' Services

UNIT 4 DIETARY SERVICES

Structure
4.0 Objectives
4.1 Introduction
4.2 Role and Functions
4.3 Planning Consideration
4.4 Physical Facilities and Layout
4.5 Staffing
4.6 Managerial Issues
4.7 Policies and Procedures
4.8 Control and Evaluation Mechanism
4.9 Let Us Sum Up
4.10 Answers to Check Your Progress
4.1 1 Furtl~erltettdings
kmexures

4.0 OBJECTIVES
I After going through this unit, you should be able to:

1 e understand the functions of dietary services of a hospital;

e outline the planning requirements of such a service;
e explain its orgrlnisatiot~at~dmanagement; and
I

r . identify various management issues.

..

4.1 INTRODUCTION
In the earlier units of this block you have learnt about various utility services of a
hospital inter connected with these, dietary services is another important area which
aims at improving the palient care.
In this unit you will learn about the planning and organisati;n of dietary services of a
hospital. To begin with, you will learn about the role and functions of dietary services
departmei~tin a Bospital. Thereafter you will learn about various planning
considerations which one need to take into account while developing's dietary
services department. Towards, the end you will learn about some of management
issues including policies, processes and control mechanisms.
Hospitals these days receive patients of varying nature, with different cultural
background, with varied food habits and with different di>eases. The cliniciai~sand
dieticians have not only to meet the requirements of patients as per their nature of
diseases, their ilutritional status and to tackle any problems related to underlying
pathological conditions. In fact the doctors and tlie dieticians have to coordinate their
activities in the best interest of patient care. Dietary service is one of the m ~ s t
important hospital supportive services contributing to the recovery of health, through
scientifically prepared diets, educating the patients attending the hospitals for
treatment regarding use and utility of diffirent foods and balanced diets.
Dieticians or the Food Service Managers have to be fully involved during the Planning
, Process of dietary services of a hospital. Proper Planning and laying down clear cut '
policies and procedures will enable in Bmooth functioning of the service and lead to
the patient satisfaction and thus better patient care. Zn day to day management of the
service planning of menu is critical bcc;ruse il affects thc work schedule, purchasing
plans, equipment uset production and distrihuri~m.The main objective of the
dep:lrtment should be to provide a halanced diet to the patielit as per physician's
instructions, properly prepared, clistributed in an aesllletic lnanner and considering his
underlying disease condition wherever applicable.
Ilospital dietary service is a service which caters to the needs of outpatients regarding
diet and food counselling and provision of diet to in-patients as per tlieir requirement
considering the nature and type of disease.

4.2 ROLE AND FUNCTIONS

Todays' llospitals are committed not only Lo the provision ol' rnetlical care to the
patiellts but also to the welfare of its e,mployeesand nceds of the attendants of the
patients and tlieir relatives who atlend auld visit tlie patients. Dielary Departmelit is
responsible for the selectio~lof food and other related i t e m ant1 has to have liaison
with Purchase Department. Requirernei~tsor all items have to he worked out. Some
items like vegetables, meat, chicken, etc., have to be purchased daily arid some items
like rice, pulses and oil call be piarcliilsed at weeklyfrnonthly t~asis.The items have to
be received inspected aiid verified iIS per thc ortlexed specifications. These are
properly stored and supplics issr~edper melt1 everyday. Daily menu planning is done
including that of therapeutic diets. 'I'hc food prepared is the11 distributed under proper
supervision of catering supervisorsfdieticians. As such the functions of a hospital .
dietary services call be grouped ulider four headings:
1) Inpatient Ciitering
2) Diet Counselling

