Health evaluation

1. Health evaluation Supervision Prof. Dr . MervatSalah

2. INTRODUCING A FOOD MANAGEMENT SYSTEM FOR HOSPITALS (HACCP)

3. AIMS • To Introduce the concept of HACCP and its benefits to you and your catering process. • To illustrate the concept of a standardized approach to food safety in catering establishments • To assist & offer assistance & advice to individual catering units on implementing the HACCP plan into their respective facilities.

4. STAGE No2 : - Determine the Critical Control Point (CCP’s) Example 3:Preparing Raw Vegetables for Cooking. A person is preparing raw vegetables by peeling and washing them. Is this a critical control point? Example 4:Preparing Raw Vegetables For A Salad. A person is preparing raw vegetables for inclusion into a salad bar. Is this a critical Control Point

5. THE CCP DECISION TREE:

6. Setting Of Critical Limits at Identified CCP’s • You’ve identified a area in the food process which needs to controlled to ensure food is prepared safely. • You now need to set a “Critical Limit” i.e. what factor needs to be measured and / or controlled to ensure food is safe to eat e.g. time/temperature, concentration of chlorine • An example of a critical limit, may be that already set by law or regulation (such as in the SASC "Poultry must be cooked so that all parts reach a minimum of 165oF (74oC))"

7. Record what CCPs you have introduced onto your HACCP Record Sheet STAGE No3: - Implement Effective Controls at the Identified CCP’s • In setting any critical limit it must be based on common sense and recognized as • a control which will prevent, eliminate or reduce a hazard to an acceptable level. • A critical limit maybe based upon factors such as: • - Time • - Temperature • - Physical parameters • - Available Chlorine e.g. used to disinfect ready to eat fruit & vegetables • - Preventing Cross- Contamination

8. STAGE No4: - Establish Monitoring Procedures Monitoring= Checking the operation to make sure things are working correctly …for example.. What do we mean when we talk about monitoring?

9. And / or you can use technical equipment: Can be very simple from using your human senses: Monitoring: Whatever method you use to have a successful HACCP program you must physically record the results of your monitoring.

10. Monitoring Must Be: • Accurate - Be aware of false or same readings • Representative – Batch monitoring / product size • Unbiased – Staff should not change results • Competently Done – Conducted by competent / trained staff who know what they are doing and can implement corrective action. • Timely – Carried out regularly and in a timely manner • Supervised – Check the records. Enforce the checks

11. HAZARD STAGE No5: -Establish Corrective Action So you’ve identified a PROBLEM or potential failure in one of your food processes – What are you going to do to correct it? 1st response – Protect the consumer and deal with the Food 2nd response – Deal with the cause. Investigate & identify the cause of the problem & correct it.

12. Chicken is undercooked Return it to the oven Until core temp >75oC (165oF) min 30sec WHAT DO YOU THINK ? By Master chef who: 1st - Protects the consumer by not allowing the undercooked poultry to be served to patients. 2nd - Corrects the cause of non-compliance e.g. returns the chicken to the oven for a longer time Examples of Corrective Actions: In any Corrective Action scenario, you need to ask yourself the following questions: Example 1. Chicken probed on removal from oven is 69oC (156oF) core temp • What is the problem? • Where / how can it be dealt with? • When will it be dealt with? • Who can deal with it?

13. Milk, yogurts and cream all warm to touch Prior to receipt of food by the catering unit Reject delivery & return it to supplier WHAT DO YOU THINK ? By Master chef who: 1st - Protects the consumer by not allowing the potentially high risk un-refrigerated dairy products to be used for catering purposes. 2nd - Corrects the cause of non-compliance e.g. rejects delivery & reassess competency of supplier Examples of Corrective Actions: As before In any Corrective Action scenario, you need to ask yourself the following questions: Example 2. Delivery of dairy food from local supplier in an un-refrigerated vehicle • What is the problem ? • Where can it be dealt with ? • When can it be dealt with ? • Who can deal with it ?

14. HAZARD STAGE No5: - Establish the Corrective Actions Your Corrective Actions must be written into your HACCP plan. It is essential that staff are trained accordingly on all these Corrective Actions and know what to do.

15. VERIFICATION HAZARD STAGE No6: - Verify & Review Procedures “…checking that the safety measures that you have implemented are working correctly..” i.e. correct temp & time visual checks etc

16. Check It & Review It? What else can you see that may be wrong here?…..look…

17. Consider reviewing the HACCP plan when: • Operations Change e.g. new equipment • Consumer Groups Change e.g. new patients, diabetics • Indication of HACCP plan failure e.g. insect found in food or complaints of food being cold

18. HAZARD STAGE No7: - Establish Records and Documentation Procedures Use the Hazard Plan & Examples Template Forms (A-N) Located in the Safer Food Better Business Folder A. Hazard Analysis Forms B. Approved Hospital Suppliers List C. Delivery Check Record D. Fridge Temperature Checks E. Freezer Temperature Checks F. Defrosting Temperature/Time Checks G. Cooking Temperature Records H. Servery Temperature Records I. Trolley Temperature Records J. Training Records K. Cleaning Schedule L. Pest Control Records M. Probe Thermometer Maintenance Records N. Internal Audit O. HACCP Diary Planner

19. ANNEX PAGES IN FOOD SAFETY GUIDANCE NOTES • A – Essential Programs Needed Before The Implementation of HACCP • B – Useful Guidelines For Typical Hospital • C – Tips on the Correct Use of Thermometers • D – Food Safety Training Programs

20. HAZARD STAGE No7: - Establish Records and Documentation Procedures Questions that you constantly need to ask….. Check your records every daily or weekly. Are your control adequate Are all your employees trained? Do they understand your recording procedures and what to do if something goes wrong? Periodically review your HACCP system – any changes needed? Physically check potentially hazards. Do not assume… Any new chemicals being used? Any customer complaints?

21. FINALLY……. ANY QUESTIONS?

22. WHAT NOW! • Complete the Hazard Analysis Form • Amend your Policies & Procedures • Amend Monitoring / check forms • Train Your Staff • Revisit Date…….

23. Recommended text book • Janet Brown