f) vending services; (9) pur-
chasing and delivery policies; and (h) descriptive informa-
tion pertaining to the dietary personnel associated with

the hospital accounts.

Types of establishments served.--Food management

 

services are contracted with five types of Michigan
establishments. As shown in Table 32, all Of the companies
studied provide food management services to hospitals and to
nursing homes. Business and industry accounts are serviced
by companies A, B, and D. Only companies A and D have food
management accounts in colleges and universities and company
B services an elderly nutrition program in metropolitan

Detroit.

Years in the hospital food management business. Of
the companies studied, companies A and C have had hospital
accounts for eight years, company B for 13 years and

company D for 16 years. Because of the relative stability

91

TABLE 32.--Types of Michigan Establishments Served.

 

Food Management Company

 

Facility Type

 

A B. .C . D
Hospitals X X X X
Nursing Homes X X X X
Business/Industry X X - X
College/Universities X - - X
Elderly Nutrition Program - X - -

 

of these companies it is reasonable to expect that the
opinions of the executives interviewed regarding the
essential qualifications of hospital food service directors

(managers) should be fairly representative.

Number of Michigan hospital accounts.--The number

 

of hospital dietary departments which each of these
companies manage are listed according to facility size in
Table 33. Among the companies studied, there is a total
of 26 accounts and, Of these, 21 (81%) of the accounts are
in hospitals with a capacity of 100-299 beds. Only three
accounts (11%) are in facilities with 300-499 beds and
only two accounts (8%) are in hospitals with less than 100
beds. None of the companies studied have contracts with
hospitals of 500 or more beds.

Within the limits of these data it appears that in

Michigan, 100-299 bed hospitals are more likely to employ

92

TABLE 33.--Number of Michigan Hospital Food Service
Accounts.

 

Food Management Company Total Groupa

 

Facility Size

 

 

A B C D No. %

Less than 100 beds 0 0 l l 2 8
100-299 beds 10 l 9 l 21 81
300-499 beds 0 0 3 0 3 11
500 or more beds _0 _Q _Q _Q __ __1
TOTAL 10 1 l3 2 26 100

 

the services of outside management companies to Operate
their dietary departments than are hospitals of less than

100 beds or more than 300 beds.

Types of management services provided.--The four

 

companies under study provide total food service manage-
ment to all their Michigan hospital accounts. Company C
also has a Specialized purchasing service, which is
available to selected accounts in Michigan. However, in
the opinion of the Official from Company C, providing only
specialized services usually presents many problems,
especially if the food service director (manager) of the
Operation feels insecure and fails to cooperate fully.

For this reason their specialized services are neither
advertised nor encouraged. Where such contract arrange-

ments do exist they usually are an accommodatiOn requested

93

by the client rather than a business solicitation by the

food management company.

Commissaries.--Only two of the companies surveyed,

 

B and D, Operate commissaries in Michigan and supply food
to their hospital accounts from them. Company B has only
one hospital account in Michigan and delivers 100 percent
of the food to this account fully-prepared and in bulk
containers. The commissary of company D provides only

food items for vending to its Michigan hospital accounts.

Vending services.--Vending services are provided

 

to Michigan hospitals by all companies studied. Manage-
ment company A sub-contracts all Of its service require-
ments from a vending firm whereas company C contracts
part of its vending needs to an outside company but also
prepares certain food items for vending in the kitchens
Of its hospital accounts.

Companies B and D do not sub-contract for vending
services. Instead, they supply their hospital accounts
wholly or in part, from their own commissaries. Company B
delivers 100 percent of the food for vending services from
their commissary. The commissary of company D supplies
only certain food items for vending use and the remaining
items are prepared on the hospital premises. Food pre-
pared and packaged for vending by hospital employees is

dispersed through the general merchandiser. Types of menu

94

items prepared and packaged on the hospital premises are
hot entrees, hot and cold sandwiches, salads, and desserts.
Other items available from the general merchandiser
usually include fruits, fruit and vegetable juices, and

milk.

Purchasing and delivery policies.--A combination

 

of centralized and decentralized purchasing is used by all
companies surveyed. The central office of each company
issues an authorized vendor's list to be used by the
hospital food service director. However, if the director
is unable to procure specific items from the company's
approved vendors, he is permitted to Obtain them from
other suppliers. In all cases, food and non-food items
are delivered to each account directly from and by the

vendors.

Hospital dietary employment practices and needs.--
The types of hospital dietary workers employed by each of
the contract food management companies surveyed are
summarized in Table 34.

Among companies, employment Of hospital dietary
workers ranged from employing only the food service
director to employing the total dietary staff. All
companies reported employing the food service director at

100 percent of their hospital accounts. Companies A, B,

95

TABLE 34.--Employment of Hospital Dietary Employees by
Contract Food Management Companies.

 

Food Management Company Accounts

 

Types Of Workers A B C D

 

NO. %a No. %a NO. %a No. %a

 

Food Service

Director 10 100 1 100 13 100 2 100
Asst. Food Service

Director 10 100 l 100 13 100 0
Food Service

Supervisor 8 80 O 6 46 0
Therapeutic

Dietitian 10 100 lb 100 6 46 0

Total Dietary
Staff 8 80 0 3 23 0

 

aPercentage of total hospital accounts

bShared dietitian.

and C also have all of the assistant food service directors
at their accounts on their payrolls. Company employed

food service supervisors was the general practice of
companies A and C only. In both cases, however, this

did p93 hold true for all of their accounts. It is con-
ceivable that this level of administrative staff was

either not necessary or not economically feasible in

relationship to the size of the contracted facility.

96

Therapeutic dietitians are employed in varying
degrees by the companies--in 100% of the accounts Of
companies A and B, in 46% of company C's accounts and in
none of the accounts of company D. Only companies A and C
have the total dietary staff of some Of their accounts on
their payroll (eight or 80% of A's acCounts and three or 23%
of C's accounts). The administrative official from company
A favors employing the total dietary staff because he feels
that employee loyalties lie with the source Of their income.
In contrast, company C's administrative official is not in
favor of employing the total dietary staff because he feels
employee discontentment can result from a company's inability
to provide fringe benefits comparable to those provided
other employees at the same hospital.

Among the 26 accounts serviced by the four companies,
the number of years that the food service directors have
served in this position ranged from three to ten years.

The number of years that each of these individuals have
served in other positions within their respective companies
was not included in this survey.