4) Education, 'Training and liesearcl~

1) Inpatient Catering: Il pertains to provision of lllcals to the patients admitted in
tlie hospital. It sliould be a balanced diet providing :~dequatecalories, taking into
account the type of underlying illness, any extra nutritional requirements and the
general food habits of patients in tlie stalc. Diffcrclil types of therapeutic diets is
shown as Annexure I.
2) Diet Counselling: This service can he provided as out-patieti1 diet cliliics where
patients are referred by clinicians to tlie dieticians for calcnlating their dietrlry
requirements considering the body weighl, height, underlying disease, food,
habits availability and acceptability of dii'ferent foods locally depending upon the
economic co~iditionof each patient. 1P:itienfs are usui~llygiven a diet c h ~tot be
followed by them along with tlie certain foods either to he avoided or to be
preferred.
Admitted patienits in the liospitals especi;~llywith certain diseases like diabetes,
hypertension, heart ailmalts, nnaeinias etc. are advised during admission and the
time of discharge regardi~lgfood il~takc.
3) Commercial Catering: he service caters to tlie needs of s(c?l'frnetnbers who are
on duty in various shifts by way of provision of meals, tea, snacks, cold drinks
etc. The service usually takes the sliapc in thc i'orm of staff cantecns open from
early ~ n o n ~ itill
i ~ glate evenings and the food provided works out to be cheaper to
the employees when colnpared lo the costs run by private parties. Moreover, the
administration can control tlie quality of food services.
I
This type of service call be extended ro tht; atlendanlsfvisilors of the patient wlio
are usually desparate to find a good quality of food at a rcilsonablc price and at a ,
conveiliellt place withill the hospital. Tlie l~ospitulscall provide this facility in a
separale place othcr than staff calllcen aind even cilli llavc mobile/vending
- machines in certain locations likc OPT., Casualty, Ward Block ctc,
4) Education, Training and Research: This fonns rtn intcgral componenl of any
department. The staff of the hospital like Nurses, Residents, Nursing aids,
 Technicians, Cooks etc. could bc etlucatcd regiirding types of foods, their caloric
value, balanced diet,\ clc. Moreover, hosl~italsl~i~ving a lull fledged dielziry
service deparlment C ~ L1i;lvc
I inservicc ccaching programmes i'or their ~ L i ~ f f
members and others like cliploma in dictitics and therapeulics, diplollla in
nutrition. Such training progriilnme CiLII be started with collaboration of other
clepartments or institutes depending upon the uvailakility of f:tcililics.
'I'he deparlrnent on ils ow11or in ~ollithoralio~~
with other depart~nentsshould be
involved in rese;~rchactivities on suhjccls related lo its role and funct.ions.
Check Your Progress 1
List the functions of hospilal tlielary services.
...........................................................................................................................................

4.3 PLANNING CONSIDERATION

Inpatient catering is Lhc major activity or the rlictary department and proper planning
leads to the economy of operation and adds to the cl'ficicncy of the service. While
planning wc hilvc to consitles:
1) Location :uld si1.e.
2) Nutnbcr of hospiti~lbeds and the specialilics existing.
3) Numhcr of meals servcd per day and lhc type o C I'oods to be scrved considering
the loci11food habits of the pcople.
of the hospital ii11dnuml~erof employees.
4) Catering to staff me~~\bcrs
5)' Extension oi'facilitics to altcndants of the p:tlient.
6) Centralised vs. dcce~~lr:~lised
scrvicc.
7) Type of equipment availahlc.
Location and Site: 'l'he area should he located on ground tloor, easily aeccssihlc to
outside roads so that supplics ciln be carried directly lo Llle storage area. It should be
, nearer to the wards ilnd lifts so that less time is utiliscd in carrying the food to
different wards. The kitchen has to close to Boiler facility due to rccjuirement oi'
steam in cooking.
Number of Reds and Specialities: 'I'liis will (letermine the work load and types of
diets to be served, e.g., lhc rcquirelnents of neonates in neon:itology ward are different
than other palient. Patients admitted in the dept~rtmentslike Cardiology,
Endocrinology may 11;~vedifferent requirements of therapeiitic diets than those in
general medicine.
It will also depend upon the type ol'llospital e.g. a government hospital with only
general beds, a government hospital with gencrnl and paying wards, n privately owned
corporate hospital where patients are chargcd I'or meals. In a government hospital
with general beds where meals are issued withouL any charges and the budgel is
limitedmeills catered for lnay kc simple witllout much variety in mcnu. In a corporate
hospital where patients are chargcd l'or the scrvicc, menu's can be claboratc and ala-
carte type of meals can be prcl'erred. Even food for each palient can be prepared and
packed individualIy. They will 21s such need inore staff and Inore space.
Food Hallits and Cultural Background: The local food habits of the population Lo
be served will determine the daily menu in general and thus enables us to pla11 for
equipment and space needed. People in Kashmir ate mainly non-vegetarian and rice
eaters. Procurelnent of bulk rice cookers will be needed. Whereas in Punjab people
prefer chappatis and vegetables. Type ofdislles will vary fro!n Statc to State. While
Suppart and Utllity Scrvlcca-I planning we have to consider the food habits, usual timings the food is consumed by. .

