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Academy of Nutrition and Dietetics: Revised 2014 Standards of Professional Performance for Registered Dietitian Nutritionists in Management of Food and Nutrition Systems
Address correspondence to: Rita M. Berthelsen, PhD, RD, LMNT, Health, Biological & Sports Science, Iowa Western Community College, 2700 College Rd, Council Bluffs, IA 51503.
Management in food and nutrition systems is presented with an ever-challenging tension between effective utilization of manpower resources, mechanical equipment, financial management, material production, and time constraints to produce optimal products. Management drives opportunities for personal development for multiple levels of its employee workforce. Given an increasing need to deliver high-quality food and services to satisfied customers, the Management in Food and Nutrition Systems Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Revised 2014 Standards of Professional Performance, which replace the 2009 Standards, as a tool for registered dietitian nutritionists working in food and nutrition systems management within health care and non−health care organizations. These Standards of Professional Performance consist of six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how strong communication skills, attention to customer satisfaction, use of various resources, and application of personnel management principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists managing food and nutrition systems.
The Management in Food and Nutrition Systems Dietetic Practice Group of the Academy of Nutrition and Dietetics (Academy), under the guidance of the Academy Quality Management Committee, has revised the Standards of Professional Performance (SOPP) for Registered Dietitians in Management of Food and Nutrition Systems,
American Dietetic Association Standards of Professional Performance for Registered Dietitians (Generalist and Advanced) in Management of Food and Nutrition Systems.
originally published in 2009. The revised document, the Academy of Nutrition and Dietetics: Revised 2014 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems, reflect advances in management of food and nutrition systems practice during the past 5 years and replace the 2009 Standards. These documents build on the Academy of Nutrition and Dietetics Revised 2012 SOP in Nutrition Care (SOP) and SOPP for RDs.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.
American Dietetic Association/Commission on Dietetic Registration Code of Ethics for the Profession of Dietetics and process for consideration of ethics issues.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Scope of Practice in Nutrition and Dietetics.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Scope of Practice for the Registered Dietitian.
that guide the practice and performance of Registered Dietitian Nutritionists (RDNs) in all settings.
The scope of practice in nutrition and dietetics is composed of statutory and individual components; includes the Code of Ethics; and encompasses the range of roles, activities, and regulations within which RDNs perform. For credentialed practitioners, scope of practice is typically established within the practice act and interpreted and controlled by the agency or board that regulates the practice of the profession in a given state.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Scope of Practice in Nutrition and Dietetics.
An RDN's statutory scope of practice may delineate the services an RDN is authorized to perform in a state where a practice act or certification exists.
The RDN's individual scope of practice is determined by education, training, credentialing, and demonstrated and documented competence to practice. Individual scope of practice in nutrition and dietetics has flexible boundaries to capture the breadth of the individual's professional practice. The Scope of Practice Decision Tool, an online, interactive tool, permits an RDN to answer a series of questions to determine whether a particular activity is within his or her scope of practice. The tool is designed to assist an RDN in critically evaluating personal knowledge, skill, and demonstrated competence with criteria resources.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics. Academy Scope of Practice Decision Tool: A self-assessment guide.
All registered dietitians are nutritionists, but not all nutritionists are registered dietitians. The Academy's Board of Directors and Commission on Dietetic Registration have determined that those who hold the credential Registered Dietitian (RD) may optionally use Registered Dietitian Nutritionist (RDN) instead. The two credentials have identical meanings. In this document, the expert working group has chosen to use the term RDN to refer to both registered dietitians and registered dietitian nutritionists.
Approved February 2014 by the Quality Management Committee of the Academy of Nutrition and Dietetics and the Executive Committee of the Management of Food and Nutrition Services Dietetic Practice Group of the Academy. Scheduled review date: November 2018. Questions regarding the Standards of Professional Performance for Registered Dietitian Nutritionists in Management of Food and Nutrition Systems may be addressed to Academy quality-management staff: Sharon McCauley, MS, MBA, RDN, LDN, FADA, FAND, director, Quality Management, at .
The Academy's Revised 2012 SOP in Nutrition Care and SOPP for RDs
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.
reflect the minimum competent level of nutrition and dietetics practice and professional performance for RDNs. These standards serve as blueprints for the development of focus area SOP and SOPP for RDNs in competent, proficient, and expert levels of practice. The SOP in Nutrition Care is composed of four standards representing the four steps of the Nutrition Care Process as applied to the care of patients/clients.