Findings relative to the professional background
and previous work experience of the 26 directors revealed
that formal academic training in hotel, restaurant and
institution management (with little or no background in
nutrition) had been acquired by 16 of the food service

directors. Only two of the 26 directors were registered

97

dietitians. All of interviewees stated that professionally-
trained dietitians generally do not show an active interest
in administrative positions, especially as food service
directors. Three of the directors had earned certificates
from food management programs and had previously had a few
years of administrative experience in the food service field.
Experience in the armed services in food service administra-
tion was the professional background for three directors and
the remaining two had educational background and experience
in business administration. V

In all companies central office staff members are
usually recruited from company employees assigned to field
accounts. Professionally trained dietitians are on the
central Office staff of all of the companies studied.
Dietitians primarily responsible for coordinating the
activities of therapeutic dietitians at the accounts have
the following position titles: ConSulting Dietitian,
Director of Research and Development, and Staff Dietitian.
Some central office staff dietitians are also responsible
for coordinating administrative activities. Titles and
major reSponsibilities of these persons are: Director of
Menu Development, Director of Nursing Homes, Coordinator of
Nursing Home Accounts (all activities), and Supervising
Dietitian, responsible for training employees and reviewing
policies and activities in each account to ensure compliance

with company procedures and standards.

98

Administrative officials from the companies surveyed
reported that they were constantly seeking qualified food
service directors, but at the time of this survey (January-
February, 1974) only two companies actually had vacancies.
Company C was searching for two full-time directors and
company D was seeking one full-time director. These execu-
tives were very optimistic about the growth potential in
Michigan hOSpitals for contract food management services.
Collectively they projected a need for 54 full-time admin-
istrative personnel for their hospital accounts by 1975.
Among the four companies studied their projected needs
ranged from three to 30.

The Hospital Food Service

Director: Essential
Qualifications

 

 

 

Opinions of company officials regarding the essential
qualifications for a hospital food service director were
sought in the following areas: (a) the five most important
managerial competences and the five most important personal
skills for a hospital food service director; (b) the most
desirable professional background and experience for the
position; (c) the minimum level of formal academic training
needed; (d) the minimum amount of work experience essential
for this position; and (e) the areas Of competence that most
professionally-trained dietitians lack that tend to dis-
qualify them for administrative positions in most hospital

dietary departments.

99

Managerialcompetencesand personal skills.--

 

ReSponses to an Open-end question that requested the
officials' opinion concerning the five most important
managerial competence and the five most important personal
traits are shown in Table 35. Technical knowledge and
skills and one administrative skill, organization and
coordination,were listed unanimously. Two other administra-
tive skills were also reported: motivation and leadership
by executives A and B, and delegation by official D.
Fifteen personal traits were reported by the Officials as
being important. Only five of these traits were reported
by more than one executive: established personal goals,
perseverance, neat appearance, intelligence, and communica-

tion skills (oral and written).

Professional background and experience.--Formal
academic training and experience in hotel, restaurant and
institution management was considered the most desirable
background for hospital food service directors by officials
from companies B and D. Administrative official A preferred
individuals with specialization in business administration
and official C favored an ADA registered dietitian with

major emphasis in administrative dietetics.

Minimum level of academic training and experience.—-

 

Three of the Officials--A, B, and D--considered a bachelor's

100

TABLE 35.--Managerial Skills and Personal Traits Essential
for the Hospital Food Service Director as Per-
ceived by Interviewees from Four Contract Food
Management Companies.

 

Food Management Company

 

Characteristics
A B C D

 

Administrative Skills

 

>4
>4

Organization and Coordination
Motivation and Leadership
Delegation

>4>4
>4>4
I
I

I
I
I

Technical Knowledge and Skills

Administrative Management

Financial Management

Production Management

Marketing Management

Purchasing and Storeroom
Management

Equipment and Space
Management

Personnel Management

Human Relations Skills

>4>4>4 >4 >4>4>4>4

>4>4>4 >4 >4>4>4>4
>4>4>4 >4 >4>4>4>4
>4>4>4 >4 >4>4>4>4

Personal Traits

 

Established personal goals
Perseverance

Well groomed and neat
Intelligence -
Excellent communication skills -
Job interest -
Enthusiasm -
Creative -
Detail oriented -
Industrious X
Aggressiveness - -
Self-discipline - —
Loyalty and honesty - -
Reliability X -

I >4

I
l>4>4>4>4>4
>4l

I
l>4>4>4|>4|>4

l>4
I
II

-I>4I>4I
>4

 

101

degree the minimum level of formal academic training
essential for employment as a hospital food service
director. Executive C did not have a minimum level of
formal academic training, but did require several years
experience in food service administration. He felt that,
at the present time, there are not enough qualified people
in the job market to be too selective. Even though the
other executives indicated the bachelor's degree as the
most desirable minimum level Of academic achievement they
also employed directors without a bachelor's degree. All
interviewees considered two years in a stressful adminis-
trative position the minimum amount of work experience
essential for employment as a director of a hospital

food service department.

Areas of competence dietitians lack.--According to

 

the executives interviewed, areas of competence which pro-
fessionally trained dietitians lack are leadership ability,
organizational skills, accountability skills, ability to
accept and cope with change, ability to maintain emotional
stability under stress, and sufficient personal motivation
to acquire the needed skills to attain management positions.

Recruitment of HOSPital Food
Service Directors

 

 

Information regarding two facets of recruitment
were elicited from the administrative officials Of the

contract food management companies: the recruitment means

102

they would most likely use in searching for hospital food
service directors and the problems they usually encounter

during the search.

Recruitment means.--The recruitment means used by

 

the officials interviewed in searching for food service
directors for their Michigan hospital accounts are detailed
in Table 36. These Officials used 12 different recruitment
means and, of these, considered three the most useful in
trying to locate qualified applicants: private employment
agencies, college and university placement offices, and

referrals.

Problems encountered.--Three problems usually

 

encountered by these administrative officials in searching
for professionally-qualified directors for their Michigan
hospital food service accounts are: (a) finding profes-
sionally-qualified applicants; (b) geographic location;

and (c) single job orientation by dietitians. Executive

A stated that most dietitians do not investigate potential
employers in terms of career advancement possibilities, but
are concerned only with the particular position for which

they are applying.

103

TABLE 36.--Recruitment Means Used by Contract Food Manage-
ment Company Officials Surveyed.

 

—-—r.a-—.

Recruitment Means Frequency 0f

 

Mention

Public Employment Agencies 2
Private Employment Agenciesa 2
College and University Placement Officesa 2
College and University Professors 2
Professional Journal Advertisements

(situations wanted) 3
Area Newspaper Advertisements

(situations wanted) 1
Post a Position-available Announcement

in professional journal 2
Post a Position-available Announcement

in Area Newspapers 2
Poll Business Colleagues for Potential leads 1
Poll Current Hospital Dietary Staff for

Potential Applicants 2
Company University Accounts
Referralsa 2

 

aRecruitment means most useful in helping executives
find qualified applicants.

CHAPTER V

SUMMARY, CONCLUSIONS AND IMPLICATIONS

This study was concerned with determining the
essential job qualifications that hospital dietary
department directors must possess in order to Operate the
department effectively. Opinions were sought from two
sources--hospital administrators and officials of contract
food management companies. It was believed that (a) the
opinions of these two main types of employers of hospital
dietary directors would serve as a realistic basis for
determining the specialized knowledge and skills needed
by the competent hospital food service director, and (b)
such knowledge would provide valuable insight for educators
in the modification of professional training programs in
Administrative Dietetics and would be useful in designing
career ladders for practicing dietitians with interest in
Administrative Dietetics.

