Management Rotation- Facility Name

xxxxxxx Dietetic Intern cell (xxx)xxx-xxxx) xxxxxx@xxxxx

9 to 5 daily unless otherwise indicatedx/x/16 to x/x/2016

Preceptor: xxxx xxx-xxx-xxxx; pager xxx-xxx-xxxx; cell/text xxx-xxx-xxxx

Schedule subject to change.

date / date / date / date
date / date / date / date / date

Welcome to Clinical Nutrition at xxxx!

Please match the assignments below to your list of required competencies and learning to make sure you accomplish what you need. If something is missing, discuss options with preceptor.

Subjects chosen below are to meet the competency requirements and to help familiarize you with management methods, strategy and issues. Intern is responsible to assure that their competency requirements are met.

Background of Job Role: the clinical management rotation can be very exciting and action-packed or sometimes not so. Activity may vary much between the weeks and between different intern’s rotations—no two rotations are ever alike. It is often rapid pace with many and

sometimesconflicting tasks and issues to be addressed. It is not a staid routine-driven day by any description. One can be working on a system wide policy one moment and dealing with a personal employee private issue the next moment. Some days and weeks offer more private time to visit with the preceptor and some less. Plan to walk quickly. You may also hear confidential information related to employee situations or business plans. Feel free to discuss with your preceptor, but please do not address or discuss with staff or others! There will be time to work privately and check in with preceptor; if the preceptor gets called away suddenly or has to deal with an urgent situation, please do not feel like you did something in error. We plan to check-in several times daily to make sure we are on track and accomplishing all of the needed rotation outcomes. Please do not hesitate if you need clarification of a situation or some more direction…it gets pretty busy and things can get missed, but it is never intentional. I am looking forward to supplying you with an excellent experience!

Assignments/Projects-(subject to change on short notice depending on what occurs during rotation; Not all assignments are required-your preceptor will indicate which ones to do. Discuss timing and progress with preceptor. Items with an * are required.)

Write any project reports in a brief format of just a few pages. Bullet points and brief comments are fine. Think of your busy audience and pretend you are a clinical manager and need to get the job done and keep a focus on the key points. However, the issues are critical so you need to include adequate information. You will want to make sure spelling, language, sentence structure; tone and presentation are business-like and professional. Please complete the assignments below during the rotation and turn as they are completed and no later than end of day the afternoon prior to the last day; Negotiate with preceptor for assignments due on the last day. This allows times to prepare for the exit interview There is flexibility in that some may not need to be completed or some supplanted by other projects depending on new conditions—part of being a manager—conditions change. Those with a * are required in order to help you understand some key features of health care nutrition management. Please turn in assignments as you get them done, or if you would like to have me take a look during the process for feedback, that is just fine.

You will be able to get to most of these links from inside the Hospital from a computer you are logged in with your login and password, only. Some links may work outside.

Your Preceptor will assign from the below learning experiences. There are too many for the short time together, so not all will be completed.

  1. * Regulatory Bodies and organizational policy: Review and compare documents extracted from the State of Oregon hospital food and nutrition related standards for hospitals and TJC (The Joint commission) standards, and CMS Center for Medicare and Medicaid from above. The purpose of this activity is to enable you to connect the regulations from CMS, the State of Oregon, and Joint Commission to the clinical and patient dining policies. Do they match? Are there topics missing? This is a critical job of the clinical nutrition manager, patient dining manager and department director in order to be in compliance. All businesses have rules and regulations to this lesson is to become familiar with this important topic.
  2. * Locate CMS Conditions of Participation-dietitian/food/nutrition related regulations primarily for hospital food service organization and diet manual; review pertinent materials. Will need to be logged in and at computer.

