Food allergy safety: a descriptive report of changing policy in a single large medical center

Abstract

Background Food allergy can result in life-threatening anaphylaxis and is considered an increasing public health burden. Hospitalized patients are dependent on the hospital menu to meet their nutritional needs; thus, errors in the meals provided can have a substantial impact on patients’ health outcomes. In Israel, no specific policy protocol exists to ensure food allergy safety in the setting of a hospital foodservice system. Objectives This paper has two aims: 1) to provide an in-depth review of food allergy as a major public health concern and 2) to report actions taken in a single large medical center, as an ongoing project that aimed to ensure patients’ safety, and which ended in developing policy on this matter. Results During the years 2017–2019, we initiated several interventions with the goal of achieving food allergy safety and ensuring quality of care for patients with food allergies at Hadassah Hebrew University Medical Center. These included integrating food management safety into the computerized foodservice system, highlighting labels on patients’ food trays, introducing safety checks into the process of food delivery to hospitalized patients; and ensuring the nutritional requirements of patients with allergy restrictions. Moreover, changes were made in specialized menus for patients with various types of food allergy, and specific procedures were implemented regarding enteral feeding, to prevent accidental allergen exposure. All the procedures were incorporated into a written protocol that applies to all hospital employees, and the staff received the relevant training. Conclusions Our experience suggests that methods for food allergy safety should be promoted, and that an established policy and suitable set of guidelines on this matter is required. This clearly mandates collaboration between the various sectors of the hospital, including management and the computer department; and the medical, nursing, dietetics and kitchen staffs. Furthermore, routine ongoing knowledge training programs for medical teams and kitchen staff are crucial for such implementational changes. In a technological world, computerized systems delivering food to hospitalized patients must be adapted such as to create a uniformly safe food environment of healthcare systems, and developing a suitable policy should be prioritized accordingly by hospitals across Israel, with collaboration and synergy between institutions management and the departments of nutrition and patient safety and risk management.

Addressing knowledge gaps in allergies among Syrian hospital patients: a cross-sectional study

“…While this study focused on infection control, the principles of department-specific knowledge and training are applicable to allergy education as well. Furthermore, a descriptive report on establishing a protocol and policy for the safety of patients with food allergies in a hospital setting emphasized targeting specific hospital processes and sectors involved in patient care 28 . By incorporating more allergy-related discussions into patient interactions, non-dermatological departments, such as internal medicine, can enhance their allergy knowledge, as suggested by our study.…”

How Should Food Offered by Health Care Organizations Meet Individual, Community, and Ecological Needs?

“…13 Food allergies and cross-contamination of foods like gluten for patients with celiac disease can also result in significant adverse health outcomes, such as anaphylaxis and acute worsening of disease. 14 While some hospitals use systems like wristbands to convey significant food allergies, 15 many people who contribute to ordering, preparing, and delivering food are not trained to-and fail to-communicate about food allergies and specialized dietary needs, leading to patients' accidental allergen exposure. 14 Technological tools that help alert team members to allergies at each stage of the food provision process, as well as training and clear communication, can help keep patients safe and better ensure adequate nutrition choices to keep patients healthy.…”

“…14 While some hospitals use systems like wristbands to convey significant food allergies, 15 many people who contribute to ordering, preparing, and delivering food are not trained to-and fail to-communicate about food allergies and specialized dietary needs, leading to patients' accidental allergen exposure. 14 Technological tools that help alert team members to allergies at each stage of the food provision process, as well as training and clear communication, can help keep patients safe and better ensure adequate nutrition choices to keep patients healthy. 15 Integrating a patient-centered approach as an organizational philosophy, as opposed to a task-focused model wherein the patient is a passive recipient of health care, is a key component of providing ethical and effective care and facilitating more effective communication, 16 both of which are relevant to the provision of safe and appropriate nutrition.…”