the people and their preferences in general.

Catering to the Staff Members and Extension of Facilities: This aspect needs to be
considered during planning stage. This will help us in designing the facilities. We
may prefer to run staff canteen departmentally so that cost of foods served works out
cheaper especially the cost of manpower and equipment etc. lnay not be calculated by
tlle department while calculating cost of foods as a staff welfare measure. Moreover,
the department can run such facilities on "no profit" "no loss" basis. Extensioi~of
such facilities to the attendants of the patients whether departmentally ?r through a
contract will help in planning for staff itself. Preference now-a-days is for running
such a facility on contract.
Centralised Service Vs. Decentralised Service: Ilaving a ccnualised service e~rablcs
effective control, eliminates duplication, helps in maintaining standards and effecting
economy in operations. The centralised service should be prhferred as far inpatient
catering is concerned especially in a large hospital.
Separate service is better for commercial catering as there is a variation in menu iuld
timings and also helps in maintaining accountability,
Qpe of Equipment Available: Preference sllould be given to such equip~nentswhich
reduces inanpower requirements like automatic cookers, vegetable cutters, dougl~ing
machines, bread slicing machines, grinders, dish wwsliing machines etc. Tllese help in
reducing processing time and e~lsuresreductioii in ~nan-l~andling.
Check Your Progress 2
What are the advantages of centralised dieliuy services?

4.4 PHYSICAL FACILITIES AND LAYOUT

Space Requirement: Food production is the core activity of the service and the
design should follow the function to minitnise Ule labour and reduce space needs. The
area and shape of the floor space will influence equip-ment arrangement uad work flow
patterns.
As per Dr. J.R. McGibony 50 sq ft per bed is required for a 50 beded hospital and 15
sq ft per bed in the 500 beded hospital. In U.K. 8-10 sq ft per bed of spilce is
provided. In Indian conditions 10-15 sq ft of space can be recommended per hcd for
food production area for inpatient catering.
Location: It should be located on the ground tYoor, nearer to the service lifts, having
easy access with the roads of the hospital for reccipt of supplies and should be as Fdr
as possible nearer to the inpatient ruea, It will be preferable that the main hospital
kitchen is planned within the service area of the hospital and if the equipment is
runnirkg on steam boilers, the distance from the location of steam boilers should he
less as far as possible, if such a service is centrally placed and feeding to other arcas ,
of the hospital especially so in a big hospital. In smaller hospital small steam
generators could be used within the patient kitchen itself.
I
Layouh It has to be arranged in such a mailner that different functions are carried out.
systematically. Facilities required are:
1
i) Reteipl and storage area
ii) Day Store . ,

iii) Preparation area

iv) Cooking area
v) Service area /
,I
 vi) Dish washing and pot washing area Dietary

