Critical Control Points of Hospital Foodservice Operations

Hazard analyses were made of hospital dietary cook/freeze, cook/chill, assemble/serve, and cook/hold-hot operations. These analyses consisted of measuring temperatures of foods during thawing, cooking, hot-holding, chilling, transporting foods to hospital units, reheating, and delivery to patients and observing food-handling activities for sources and modes of contamination. Identified critical control points in the cook/freeze and cook/chill operations were cooking, cooling, and handling after cooking; in the assemble/serve operation was the incoming foods, and in the cook/hold-hot operation was cooking and hot-holding. No hazards were observed during thawing. Foods were usually cooked to temperatures that would have killed vegetative forms of foodborne pathogens. Either the periods of hot-holding were short or the temperatures were high enough to preclude multiplication of these bacteria. Cooling of foods of similar kind, size, and weight was much more rapid in a rapid-chill refrigerator than in walk-in refrigerators. In the cook/hold-hot operations, temperatures of foods continued to decrease in spite of attempts to keep them hot by placing heated metal pellets under plates and covering the dished-up meal in covered carts during transport from kitchen to patients. Microwave reheating could be a critical control point whenever used, but monitoring is difficult because of considerable variation of temperatures throughout a serving of a particular food and differences between different foods on the same plate.