(section 482.28) large file takes a while to come up.also at

  1. State of Oregon hospital regulations.
  2. (TJC) The Joint Commission on Hospital Accreditation standards found at search words like food, diet, nutrition, enteral feeding, parenteral feeding, and dietitian; select all glossary words related to nutrition, and copy into word doc. You will see all the regulations that hospital nutrition depts. are to comply with and that your preceptor and others are accountable for. Must be logged into hospital computer to locate this info. Cannot get to it on your own from the link above.
  3. Review clinical department policies and identify the policies in the dept policy manual that support these State standards and TJC standards. Foundhere: URLxxxx; if your access does not allow you to get to these, let preceptor know to log you on. (500 and 600 policies primarily, but look through the others). Do you notice similarities between State of Oregon and CMS regulations on hospital food systems? What are some connections?
  4. Review the Academy standards of Professional Practice and Professional Performance for Clinical Nutrition Managers. There are resources on this site.
  5. Locate and read State of Oregon Dietetics Practice Act which confers Licensure on dietitians. Discuss with preceptor what you found of significance or special interest
  1. Quality Management. Quality and quality improvement is a significant topic in nutrition management. Review and become familiar with this subject and during the rotation, identify areas where this is addressed. What organizations address quality? How does quality impact hospital reimbursement? You will be provided an article:Addressing Disease-Related Malnutrition in Hospitalized Patients: A Call for a National Goal, Guenter, et al. The Joint Commission Journal on Quality and Patient SafetyOctober 2015 Volume 41 Number 10
  1. Outpatient/Ambulatory Services. Arrange a little time with the outpatient dietitian or preceptor who helps with operational issues in the OP area if you have not already been on an outpatientrotation.(contact: xxxxxx); Review topic of productivity of OP dietitian and their monthly business-related reporting. If they are too busy, let management preceptor know so other arrangements can be made. Please download this reference and review. It will help prepare you for the conversation with the outpatient dietitians; and understand the business side of healthcare;
  1. * Review the malnutrition coding process, procedures and policy. From Theory to Practice: Optimizing Recognition and Documentation of Adult Malnutritionwill need to be logged in to OPDiet file. I:\REG PSA CLINICAL NUTRITION\Webinars-Teleseminars-clinical educational materials\Malnutrition\From Theory to Practice-optimizing recognition and documentation of adult malnutrition 5-2012 This webinar from 2012 will explain the organization and work flow of the malnutrition coding process completed by Providence. The codes are per ICD-9, and at the time, mild protein calorie malnutrition was not a comorbidity or complication code, which it is now. The remaining information is accurate.
  1. Complete the Hand Grip Strength training competency. You will complete this learning during the rotation and will obtain a certificate that you passed this. It is approved by the Commission on Dietetic Registration, and you can put it on your portfolio if completed successfully.
  1. Complete Providence Order Writing Privileges competency. You will complete this learning during the rotation and will obtain a certificate that you passed You can put it on your portfolio if completed successfully.
  1. * Review topic of food and nutrition informatics and how impacts patient care and dietetics. You will need to be logged into eatrightpro.org and read topics. Purpose to be aware of this important area for dietetics and ideas on how to use in dietetics.Read Nutrition Informatics Practice Paper Review website for SNOMED CT

Informatics dietitians will have you for a little time to see thier role as relates to Computrition/Hospitality Suite, and how we control the patient menu, menu correction and policy related to patient dining via the controls we have in Computrition.Review terms the Academy is forwarding to SNOWMED as diet order naming is very important. You will be provided some background reading of the history of diet orders and see a self-run presentation on this important and often missed topic. You will review the Academy Nutrition Informatics offerings and we will discuss the next level of clinical meaning on this rotation, especially the impact to operations and quality.

  1. During the course of the rotation, your Preceptor will discussmanagement issues in work place. Work/discuss with preceptor to review/discuss a management, labor relations and situation in the workplace. Reading materials may be suggested.
  2. * Clinical Staffing: Review some of the more recent topics and discuss with preceptor. Discuss staffing issues and productivity issues with preceptor. What is Truven/Action OI benchmarking? does staffing impact Action OI Productivity benchmarking? Preceptor will provide articles and reading and discuss.
  3. *Review with preceptor the process for and type of data received from the processes input into computer that track work volumes and budgets (Revenue Reports).
  4. *You will receive a handout to see how productivity and documenting units of service are categorized.
  5. Review how the staff work schedule is managedfor scheduling staff- See the staffing policy and learn how to ease your and the teams way when dealing with scheduling and staffing issues in the workplace.
  6. *Budget; preceptor will share the budget and discuss how it is created and how it works.
  7. *Clinical Metrics: malnutrition, admission screening, RD documentation audits, weights.
  8. *Organizational Structure: how RDs communicate to Medicine/Surgery, the state-wide Medical Nutrition Subcommittee
  9. *Review annual evaluation process used for clinical staff, with preceptor. Purpose, how employee and management can use it communicate and create common goals and purposes and support both staff and the organizational mission.
  10. Note and review types of material in the clinical nutrition management dietetic practice group newsletter to become familiar with typical issues in clinical management. Manager will provide access: or ask for paper versions.
  11. Nutrition Risk screening and workflow in radiation oncology, inflammatory bowel disease, colon-rectal surgery, complex spine, PMH teaching kitchen; Admission Screen NRS 2002 for acute care. State Health Authority communications in progress. Learn how screening with a validated tool positively impacts the patient care flow and resource utilization.
  12. View Nutrition Focused Physical Assessment resources, videos and reading. Preceptor will provide if you have not already received this type of training elsewhere.
  13. Take assigned learning sessions on TPN and TF if you have not already learned or need enhancement on these topics.

Management Projects(Detail of specific projects assigned during the rotation in addition to the above)

  1. xxx
  2. xxx
  3. xxxx
  4. xxxx
  5. Other projects as assigned.

Dress/Appearance

Business-like professional clothing, no low waist pants or skirts, no low cut at neckline; no short skirts, no spandex no leggings; Lab coats okay; no see through, no form fitting, no casual dress. Men tie, professional trousers.

Locations to work during rotation:

To locate facilities:

URL’s of facilities assigned to or for meetings

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