HR Case Study Linda Bolton, MS, RD, is the clinical nutrition manager for Memorial Hospital. Of the total beds, 250 would be considered medical and the rest are associated with the intensive care (ICU) and the neonatal intensive care units (NICU). The staffing for clinical dietitians is five FTE’s, not including Linda. The activities for clinical dietitians include nutrition screening, nutrition assessment, nutrition reassessment, calorie counts, and education for patients. Dietitians also are involved with tray assessments and conducting meal rounds to assure patients’ satisfaction with food service. The clinical dietitians who feel their time could be better spent working with high-risk patients and enhancing their nutrition care universally dislike these last activities. Jim Hennessey, the foodservice director, insists that dietitians be involved with tray assessments and meal rounds. He believes that the RDs provide wonderful, informed observations of how the food is presented on the floors and the reaction of the patients to the trays. He knows that registered dietitians are extensively educated in foods and foodservice in addition to their comprehensive knowledge of medical nutrition therapy, and he does not want to forgo this expertise, which can assist him in maintaining a high quality foodservice as he works to increase Press Ganey scores. Linda believes that it would be helpful to get either another part-time registered dietitian or a full-time dietetic technician registered. In order to make the case to get this increase in staff, she needs to develop good justification. Although the dietitians seem to be very busy and highly productive, Linda knows she needs to gather some data to demonstrate the need for additional help. The first step is to identify the nutritional status of the patients. She determines that the patients in the medical beds are either at low-to-moderate risk nutritional status. The patients in ICU or NICU are at moderate-to-high risk nutritional status. Next she wants to figure out how many different activities each of her dietitians are doing with the patients. So she asks them to record the number of times they do the activities in each of these categories every day for one month: nutrition screening, nutrition assessment moderate risk (MR) and high risk (HR), nutrition diagnosis for weight loss and inadequate intake, reassessments MR and HR, calorie counts MR and HR, basic education MR and HR, complex education MR and HR, tray assessments and meal rounds, and other duties. She also asks them to note if they need to stay extra hours to complete their work on any day or if any of their work is postponed to the next day because they could not complete everything.

1. Develop a detailed job specification that includes a list of skills, traits, and attributes for the clinical dietitian at this facility. Include job duties and a salary range based on current market value in Raleigh, NC.

2. Determine the productivity of the clinical dietitians in the following table using this equation (round up to the nearest whole number): Productivity Factor (%) = Total direct care time Total paid time

3. The productivity standard at this hospital is that 100% of all employees working within a department must spend on average 90% or more of their workday on job specific duties. With that productivity standard in place, can Linda justify the addition of a part-time registered dietitian or a full-time dietetic technician registered? Why or why not?

4. What should Linda do to ensure that all dietitians are performing meal rounds and tray assessments?