Monitor of tray error rates for quality control.

Accuracy of tray assembly is essential for providing appropriate nutrition care to patients and maintaining patient satisfaction. A monitoring system of tray assembly error rates was designed to evaluate patient tray accuracy and to identify types of assembly errors. Data were collected during two morning, five noon, and five evening meals. Errors were classified according to type: omission, addition, or substitution. They were also classified by severity: error of convenience (not critical with respect to diet) or error of compliance (contradictory to diet order). Error rates were determined and compared by meal, weekday vs. weekend, and first half of assembly period vs. second half. An average error rate of 12.9% was calculated from the 6,553 trays studied, with error rates of 12.5%, 10.9%, and 15.1% for breakfast, lunch, and dinner, respectively. Evaluation of data revealed no significant difference in error rate as sorted by type of error, among meals, or between weekday and weekend. Only 2.7% of the trays had errors contradictory to the diet order. The error rate was significantly higher during the second half of the assembly period, and the highest error rates were observed for the evening meal. The methodology used in this study serves as the basis for quality control monitoring and as a motivational tool to stimulate improved performance by trayline employees.