The data gathering technique used for Part A Of
the survey was the mail questionnaire which consisted of
open-end and fixed alternative questions. This research
instrument solicited opinions from the administrators Of

one hundred non-governmental hospitals, located in the

104

105

lower peninsula of Michigan, with a bed capacity of one
hundred or more.

For Part B of the study the Opinions of Officials
of four contract food management companies operating in
Michigan were obtained through personal interviews con-
ducted by the researcher. A standardized interview guide
consisting of both Open-end and fixed alternative questions
comparable to those presented to the hospital administra-
tors contacted in Part A of the study ‘was used.

The summarized data are presented in basically
the same sequence as the items are listed in the survey

instruments (see Appendix, Part A, p. 120, Part B, p. 128).

Summary of Mail Questionnaire Findings

 

Assessment of Response Representation

 

The 50 usable returned questionnaires were
analyzed to determine the representation of returns to
initial mailings and it was revealed that despite only a
50 percent response, the returns received were fairly
representative Of the initial mailing with respect to
hospital size, community size, and region within the lower

peninsula.

The Study Participants

 

l. The respondents to the mail questionnaire held
thirteen different administrative titles. Of
these, the largest percentage (42%) of
respondents have the title of Assistant Admin-
istrator and the second largest percentage (32%)
have the title of either Administrator or
Director.

106

Seventy-two percent of the hospital administra-
tors had earned an advanced degree in one of
four areas: Hospital Administration (48%),
Business Administration (16%), Liberal Arts
(6%), and Law (2%). Eight different areas of
specialization were reported but the majority
(54%) of the respondents specialized in
Hospital Administration.

Inquiries into the employment history of the
administrators revealed that the majority were
relatively new to the field of hospital
administration and to their present positions:
64 percent had been in the field for 10 years
or less and 92 percent had been employed in
their present positions for 11) years or less.

Hogpital and Dietary Department

 

Operational Characteristics

 

1.

Facility size as expressed in terms of average
daily inpatient census, average daily out-
patient census and total staff employed for the
hospital and for the dietary department indicated
considerable variation both within and among
hospital size ranges for each Of these opera-
tional characteristics.

The number of total dietary staff ranged from

17 to 325 and represented from 4.5 to 14.2 ,
percent of the total hospital staff. In the
area of professional dietary staff all respond-
ing hospitals had at least one full-time
administrative staff member, but full-time
therapeutic dietitians were not employed in some
hospitals of less than 300 beds.

The hospital food service departments were pre-
dominantly (72%) hospital-Operated and offered
twelve different types of meal services.

Present Directors of hosPital food service
departments:

a. Persons responsible for the management Of
the hospital dietary department are full-
time employees and generally have the
position title of Food Service Director or
Manager (46%) or Director or Manager of
Dietary Services (22%).

107

b. The majority (64%) of the food service
managers had obtained a bachelor's degree
and specialized in one of the following
areas: general dietetics (28%), hotel,
restaurant and institution management (20%);
and administrative dietetics (12%).

c. The managers of dietary departments have
had a considerable degree of experience in
the food service field (64% have been in
the field for 11 years or more) but have
been in their present position for a much
shorter period of time (74% for 10 years
or less, and of these, 48% for five years
or less).

d. American Dietetic Association affiliation
was held by only 22 (44%) of the directors.

e. An overwhelming majority (90%) of the
respondents gave the managers of their food
service department a competence rating Of
average or better (28% excellent; 36% above
average; 26% average and 2% below average).

f. When the competence ratings of managers were
compared to professional classification the
competence ratings for each category
(excellent, above average, average) was
shared nearly equally by ADA members and
non-ADA members. .

Only eight (17%) Of the hospitals surveyed
reported vacancies for dietary administrative
personnel--ll full-time and 0 part-time. The
1975 projected needs for additional dietary
administrative staff reported by administrators
were 28 full-time and seven part-time positions.
Thirty of the 35 projected positions were for
hospitals of less than 400 beds.

Contract Food Management Company

Service

1.

Fifteen (30%) administrators gave eight reasons
for employing contract food management services
but only two reasons were given by more than 50
percent of the responding administrators. Both
of the reasons given indicate that the former
directors of food services were inept in per-
forming managerial tasks.

108

The reasons for discontinuing the services

Of contract food management companies given

by 12 administrators (24%) basically fell into
two categories: (a) services were too expen-
sive, and (b) the quality of services was sub-
standard.

The largest percentage (45%) of the administra-
tors rated the services Of contract food
management companies as being either comparable
to or significantly better than hospital-
operated services.

The Hospital Food Service Director:

 

Essential QualificatiOns

1.

Recruitment

The hospital administrators reported numerous
managerial competences and personal traits and
skills as being essential for the food service
director. However, only four were reported

by more than 50 percent of respondents: organi-
zation and coordination, 3O (60%); financial
management, 27 (54%); human relation skills,

26 (52%); and communication skills, 28 (56%).

The administrators considered the following
formal academic and experiential training to

be essential for the food service director:

(a) a bachelor's degree (74%); (b) 3-5 years or
more experience (68%); and a professional back-
ground as a registered ADA generalist (36%).

Even though 41 (82%) of the respondents replied
to the question regarding areas of competence
that professionally trained dietitians lack,
the frequency of mention for each area was low,
16 or less. The largest frequencies of mention
were in the general category of technical
knowledge and skills.

Means

 

1.

Fourteen recruitment means were used by the
administrators in searching for a director of
their food service department. Only four means
were used by more than 50 percent of the
administrators: college and university place-
ment Offices, 26 (52%); post a position-avail-
able announcement in professional journals, 30

109

(60%): poll professional colleagues for
potential leads, 31 (62%); and professional
journal advertisements (situation wanted, 36
(68%). '

The four most frequently mentioned recruitment
means that the administrators felt were more
apt to help them find qualified applicants were:
private employment agencies, post a position-
available announcement in a professional jour-
nal, post a position-available announcement in
area newspapers, and poll professional col-
leagues for possible leads.

Finding professionally qualified applicants
was the major recruitment problem encountered
by the majority (58%) of the administrators in
searching for a qualified director of food
service.

Summary of Personal Interview Findings

 

The Study Participants

 

1.

Descriptively the present position titles of the
four executives interviewed are Personnel
Manager, Market Personnel Director, Manager of
Operations and Executive Vice President.

The four officials had all attained bachelor's
degrees, but in each case, the area of
Specialization differed--economics, personnel
management, pre-medicine, and hotel, restaurant
and institution management.