vii) Record room

viii) Staff room
ix) Store area for dead stock and unserviceable items.
1

ReCieipt and ~tordgeArea: The area should have easy outside access for receiving of
supplies, loading, unloading platform with platform scales are needed. Door space
should be enough to permit handling o i crates. There should be enough space for
'
storage of food items and includes shelves, racks, barrels, drums etc., which are
needed to store various items. Walk-in-refrigerators are ~leededfor supplies to be
kept in reserve for certain food items. 15-20% of total space is needed for these
activities. The storage area should be rodent free.
Day Store: In this store supplies for one day's requirement issued from main store
are temporarily stocked. We need few bins and 1-2 refrigerators in this area.
Preparation Area: Preliminary preparation of food involves peeling, washing,
soaking, cutting, chopping, slicing, mincing, kneading and sorting before being sent
for cooking, The area should be located between the storage and the cooking area. It
should have all facilities of washing with sinks, drain boards work top tables, peelers,
slicers, grinders, mincers etc.
Cooking Area: This areB should be located between preparation area and the point of
distribution for direct flow and to avoid any criss cross traffic. It should be fitted with
. cooking ranges, bulk cookers, fat frying equipment, chapati puffers, baking ovens.

Service Area: This sl~ouldhe adjacent to Lhe cooking area, where the cooked food is
put in the different pot and call be carried in food service trolleys which have
normally a double jacket in keep the food warin till it is served. For such patients who
are on different therapeulic diets and to be prepared for each patient, the food can be
. arranged in specially designed ways which are also loaded in the Food Lrollqs.

Dish Washing and PotIPun Washing: Adequate facilities need to be provided with
proper equipment and 11oL and cold water. The automatic dish washing machines are
also available now-a-days. Area for potlpan waslli~lgshould be separate hut aqjacent
lo each other preferably.
Other Facilities: The area should be properly ventilated and have good ligbting
arrangement. Adequate number of exhaust fans sl~ouldbe fixed to let out ally steam
and fumes. In addition we should have L.P.G. cylinder Bank, steam supply and
electrical points for utilisitlg different equipments. Flooring with tileslkota stones lor
easy washing and cleaning is needed. A seminar rooin in a large teaching hospitals is
needed for training student nurses and dieticians and other shff members.
Adequate space is needed for the offices of Catering Manager, Dieticians and other
staff members working in the department. Provision should be made for staff change
rooms, lockers for each worker, attached toilets and resl room for staff working there.
'A room is also needed for clerks maintaining different records.
Luyout of a Patient Kitchen

Office Store Refrigerati011

Keeper Store Dry Store,

Day Store
I
Supervisor
n o 0 Preparation urea
Staff Rooms
Support und Utility Services-I Equipment: Detailed list of equipments is cnclosed as Annexurc I I . 'I'he choicc depends
upon h e budgetary provision, facilities to he provided rind the policies of thc hospital.

4.5 STAFFING
It may not be possible to generalise the requirement of staff according to tlie sizc of
the hospital. It will vary from liospital to hospital due to the differences in the type of
foocls served, physical facilities, equipment, type of service. Following type of
organisational structure is recommended for largc hospitals of' 500 beds ar~dabove.
Medical Si~perintendcnt'
I
Chief ~ i c t a :of'
~ Services
(Chief Momi~gcrIChief1)icticiun)

MallagerlDietician ManngerIDietician
(Patient Care Service) (Commercial Catering)
I I
ring

Food Production Service Food Production Service

Head Cook Head Bearer Head Cook I.Ieiicl l3earer
I 1 I I
Tk
Asstt. Cook
B arer
7
Masalchis
Cook
I
Asstl. Cook Musalchis
(Cleaners) (Cleaners)

