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Dietetics in Health Care Communities
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Business Practice

How to Talk to an Administrator

Talking points and considerations for meeting with a new client may include the following:

Assessing an RD position: How to prepare for a sales call to a potential new client:

  1. Research the facility online and examine past survey records
  2. MapQuest to determine time and mileage commitment
  3. Update your resume, references; take notes on relation to current position
  4. Prepare your answers for standard questions: why are you the best dietitian for this job; why did you leave your other jobs; how did you contribute? How will you fit this new facility into your schedule?
  5. Calculate how much time it will take to provide services to the facility.
  6. Calculate contracted pay and hours to be worked. What is your daily hourly rate plus travel and expenses?

Questions to consider asking to evaluate an RD position

  1. What is the average census? Average length of stay?
  2. How many admissions monthly?
  3. What meetings does the RD attend weekly and how much time is scheduled for each meeting?
  4. What are the best days of the week to have an RD in the facility?
  5. How does the process of completing the MDS occur? What is the RD’s role in completing the MDS and CAA’s? How many per week are completed?
  6. What computer access / work space is available for the RD?
  7. What computer applications are in place for the dietary department?
  8. What staff works on the computer? Who needs additional training?
  9. How does the admission process occur and how is the dietary department involved?
  10. How are food preferences obtained? Updated?
  11. What are the expectations for quality checks done by the RD in the kitchen?
  12. What process has worked best for obtaining routine weights? Is there a computerized system for recording and determining weight trends?
  13. How does nursing communicate nutritional concerns to the dietitian? How are RD recommendations communicated to nursing and what is the process for nursing to follow through on the recommendations?
  14. What are the documentation/assessment expectations for the RD—within 7 days of admission; quarterly; bi-annually? How do the nurses communicate at-risk residents, and on average how many people are referred weekly?

And the big questions:

  1. What are your goals for the RD? What changes would you like to see? What should remain unchanged?
  2. What are your goals for the dietary department and how do you see the RD assist with reaching these goals?
  3. Do you have certain projects or concerns regarding the dietary department that are your priorities? What is/are the time frame(s) for these?
  4. What are the long term goals for the facility?

Reassessment of time required for an existing position: How to talk to the administrator about increasing dietitian hours

Talking points to include:

  1. Have the monthly admissions increased and the length of stay decreased?
  2. Has the stability of the residents been changing with more status change assessments required?
  3. How many residents are followed in the nutrition at risk programs?
  4. Remind administrator of need to document more frequently on these residents.
  5. Has the Rehab unit expanded or the amount of rehab admissions increased?
  6. Are there more residents requiring nutrition education?
  7. Are residents’ families requiring and wanting more time and attention from the dietitian?
  8. Are the residents having more complicated clinical situations, dictating increased need for consultation with nursing about their medical status?
  9. Has the increased focus on the importance of sanitation, safe food handling, and dining services resulted in more time needed for the dietitian to work with the dietary department?
  10. Is additional observation of staff members who work with dependent diners required, to assure that residents are receiving the nutrition and level of assistance they need?
  11. With culture change issues moving forward, will the dietitian have time to be involved with planning of such projects?

Additionally:

  1. Explanation of the differences between the Academy's Standards of Practice/Standards of Professional Performance (SOP/SOPP) and the Dietary Managers Association (DMA) Professional Practice Standards of the Certified Dietary Manager (CDM).
  2. With additional RD hours allotted, the dietitian will be able to monitor efficacy of nutritional interventions and make changes related to resident response and/or acceptance.
  3. In order to meet the nutritional needs of the residents it is important to have an effective Nutrition at Risk Program for determining and addressing weight trends. The RD is a valuable member of the NAR team.
  4. Increasing RD hours will allow the dietitian to work more closely with the dietary manager and the food service operation – assisting with menu development, to incorporate favorite foods into the menu and to decrease food waste; in review of policies & procedures to ensure compliance with current regulations; and in education of Dietary staff.
  5. Showing how the RD plays an integral part in achieving positive resident outcomes – i.e.: wound healing in a shorter time through utilization of nutritional interventions and greater RD involvement with the interdisciplinary team (participation in wound rounds; regular reassessment of healing; etc).

Of course, in addition to cost savings and financial impact, the RD must be able to show the administrator in black and white the amount of time it realistically takes to do the job. DHCC’s “Adequacy of Consultant Hours” worksheet will assist with calculation and demonstration of these numbers.

©2010 Dietetics in Health Care Communities, A dietetic practice group of the Academy of Nutirtion and Dietetics