The number of years that three of the officials
had been in the field Of food service was
extensive: 16, 12, and 18 years. Each had held
at least three other management positions in

the field before occupying their present posi-
tion. The fourth official had only been in the
field for three years and his present position--
Personnel Manager--is his only area Of experi-
ence in the food service field.

The number of years that the officials have been
in their present positions ranges from six
months to seven years.

 

It'll
II II [.1411] i 4"!

110

Operational Characteristics

1.

Collectively the four contract food management
companies provide total food service to five
types of establishments in Michigan--hosPitals,
nursing homes, business/industry, colleges/
universities, and elderly nutrition programs.

The number Of years that the companies have been
in the hospital food management business ranged
from 8 to 13 years, thus indicating relatively
stable establishments. Collectively they have
only a total Of 26 Michigan hospital accounts,
with the majority (81%) of the accounts in
hospitals with a bed capacity of 100-299 beds.

Only two of the companies surveyed Operated
commissaries in Michigan and supply food to
their hospital accounts from them. One company
delivers 100 percent of the food to their
accounts fully-prepared and in bulk containers.
The other company provides only food items for
vending to its Michigan hospital accounts.

Vending services are provided to Michigan
hospital accounts by all companies studied
(frequently sub-contracted to outside firms).

A combination of centralized and decentralized
purchasing is used by all companies surveyed.
All companies have some food and non-food items
delivered to each account directly from and by
the vendor.

The employment of hospital dietary workers by
contract food management companies ranges from
employing the food service director (100% of
total accounts) to employing the remaining
dietary staff (42% of the total accounts). The
food service directors employed by the company
have been in their positions at least three years
but not more than 10 years. Sixty-two percent
have had formal academic training in hotel,
restaurant, and institution management and the
majority (93%) are not registered ADA dietitians.

lll

Among the companies surveyed, only two had
administrative dietary vacancies--two full-time
directors for one company and one full-time
director for the other, but collectively the
projected needs of the four companies surveyed
for full-time administrative personnel for
their hospital accounts by 1975 was relatively
high, 54 positions.

 

The Hospital Food Service Director:
Essential Quaiifications -

 

1.

Only two areas of managerial competence and
personal traits and skills were considered
essential by all of the executives: the ability
to organize and coordinate, and items included
in the broad category of technical knowledge

and skills.

The areas of formal academic and experiential
training considered essential by the executives
were: (a) formal training and experience in
hotel, restaurant and institution management
(50%); (b) a bachelor's degree (75%); and

(c) two years experience in a stressful admin-
istrative position (100%).

According to the four executives interviewed,
areas of competence which professionally trained
dietitians lack are leadership ability, organi-
zational skills, accountability skills, ability
to accept and COpe with change, ability to main-
tain emotional stability under stress, and ‘
sufficient personal motivation to acquire the
needed skills to attain management positions.

Recruitment of a Hospital Food

 

Service Director

 

1.

Twelve different recruitment means were used by
the executives, but only three were considered
to be most useful in helping them find qualified
applicants: private employment agencies,
college and university placement offices, and
referrals. ‘

112

Three problems usually encountered by officials
in searching for professionally qualified
directors for their Michigan hospital food
service accounts are: finding professionally
qualified applicants, geographic location, and
single job orientation by dietitians.

Conclusions and Implications

 

Based on the findings from this very limited

investigation, several situational factors appear to

influence the management practices of food service depart-

ments in Michigan hospitals.

1.

Although a high percentage of Michigan hospitals
are retaining the responsibility Of managing
their dietary departments, they are, with
increasing frequency, employing individuals

with demonstrated competence in management
related skills to direct the activities of

their departments.

The role of administrative leadership in
dietary departments in Michigan hospitals is no
longer the nearly exclusive domain of profes-
sionally-trained dietitians. Hospital adminis-
trators and contract food management companies
alike are searching for and selecting individ-
uals to manage their dietary services primarily
on the basis of experience and potential
ability to manage the operation. Dietetic
specialization and professional affiliation,
although still held in high regard, are cur-
rently viewed as less important criteria than
evidence Of proven and/or potential effective-
ness in managerial leadership.

Based on the response of hospital administrators
and contract food management company officials,
hospital administrators are more likely to
select professionally trained dietitians to
direct their food service departments than con-
tract food management officials are.

113

Finding professionally-qualified applicants is
the major concern of both types Of employers.
This problem has lead hosPital administrators
and contract food management company Officials
to seek employees from outside the field of
dietetics.

If one's goal is to be a director of a dietary
department, in hospitals of 400 beds or less
one should: (a) be a registered dietitian with
a general background, (b) have three years or
more experience in the field, (c) be competent
in management related skills, and (d) be willing
to assume the extent of responsibility inherent
in the position. In hospitals of 400 or more
beds the professional background should be that
of a registered dietitian with administrative
specialization, five or more years experience
and with the remaining qualifications the same
as for the dietitian in hospitals Of 400 beds
or less.

The practice of employing contract food manage-
ment firms to operate dietary departments in
Michigan hospitals is not very extensive.

When such contractual arrangements exist, they
are predominantly associated with hospitals of
400 beds or less.

LITERATURE CITED

114

10.

LITERATURE CITED

Janet. "Liberation." Food Management, IX
(March, 1974), 44-47.

 

Benson, Rosen, and Thomas, Jerdee. "Sex Stereotyping
in the Executive Suite." Harvard Business Review,
LII (march-April, 1974), 45-58.

 

Benis, Arthur, et al. Executive Recruiting: How
Companies Obtain Management Talent. Lake Forest:
Executive Reports Association, 1960.

 

 

Bussart, Joan P. "Qualities Every Good Manager Should
Have and Should Use." Southern Hospitals
(October, 1968), 33-34.

 

Cabot, Elaine E. "Dietitian's Work: Therapeutic,
Instruction, Audits." Modern Hospitals (August,
1972), 117.

 

Cartmill, George. "What Does TOp Management Expect?"
Journal of the American Dietetic Association,
XXXIV (July, 1958), 727-729.

 

Clark, Harriet, and Knickrehm, Marie. "How Do
Administrators and Administrative Dietitians
Perceive the Chief Dietitian?" Journal of the
American Dietetic Association, LXI (December, 1972),
647-651.

 

 

Denerley, R. A., and Plumbly, P. R. Recruitment and
Selection in a Full-Employment Economy: London:
Lawrence Bros., 1968.

 

 

Donovan, Anne, and Ehrlich, Geraldine. "Survey Of
Contract Management Firms Servicing Dietary
Departments." Journal of the American Hospital
Association, XLII (June 16, 1968), 91-97.

 

 

Fretz, C. F., and Hayman, Joannes. "Progress for
Women-Men are Still More Equal." Harvard Business
Review, LI (September-October, 1973), 133—142.

 

115

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

116

Gleiser, Fern. "The Dietitian--An Executive!" Journal
Of the American Dietetic Association, XXXVI
(February, 1960), 103-106.