The department should be headed preferably by a person who possess a degree in

Hotel Mai~agementICatering,Dietitics and Nutrition and having experience of
working in a hospital setting. The other supervisory staff should also be trained and
experienced. There should also be at least 2 dieticii~nsfor hospital catering so that 1
dietician could supervise therapeutic diets and other norlnal diets. Number of cooks,
bearers will vary, however, as a broad guidelines there should be tit least one number
of service personnel (bearers etc.) for every 25-50 mid-day meals served and same
numher for food preparation. The hierarchy of workers like Asstt. Cook, Cock, Head
Cook has been recommended lo allow the promotion of tllesc employees from tlie
point ofentry. The following estiinates may be considered for staffing for in-patient
dietary service:

Beds
50 100 200 300 400 500 750 .

br. Dietician 1 1 1 2 2 3 4
Head Cook 1 2 2 3 4
Cook 1 2 3 3 4 4 5
Asstt. Cook 2 4 6 7 8 8 1 0
Read Bearer 1 2 2 3 4

Total 8 16 25 32 35 43 60
C
@*
n
I
Besides these workers, a store keeper, a11orclalylporter and secretarial assistance is needed. I
 4.6 MANAGERIAL ISSUES
The department should be concerned with supply of proper diets at fixed timings
maintaining good hygiene. The quality of preparation and cookillg of different meals
should be strictly monitored. The feed back from the patieotslstaff to whom the food
is served acts as a control mechanism lor improving the service. It is important to
involve the staff members of the llospital like nurses, doctors, other para-medical
workers in decision making like purchasing, inspection of materials; opinion and
advice regarding the diets served, fixing of cost of diets for staff etc. Regular feed
back from the staff working in wards regarding the cliezs served to the patients is
equally important. The officer incharge should ensure:

1) Regular cleanliness of the food preparation area.

2) Regular mai~iter~ance of equipment and proper day to day cleaning of utensils,

crockery, cutlery etc,

3) Periodical health check up of stad working in rlepartment is essential. This

should be done every year. Propcr health record of each e~nploycesllould be main
trained.

4) Theelnployees should be given 2-3 sets of rtnnforms and ensure they wear it.

5) On the Job training of new e~rlployeeswho join the department should he done.

6 ) Food prepared sllould be checked by the dieticians beforc serving.

7) The menu sllould be displayed.
8) Dieticians and officer incharge should rnake regular visits towards and enquire
from the staff and the patients about ally observations in the diets served.

9) Hudgetary provisions act as a regulatory ~necllanislnto control costs. Working

out food costs regularly (weeklylmonthly), helps in guiding tllc department.
10) Proper rnair~tcnatlceof records in the department regarding materials received,
daily issue, number of diets served, etc.
Check Your Progress 3
Fill in the blanks:

a) Total staff required in 500 bedded hospital will he ..........................................

b) Number of cooks required for 300 beds hospital will be .................................

4.7 POLICIES AND PROCEDURES

1.) The DieticianslOff'lcer Incharge of the dietary services should be responsible for
detennining the quantitylquality of h o d items to be purchased.

2) Dieticians should form part of the team to identify the sources of purchase either
spot purchase or on rate contract basis. Thcy should delermille the frequency of
purchasing different items.
3) The procedures for purchase should be laid down. It will be economical and
convellient to have most of the food items on rate contract basis tixed for a year.
4) Powers of emergency purchases whenever required should be delegated to the
officer in-charge of the service.
5) The food items received should be inspected by a team comprising of 3-4
members which sl~ouldinclude DieticianIOfiicer in-charge as well. Aflet receipt
of goods the stocks should be entered in the stock registers and maintain proper
consimption records under the supervision of the colltrolling ofticer.
6 ) The storage bins, racks, cupboards, rel'rigerators, coolers elc, should be properly
maintained and kept clean.
Support md Utllny &rvkw-I 7) Proper sanitation and cleanliness including
. . rodent control measures should be
observed.
8) A supervisory staff should be available in the patient kitchen during all the
working hours.
9) Work schedule should be planned properly avoiding split shifts as far as possible.
10) Dieticians should visit the wards everyday and have liaison with the staff nurses
and the patients. ,
11) Requisition of different diets from the wards should be signed by the sister
in-chzirge giving the bed number, ward number and the type of diet required by
the patient.
12) Nurses sbould also check and supervise the distribution of meals in the wards.
13) Supplementary requisitions for those patients who are admitted late in the day,
should also be entertained by the dietary department.
14) Service timings should be fixed with due regard to the traftic on floor, lifts aiid
local food habits of the people in general.
15) Menus should be planned in advance and also displayed everyday on a notice
board in the main kitchen. The rneals should supply physiological needs aiid
should be appealing and attractive to the patients.
16) Records pertaining to the diets served sliould be maintained ai daily basis and
compiled on weekly and monthly basis. Cost analysis of diets should be worked
out every weeklmonth.
17) Charges for meals for staff members and visitors should be fixed by a committee
involving management and staff members whiCh should be reviewed periodically.
*