 

Goulet, Charles R. "How Administrators Evaluate Food
Service." The Modern Hospital, C (May, 1963), 103-
105.

 

Greenaway, Donald. "Food Service Management--Its
Problems and Promises." Journal of the Americap
Dietetic Association, XLI (December, 1972), 547-
549.

 

 

Hofto, Joyce, and Brush, Mirian. "Hospital Administra-
tors, Appraisal of Dietitians Managerial Perform-
ance." Journal of the American Dietetic Associa-
tion, LXI (July, 1972), 296-298.

Johnson, Doris. "Changing Role of the Dietitian."
Journal of the American Dietetic Association,
XXXVI (June, 1960), 593-595.

Letonrneau, Charles, M.D. "Management and the
Profession of Dietetics." Journal Of the American
Dietetic Association, XXXIII (July, 1957), 691-694.

 

 

Lipscomb, Mary, Lt. Col., and Donaldson, Beatrice.
"How Well Do Directors of Dietetics Fulfill
Managerial Re5ponsibilities?" Journal Of the
American Dietetic Association, XLV (September,
l964),0218-224.

 

 

Little, Keith. "Are Dietitians Being Supplanted as
Department Administrators?" Canadian Dietetic
Association, XX (November, 1958), 18-22:

 

McCarthy, Eleanor. "Food Service and Dietetics."
Journal of the American Hospital Association,
XLIII (April, 1969), 101- 104.

McGibory, John R. Principles of Hospital Administra-
tion. New York: G. P. Putnast Sons, 1952.

Mannick, Angeline. "Food Service and Dietetics. "
Journal of the American Hospital Association,
XXXIII (April l6, 195973—57- -59.

22.

23.

24.

25.

26.

27.

28.

29.

30.

31.

32.

117

Miller, Grace A. "A Study of the Effectiveness of
Academic Preparation of Recent Home Economics
Graduates as Related to Managerial Responsibilities
in the Food Service Industry." Unpublished Ph.D.
dissertation, Michigan State University, 1959.

 

Moon, James E. "Contract Services Features Catered
Food." The Modern Hospital, LVI (June, 1966),
122-124. ‘

Puckett, Ruth P. "The Dietitian as a Manager."
Hospital and Nursing Home Food Management, IV
(May, 1968), 36-37.

 

Puckett, Ruth P. Letter to the editor. Journal of the

 

American Dietetic Association, LXIV (February,
1974), 192.

 

Rainier, Warren G. "What is a Well Organized Dietary
Department? An Administrator Speaks." Journal
of the American Dietetic Association, XXXIV
(September, 1958), 938-940.

 

Richards, Linda. "Factors That Affect Career Mobility
Among Michigan's Professionally Qualified Dieti-
tians." Unpublished MS Thesis, Michigan State
University, 1974.

Ross, Austin. "An Administrator Looks at the Depart-
ment of Dietetics." Journal of the American
Dietetic Association, I (January, 1967), 26-31.

 

 

Ross, Austin. "Evaluating Dietary Department
Management." Journal of the American Hospital
Association, XLII (April 16, 1968), 109-114.

 

 

Sanford, Jeanne, Mckinley, Marjorie, and Scruggs,

Marguerite. "Graduates of Hospital Dietetic
Internships--Perception of Administrative
Experience in Internships." Journal of the

 

American Dietetic Association, LXIII (September,
1973), 259-268.

 

Schill, John. "Who Should Head the Food Service
Department?" Journal of the American Dietetic
Association, XXXV (October, 1959), 1068.

 

 

Schwartz, Stewart. "How Administrators Rate Dietary."
Food Management, VI (February, 1970), 38-39.

 

33.

34.

35.

36.

37.

38.

39.

41.

42.

43.

44.

45.

118

Spangler, Alice. "The Role and Responsibilities of
Michigan Hospital Dietitians." Unpublished Ph.D.
dissertation, Michigan State University, 1971.

Spenner, Paul J. "Why it May Pay to Buy Dietary
Management." Hospitals, XXXV (September, 1961),
134-136.

 

The Food Service System Management Education Council.
"An Open Letter." Journal of the American Dietetic
Association, LXIII (November, 1973), 556-557.

 

 

Vanderwarker, Richard D. "The Dietitian and Decision
Making." Journal of the American Dietetic
Association, XXXV YOctober, 1959), 1032-1036.

 

 

Walter, Frank S. "Should the Hospital Contract for
Its Food Service? Yes." Journal of the American
Hospital Association, XXXVIII (June 16, 1964),
86-96.

 

 

Zugich, John J. "Should the Hospital Contract for Its
Food Service? No." Journal Of the American Hos-
pital Association, XXXVIII (June 16, 1964), 87-96.

 

 

"ADA Report, Duties and Responsibilities in the
Department Of Dietetics." Journal of the American
Dietetic Association, XLVI (March, 1965), 179-182.

 

 

"ADA Survey, Food Service Management in Hospitals."
Jgurnal of the American Dietetic Association,
XXXII (April, 1964), 255-260.

 

Journal of the American Hospital Association (Guide
Issue), I958.

Journal of the American Hospital Association (Guide
Issue), 1960-1966.

Journal of the American Hospital Association (Guide
Issue), 1973.

 

"More Definitions of Dietitions." Journal of the
American Dietetic Association, XXXVII (October,
1960), 347.

 

 

The Profession of Dietetics--The Report of the Study
Commission on Dietetics, John S. Millis, Chairman.
Chicago: The American Dietetic Association,

1972. ‘

 

 

APPENDICES

119

APPENDIX A

HOSPITAL ADMINISTRATORS

120

MICHIGAN STATE UNIVERSITY

 

Department of Food Science and Human Nutrition East Lansing, Michigan 48824

January 1974

Dear Hospital Administrator:

This questionnaire is a request for descriptive information about the dietary service
practices at your hospital and for your views concerning: a) the essential qualifica-
tions for a hospital dietary service manager, and b) the major shortcomings of profes-
sional dietitians for administrative assignments in hospital food service.

Dissatisfaction with the managerial competence levels of professional dietitians has

led some hospital administrators to employ outside food service management firms or
independent managers to operate their dietary departments. This practice is of con-
siderable concern to the profession of dietetics and to those responsible for designing
and improving dietetic curricula in colleges and universities. If administrative dieti-
tians are to attain and maintain competitive employment status, the present shortcomings
of dietitians must be identified so that meaningful improvements in professional training
programs can be effected.

Similar information is being requested from the administrators of one hundred Michigan
hospitals. Responses from participating institutions should provide an overview of the
professional skills essential to success in hospital dietary service management, enable
us to identify the academic and experiential areas of our training programs which need
modification and provide direction for improving our dietetic curricula at Michigan State
University. It is hoped that you will consider this study of value and that you will
complete the enclosed questionnaire. This questionnaire has been designed to take not
more than fifteen minutes of your time. '

Your cooperation in completing and returning the questionnaire by February 1 will be
sincerely appreciated. A self-addressed envelope is enclosed for your convenience. If
you do not wish to participate in our study, please return the unanswered form in the
envelope provided.

Sincerely,

:2225‘L6362?| ' £222: IA<;5E;v¢‘v 4?! )5494214.
Gilbert A. eille, Ph.D. Grace A. Miller, Ph.D.
Professor and Chairman Professor, Food Service Management

gm... WM

Gatha Williams
Teaching Assistant

 

 

 

 

 

STUDY OF THE HOSPITAL FOOD SERVICE DIRECTOR - ESSENTIAL QUALIFICATIONS

Michigan State University, East Lansing
Food Science 5 Human Nutrition Dept., College of Human Ecology

PART I - THE RESPONDENT: THE HOSPITAL ADMINISTRATOR

YOUR ADMINISTRATIVE TITLE:

 

EDUCATIONAL BACKGROUND:

 

a. Earned Degrees:

 

b. Professional Specialization: (check all areas that apply)

(0) Human Medicine (3) Hospital Administration

(1) Osteopathic Medicine (4) Business Administration
(2) Nursing

(5) Other (please specify):

 

 

EXPERIENCE IN THE FIELD OF HOSPITAL ADMINISTRATION:

 

a. TOTAL years in the field: b. YEARS in present position:
(no.)

PART II - HOSPITAL G DIETARY DEPARTMENT:
OPERATIONAL CHARACTERISTICS

 

 

 

HOSPITAL:
a. PATIENT Census: Inpatients (daily average)
Outpatients (daily average)
b. TOTAL Hospital Staff: Professionals: (total no.)
Support Personnel: (total no.)
DIETARY DEPARTMENT:
a. TOTAL Dietary Staff: Administrative: full-time (total no.)
part-time (total no.)
Therapeutic: full-time (total no.)
part-time (total no.)
Employees: full-time (total no.)
part-time (total no.)
Volunteers: (average no.)

b. Types of Meal Service Provided: (check as many as apply)

 

(0) patient tray
cafeteria (hospital personnel only)

cafeteria (open to public)

coffee shop or snack bar

dining room, table service (hospital personnel)
dining room, table service (open to public)
vending machines (hospital-operated)

vending machines (outside contract firm)
off-premise meal service

(9) OTHER (describe):

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on \I Ch U1 A (N N H
VVVVVVVV

IIHIHIH

(no.)

 

 

 

S. DIETARY DEPARTMENT (continued)

c. Type of Food Service Management: (check one)

(0) Hospital-operated
(1) Contract food service management company

(2) Combination hospital-operated and contract firm

d. The Food Service Director (Manager)_of YOUR Hospital:

(1)
(2)
(3)

(4)

(5)

(6)

(7)

(8)

(9)

Position Title:

 

Employment Status: (0) Full-time ‘93 (1) Part-time
Academic Background:

a. Degree(s) Earned:

 

b. Area(s) of Specialization: (check as many as apply)

(0) Dietetics-Administrative (4) Business Administration
(1) Dietetics-Therapeutics (5) Hotel, Restaurant and
(2) Dietetics-General Institutional Management

(3) Home Economics-General
m)0an:

 

 

Experience in Food Service Operation:

 

3. TOTAL number of yg§£§_in food service field: (approx.)
b. Number of years in present position: (approx.)
Professional Classification: (check one)

(0) ADA Registered Dietitian ‘_____(3) OTHER (describe):

(1) ADA Member (not registered)
(2) Not member of ADA

 

Was your Food Service Director (Manager) promoted from within the dietary
department?

______(0) Yes ______(1) No

At the present time, how do you rate the managerial competence of YOUR Food
Service Director (Manager)? (check one; additional comments welcomed)

(0) Excellent COMMENTS:
(1) Above Average

(2) Average

(3) Below Average

(4) Poor

 

 

 

 

Are you currently seeking professionally-trained employees for the admini-
strative staff of YOUR food service department?

(0) Yes (1) No
If Yes, how many vacancies do you have?
Number Full-Time Number Part-time

In estimating YOUR projected needs, how many additional administrative
staff will you need by 1975 for YOUR food service department?

Number Full-time Number Part-time

 

PART III - CONTRACT FOOD MANAGEMENT COMPANY SERVICES

If your food service department is now operated by a Contract Food Management
Company, why were the services of an outside firm employed? (check as many as
apply) If this question does not apply to your operation, skip to question 7.

(0) Unable to employ a qualified person to manage the food service department,
if operated by the hospital

(1) Dissatisfied with the managerial competence of the former director/manager

(2) To reduce departmental operating costs

III

A

3) To minimize the responsibility and involvement of the hospital administrator
in the daily operational problems of the food service department

4) OTHER (describe briefly)

f"

 

\

If your hospital formerly employed a Contract Food Management Company but your food
service department is now hospital-operated, why were the services of the outside
firm discontinued? (check as many as apply) If this question does not apply to
your operation, skip to question 8.

 

(0) Contracted services were too expensive
(1) Quality of food services was sub-standard
2) Nutrition (therapeutic) services inadequate

r-\

3) Firm employed did not fulfill the provisions of the contract
(4) Hospital could not fulfill demands of contractor

(5) Contract not renewed by management firm

(6) Contract not renewed by hospital

A

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7) OTHER (describe briefly):

r-s

 

 

From YOUR experience as a Hospital Administrator, how would you rate the services
generally provided by Contract Food Management Companies?

0) Significantly better than is currently possible if the department is
hospital-operated

fl

1) Comparable to most hospital-operated departments and significantly less

£933.11
2) Comparable to most hospital-operated departments, but more costly

A

I

fix

(3) Qualitatively, their services are inferior to most hospital-operated
departments

1 I

(4) Unable to judge - no experience with their services

ADDITIONAL COMMENTS APPRECIATED: a

9.

10.

11.

12.

13.

PART IV - ESSENTIAL QUALIFICATIONS FOR A HOSPITAL FOOD SERVICE DIRECTOR

As a Hospital Administrator, what do you consider the FIVE most important managerial
competences and the FIVE most important personal skills for a director (manager) of
a hospital food service department? (please list)

 

 

 

 

 

 

 

 

Managerial Personal
1. l
2. 2
3. 3
4 4.
S 5.

 

 

What do you consider the most desirable professional background for a director
(manager) of a hospital food service department? (check one)

 

(0) Formal academic training and experience in hotel and restaurant management
(little or no background in nutrition)

(1) Registered ADA dietitian with major emphasis in administrative dietetics

(2) Registered ADA dietitian with equal educational background and experience
in nutrition and administration

(3) Earned certificate from a food service administrative program and a few
years work experience in the field

(4) Food service administrative experience in the armed services

(5) OTHER (describe briefly)

 

 

 

What is the minimum level of formal academic training you consider essential for
employment as director (manager) of a h05pital dietary department?