4.8 CONTROL AND EVALUATION MECHANISM

Food service department is a major cosecentre and generally labour intensive. The
department shouldbe headed by a trained person in dietetics and also hotel
management/catering. This enables the departmeilt to plan and organise the affairs.
There should be a committee conlprising of niedical staff, nursing staff, purchase .
section and officer in-charge dietary service. This committee will facilitate in taking
important decisions like fixing of diet scales, purchases, policies, changes in -.
menus,
fixing charges and also develop a sort of inter departmental relationship.
Officer in-charge of thcdietary services (DieticianlManager)should be able to
organise the staff and its work to achieve the maximum output at the minimum cost
without affecting the quality and nutritional value of the meals. Cost controls and
effective management rely on the technology of various operating systems and careful
resourcescontrol strategies.
There should be separate supervisors like Catering supervisorlJr. Dietician posted for
. ..
I

patient kitchen and commercial catering and also available in two shifts as the ,
department has to work for at least in two shifts to cover the breakfast and dinner. , D ,

Petty thefts and pilferagesare common in the food service department. These mostly
involve food dishonestly consumed in the premises, stealing patient food, eating
leftover foods and pilfering food items from the stores. The offenders are usually the
employees of food service department, llousekeeping and maintenance personnel.
4
Proper inspection and receipt of materials, maintaining stocks, issue of materials f
under authorisation czY dieticians enables uproper control and check pilferage of i
materials. Moreover, the stores should always be locked and have very limited
accessibility to the stores.
&
Cost control measures include cost analysis of materials consumed, working out unit
costs and developing standards by adopting standard costing techniques. With this;ue
I
can develop norIns and also detect any deviations and take corrective steps. This will
also enable budgetary control and fixing charges for commercial catering purposes.
.Daily checking of foods prepared and served, feed back from patients and staff act as
a strict control mechanism and also helps in taking corrective measures. Officer in-
charge/Dieticians/Supervisorsshould go around the wards, talk to the patients and
discuss the food problems with them.

4.9 LET US SUM UP

A good quality of food service is not only necessary for improvement of health of a
patient but also an important aspect for public image of a hospital. Careful planning,
proper layout, adequate equipment, efficient menu planning, proper cooking,
motivated staff and adequate supportive supervision are essential for a good dietary
service. In addilion to these following efforts should be made by the management:

i) Proper and timely purchase of food items.

ii) Inspection-of materials received.

iii) Contacting nurses and patient in the wards by the DieticiausIJr. Dieticians1
Catering Supervisors to get feed back from the patient and ward staff.

On a regular basis the dietary service sllould be evaluated by undertakings:

e Patient satisfaction surveys

o Food wastage rate

i Physical check for usual impact, temperature of food, taste alid variety of
food

o Method of serving

0 Method of trailsportation

e Remarks of patients in suggestion books

e Kitchen hygiene and sanitation

4.10 ANSWERS TO CHECK YOUR PROGRESS

Check Your Progress 1

1) a) In-patient catering
b) Diet Counselling

c) Commercial

d) Education, training and research

Clreck Your Progress 2

Effective coiltrol, eliminate duplication helps in maintaining standards and

effective economy in operations.

Check Your Progress 3

a) 49

b) 12
 1. *
Support and UUUty Sewlces-I
4 FURTHER READINGS
Geervani, P., Situutionul Analysis of the Economics of Hospital Dietary Services with
Special reference to Andhra Prudesh, Proceedings of the XXII Annual
Convention, Indian Dietitics Association, Hyderabad, 1990.
Gibony, Mc Jr., Hospital Dietary Department: A guide to Planning and Service, Jan.
1961.

Kaushik, P., The Organisarion and Mw~gernentof Hospitul Dietary Services,

Background Document Course on Hospital Administration, National Institute of
Health and Family Welfare, New Delhi.
Malik, A.Q., Hospitul Dietury Services, Sher-i-Kashmir Institute of Medical Sciences,
Mimeograph.
Quadiri, G.J., Tabish, S.A., Bukhari, I.A., Costing of Dieiuty Services and Part.of an
Operutionul Manugernent, Health and Population - Perspectives and Issues 16
(I and 2), 31-36:195)3.
 Annexure I Dietary Services

merapeuGc Nant~Gorra
The normal diet may be modified to:
1) provide change in consistency;
2) increase or decrease the energy value;

3) include greater or lesser amount of one or more nutrients;

4) increase or decrease bulk;
5) provide food bland in flavour;

6) include or exclude specilic foods; and

7) modify the intervals of feeding,
Types of Therapeutic Diet
,s:.
1) Higl~energy well balanced: For cotivalescing patients and those with wasting
disease or who are under nourished.
2) Low energy well balanced: For patients with obesity, with or without maturity
onset diabetes.
3) Very low protein, low to lnoderatle energy: For patients wit11acute
glomerulonepllritis or with hepatic encephalopathy.

4) Very low protein moderate energy: For patients with.acuterelia1failure.

5) Low protein sodilirn restricted: For patients with cllronic renal failure.

6) High protein sodium restricted: For patients with Nephrotic syndrome or

hypoalbuminaemia.
7) . Very low fat high carbohydrate: For patients with Iiausea due to hepatic or
obstructive jaundice, malabsorption and steatorhoea.
8) Low sodium low energy : For patients with severe heart failure.
9) Reduced saturated fats: To lowcr plasma cholesterol.
10) Gluten Free: For patients with coeliile disease.
11) High fibre diet: For patier~tswith diverticulosis and constipation,
12) LiyuidISemi-liquid: For patients with difficulty in chewing or swallowing or
who are severely ill with ulcerative or malignant disease or G.I.T. Iract.
13) Bland soft Diet: To relieve symptoms in patients with peptic ulcer gastrites and
some other gastrointestinal diseases. .
14) Tube Feeds: For patients with surgery of head and neck, Esophageal obstruction,
gastrointestinal surgery, severe burns, comatose patients etc.
suppast m d utility strvlcos-I Annexure N
List of Recommended Important Equipments.
I) ProductionArea

1) Cooking range with different size burners

2) Potato peeler
3) Chapatti plat:.
4) Boiling pan:; (steamlgas operated)
5) Pressure c!,okers (steam/gas/electric operated)
6) Deep fat fryc,
7) Tilting fat fryer
8) Food cutier
9) Vegetable mill
10) Mixing machine
11) Meet mincer
12) Kneading machine
13) Dough dividing machine
14) Masala grinders
15) Tandoors' gaslelectrical operated
16) Coffee machine
17) Juicers and mixers
18) Ice-cream making machine
19) Microwave ovens
20) Toasters
21) Kitchen racks
22) Dust bins
23) Working SIS tables.
IS) Distribution Area
1) Pre heated food trolleys
2) Rice cookers
3) Milk Boilers
4) Backing ovens
51' Range of cutting knives
6) Chopping boards
7) Weigh bridgelmachine.