 

What is the minimum amount of work experience you consider essential for employment
as director (manager) of a hospital dietary department?

 

In your opinion, what areas of competence do most professionally-trained dietitians
lack which tend to disqualify them for administrative positions in most hospital
food service departments? (please list)

 

 

 

 

.; ‘ .;__ a..- _-,-—.: Ahfl.‘_... -- .— __._...~_._._»_.. ..——-.__—-1-—— ._‘_ n-_ H.“

PART V - RECRUITMENT OF A HOSPITAL FOOD SERVICE DIRECTOR (MANAGER)

14. Which of the following recruitment means would you most likely use if you were
searching for a director (manager) of YOUR hOSpital food service department?
(check as many as apply, and then please star (**) those which, in your opinion,
are most apt to help you find qualified applicants)

Public employment agencies

Private employment agencies

College and University placement offices

College and University professors

Professional journal advertisements (situations wanted)

Area newSpaper advertisements (situations wanted)

Post a position—available announcement in professional journals
Post a position-available announcement in area newspapers

Poll professional colleagues for potential leads

(9) Poll current hospital dietary staff for potential applicants

mmflmr‘mflmfl
(X) \l 0‘ U1 1:- {N N H O
VVVVVVVVU

llHllllll

(10) OTHER (describe briefly)

 

 

15. From your experience as an administrator, what are the most usual problems you
have encountered in searching for a professionally-qualified director (manager)
of a hospital food service department? (check all that apply, and then please
star (*) those which are or have been the most difficult)

(0) Geographic location

(1) Meeting salary level requirements of applicants

(2) Meeting work hour demands of applicants

(3) Finding professionally-qualified applicants

(4) Finding qualified applicants who are willing to assume the extent
of responsibility inherent in the position

5) Employee fringe benefits which are offered by the hospital are
somewhat less than available from competitors

fix

6

A
\_J

OTHER (describe briefly)

 

 

 

****************************t**i************

SPECIAL NOTE TO RESPONDENTS:

If you would like to receive a copy of our summary report, fill in the information
requested below and a copy will be forwarded to you when it is ready.

NAME:

 

TITLE:

 

ORGANIZATION:

 

NO. AND STREET:

 

CITY/ZIP CODE:

 

 

MICHIGAN STATE UNIVERSITY

 

DEPARTMENT OF FOOD SCIENCE AND HUMAN NUTRITION EAST LANSING ' MICHIGAN ° 48824

DEFINITION OF TERMS
FOR

STUDY OF THE HOSPITAL FOOD SERVICE DIRECTOR - ESSENTIAL QUALIFICATIONS

1. Hospital Administrator: The hospital administrator is the executive director
of the hospital and the deputy of the Board of Trustees. His functions con-
sist of all activities necessary to effectively direct and manage the affairs
of the hospital.

 

2. Director of Hospital Dietary Department: The person who administers, plans,
and directs activities of the department in a manner that facilitates the
achievement of the department's foremost objective, the patients well-being
and satisfaction. Establishes policies and procedures. Provides administra-
tive direction to menu formulation, purchasing, fOod preparation and service,
sanitation standards, safety, and personnel utilization. Is responsible fer
financial management; maintains a system of records for planning and control.
Selects the professional dietary staff. Directs departmental programs of
education. Coordinates interdepartmental professional activities and relation-
ships. Serves as a consultant to management in matters relating to dietetics.

 

3. Independent Food Service Manager: A person who perfbrms all the activities
of the hospital dietary department director. The dietary manager's status
of employment differs from that of other hospital employees in that the
manager has a personal contract with the hospital.

 

4. Contract Food Management Company: Outside management firm that is employed
by the hospital to operate the dietary department. The company provides
total management fer the department, but the h05pital retains the right to
establish dietary policy.

 

5. Administrative Staff: Department personnel whose fhnction is to direct the
activities of employees or operations within the framework of policy estab-
lished by higher management.

 

I III (III

 

MICHIGAN STATE UNIVERSITY

 

DEPARTMENT OF FOOD SCIENCE AND HUMAN NUTRITION EAST LANSING ' MICHIGAN ' 48824

February 4, 1974

Dear Hospital Administrator: -'

On January 15, a questionnaire requesting descriptive information about the
dietary service practices at your hospital and your views concerning the
essential qualifications for a hospital dietary service manager was mailed
to you and one hundred other administrators of Michigan hospitals. The
responses we have received thus far are encouraging, but, to date, we have
not received a response from you.

We hope you will also consider our inquiry of value and complete and return
our survey form a§_soon a§_possible. If, by chance, our earlier mailing did
not reach you or has been mislaid, a duplicate questionnaire fOrm and a pre-
addressed return envelope are enclosed for your convenience. We hope to begin
summarization and analysis of the study data during the third week in February,
and we are anxious to include your views.

 

If your response has already been mailed, please disregard this letter and
accept our sincere thanks for assisting with our study. If you do not wish
to participate, please return the unanswered form.

Sincerely,
Gilbert A. L35:' 1e, Ph.D. Grace A. Miller, Ph.D.
Professor and C airman Professor, Food Service Management

[Agi6i254éz> (QC/4;192265'°‘5/’
Gatha Williams
Teaching Assistant

APPENDIX B

CONTRACT FOOD MANAGEMENT

COMPANY OFFICIALS

128

 

 

INTERVIEW GUIDE FOR CONTRACT FOOD COMPANY EXECUTIVES

First,

1. mmTIS
(0)
(l)
(2)
(3)
(4)
(5)
(6)

2.

STUDY OF THE HOSPITAL FOOD SERVICE DIRECTOR:

ESSENTIAL QUALIFICATIONS

PART I - THE RESPONDENT

I would like to know about your background.

YOUR ADMINISTRATIVE TITLE?

regional director

manager of hospital Operations
vice president of Operations

vice president and treasurer

vice president and general manager
director of technical services
other:

WHAT HAS BEEN YOUR HIGHEST FORMAL EDUCATIONAL ATTAINMENT?

(0)
(l)
(2)
(3)
(4)

Mil

(5)
(6)

(7)
(8)

WHAT IS

(0)
(l)
(2)
(3)

high school graduate

attended college, but did not graduate

college graduate

dietetic internship

post-graduate courses not terminating in M.S. or M.A.
degree

M.S. or M.A. or M.B.A. (circle one)

graduate courses beyond Masters, but not resulting

in doctoral

doctoral -- Ph.D. or Ed.D.
other

(circle one)

(ARE) YOUR AREA(S) OF PROFESSIONAL SPECIALIZATION?

hotel or restaurant administration
business administration

dietetics

other:

HOW MANY YEARS HAVE YOU WORKED IN THE FIELD OF FOOD SERVICE? yrs.

WHAT TYPES OF POSITIONS HAVE YOU HELD?

129

130

PART II - FOOD SERVICE MGT. CO.: OPERATIONAL CHARACTERISTICS

5. HOW MANY YEARS HAS YOUR COMPANY BEEN IN THE HOSPITAL CONTRACT
FOOD MANAGEMENT BUSINESS?

In what other types of Michigan establishments do you currently
provide food management services?

6. HOW MANY HOSPITAL ACCOUNTS DO YOU HAVE IN THE STATE OF MICHIGAN
AND WHAT ARE THEIR SIZES (APPROXIMATE)?

 

No. Bed Size

(0) below 100
(l) 100 - 299
(2) 300 - 499
(3) 500 - 699
(4) 700 - 999
(5) above 1000

7. WHAT DEGREE OR TYPES OF SERVICES DO YOU PROVIDE YOUR MICHIGAN
HOSPITAL ACCOUNTS?

 

 

 

No. % (0) Total food service management
No. % (1) Specialized services only

No. % (2) Consultant services only

No. % (3) Other (please specify):

 

IF SPECIALIZED SERVICES -- What are the specialized services that
your company offers to Michigan hospital
accounts?

131.

8. DOES YOUR COMPANY OPERATE A COMMISSARY? (0) Yes (1) NO

IF YES: a. What percentage of your Michigan hospital accounts

receive food items from your commissary?

% (approx . )

b. In what stage of preparation is the food delivered
to your accounts?

(0) fully-prepared (service ready)
(1) partially-prepared (additional on-premise
service needed)
(2) some fully-prepared; some partially-prepared
c. In general, what percentage of the food items
delivered to hospital accounts is:

% (O) sent in bulk containers (multi-portions)
% (l) sent in pre-portioned containers
(individual servings)

9. DOES YOUR COMPANY OFFER/PROVIDE VENDING SERVICES TO MICHIGAN
HOSPITAL ACCOUNTS?

____(0) Yes ______(1) No

Does your company contract for vending services from another

company for hospital accounts?

____10) Yes ____}1) No

What are the types of food items provided for vending?

At the hospital accounts where your company does provide
vending service, are the food items for vending generally
prepared and packaged on-premise by the food service
department?

(0) Yes, all items (2) No, commissary-prepared

(1) Yes, certain items (3) No, purchased from
outside vendors

What are the types of food items that are generally prepared
on-premise for vending services?

132

10. PURCHASING:
a. How are food items for hospital accounts in Michigan purchased:

(0) Decentralized purchasing by staff at each account
(1) Centralized purchasing by central office staff
(2) Combination of decentralized and centralized
purchasing
(3) Other (explain):

 

 

b. How are non-food items for hospital accounts in Michigan
purchased?

(0) Decentralized purchasing by staff at each account

(1) Centralized purchasing by central office staff

(2) Combination of decentralized and centralized
purchasing

(3) Other (explain):

 

 

11. DELIVERY:
a. How are food items for hospital accounts in Michigan delivered?

(0) Orders delivered to each account directly from

vendors
(I) Orders delivered to each account from company's

central commissary and/or warehouse
(2) Other (explain):

 

 

b. How are non-food items for hospital accounts in Michigan
delivered?

(0) Orders delivered to each account directly from vendors

(l) Orders delivered to each account from company's
central commissary and/or warehouse

(2) Other (explain):

 

 

12.

133

HOSPITAL DIETARY PERSONNEL:

a.

In how many Michigan hospital accounts do you employ the
following types of workers?

No. Accts. Position Type No. Employees

(0) Dietary Department Director (Manager

(1) Other professional food service staff

(2) Food Service Supervisors

(3) Therapeutic Dietitians

(4) Total Dietary Staff, including
employees

 

What is the average number of years that YOUR hospital dietary
directors (managers) have been in YOUR employ?
(avg. no. yrs.)

 

What percentage of your Michigan hospital accounts are
directed (managed) by personnel with the following types
of professional background and/or experience?

% (0) Formal academic training and experience in hotel,
restaurant and/or institution management (little
or no background in nutrition)
% (1) Registered dietitian with major emphasis in clinical
(therapeutic) dietetics
% (2) Registered dietitian with major emphasis in
administrative dietetics
% (3) Registered dietitian with background and experience
in nutrition and in administration
% (4) Dietitian - American Dietetic Association member--
not registered
% (5) Earned certificate from a food service management
program and a few years experience in the field
% (6) Food service administrative experience in the
armed services
% (7) OTHER (describe briefly):

 

 

 

Are members of your central office staff recruited from
employees assigned to your field accounts? (check one)

(0) Yes, usually (2) Only rarely
‘(l)'Yes, sometimes (3) No

 

134

12. HOSPITAL DIETARY PERSONNEL (continued)

e. Do you have a professionally-trained dietitian(s) on your
central office staff at the present time?

(0) Yes (1) No
IF YES: What are their position titles and major assignments?

Title Major Assignment

f. Are you currently seeking Food Service Directors (Managers)
for YOUR hospital food service accounts?

(0) Yes (1) No

IF YES: How many vacancies do you have? (0) No. Full-time
(1) No. Part-time

In estimating YOUR COMPANY'S needs for hospital food service
accounts in Michigan, how many additional administrative
(managerial) employees will you need by 1975?

(O) No. Full-time (1) No. Part-time

135

PART III - THE HOSPITAL FOOD SERVICE DIRECTOR: ESSENTIAL QUALIFICATIONS

13. WHAT DO YOU CONSIDER THE FIVE MOST IMPORTANT MANAGERIAL COMPE-
TENCES AND THE FIVE MOST IMPORTANT PERSONAL SKILLS FOR A SUCCESS-
FUL DIRECTOR (MANAGER) OF A HOSPITAL FOOD SERVICE DEPARTMENT?

 

 

 

 

 

 

 

 

Managerial Personal
1. l.
2. 2.
3. 3.
4. 4.
5. 5.

 

 

14. WHAT DO YOU CONSIDER THE MOST DESIRABLE PROFESSIONAL BACKGROUND
AND EXPERIENCE FOR A DIRECTOR (MANAGER) OF A HOSPITAL FOOD
SERVICE DEPARTMENT?

 

 

 

(0)

(1)

(2)

(3)

(4)

(5)
(6)

Formal academic training and experience in hotel,
restaurant and/or institution management (little or no
background in nutrition)

Registered ADA dietitian with major emphasis in clinical
(therapeutic) dietetics

Registered ADA dietitian with major emphasis in
administrative dietetics

Registered ADA dietitian with background and experience
in nutrition and in administration

Earned certificate from a food service management program
and a few years experience in the field

Food service experience in the armed services

Other (describe briefly):

15. WHAT IS THE MINIMUM LEVEL OF FORMAL ACADEMIC TRAINING YOU CONSIDER
ESSENTIAL FOR EMPLOYMENT AS DIRECTOR (MANAGER) OF A HOSPITAL
DIETARY DEPARTMENT?

 

"‘I)lljiflnljl‘mylljn'willful)“

 

44292