The Management in Food and Nutrition Systems Dietetic Practice Group does not include the SOP competencies in its standards, but does recognize their importance in other focus areas that participate in direct patient and client care. The SOPP consist of standards representing the following six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. The SOPP for RDNs are designed to promote the provision of safe, effective, and efficient food and nutrition services; facilitate evidence-based practice; and serve as a professional evaluation resource.
These focus area standards for RDNs in management of food and nutrition systems provide a guide for self-evaluation and expanding practice, a means of identifying areas for professional development, and a tool for demonstrating competence in managing food and nutrition systems. They are used by RDNs to assess their current level of practice and to determine the education and training required to maintain currency in their focus area and advancement to a higher level of practice. In addition, the standards may be used to assist RDNs in transitioning their knowledge and skills to a new focus area of practice. Like the SOPP for RDs,
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.
the indicators (ie, measureable action statements that illustrate how each standard can be applied in practice) (see Figure 1, available online at www.andjrnl.org) for the SOPP for RDNs in Management of Food and Nutrition Systems were developed with input and consensus of content experts representing diverse practice and geographic perspectives. The SOPP for RDNs in Management of Food and Nutrition Systems were reviewed and approved by the Executive Committee of the Management in Food and Nutrition Systems Dietetic Practice Group and the Academy Quality Management Committee.
identifies levels of proficiency (novice, advanced beginner, competent, proficient, and expert) (refer to Figure 2) during the acquisition and development of knowledge and skills. This model is helpful in understanding the levels of practice described in the SOPP for RDNs in Management of Food and Nutrition Systems. In Academy focus areas, the levels are represented as competent, proficient, and expert practice levels.
Figure 2Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems.
Figure 2Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems.
Competent Practitioner
In dietetics, a competent practitioner is an RDN who is either just starting practice after having obtained RDN registration by the Commission on Dietetic Registration (CDR), or an experienced RDN who has recently assumed responsibility to provide nutrition and dietetics services in a new focus area.
A competent practitioner who has obtained RDN status and is starting in professional employment acquires additional on-the-job skills and engages in tailored continuing education to enhance knowledge and skills obtained in formal education. An RDN starts with technical training and professional interaction for advancement and expanding breadth of competence. A general practice RDN may include responsibilities across several areas of practice, including, but not limited to community, clinical, consultation and business, research, education, and food and nutrition management.
A proficient practitioner is an RDN who is generally 3 or more years beyond entry into the profession, who has obtained operational job performance skills and is successful in the RDN's chosen focus area of practice.
The proficient practitioner demonstrates additional knowledge, skills, and experience in a focus area of dietetics practice. An RDN may acquire specialist credentials, certifications, or advanced degrees to demonstrate proficiency in a focus area of practice.
Expert Practitioner
An expert practitioner is an RDN who is recognized within the profession and has mastered the highest degree of skill in or knowledge of a certain focus or generalized area of dietetics through additional knowledge, experience, or training.
An expert practitioner exhibits a set of characteristics that includes leadership and vision, and demonstrates effectiveness in planning, achieving, evaluating, and communicating targeted outcomes. An expert practitioner may have an expanded or specialist role, and may possess an advanced credential, if available, in a focus area of practice. Generally, the practice is more complex, and the practitioner has a high degree of professional autonomy and responsibility.
These Standards, along with the Academy/CDR Code of Ethics,
American Dietetic Association/Commission on Dietetic Registration Code of Ethics for the Profession of Dietetics and process for consideration of ethics issues.
answer the questions: Why is an RDN uniquely qualified to manage food and nutrition systems? What knowledge, skills, and competencies does an RDN need to demonstrate for the provision of safe, effective, quality, and cost-effective management of food and nutrition systems at the competent, proficient, and expert levels?
Overview
In a climate of change in health care delivery and payment systems, tight operating budgets, and heightened focus on customer service in all segments (eg, health care, college and university, school nutrition, and retail venues), RDNs in management roles (eg, manager, director, administrator) are challenged to lead fiscally sound, quality focused, outcomes-oriented food and nutrition systems. Effective leadership and mentoring of staff at all levels is critical to achieving customer-centered services that meet organization objectives, safety standards (ie, state or US Food and Drug Administration Food Code, Occupational Safety and Health Administration), regulatory agency (ie, state and local health departments, Occupational Safety and Health Administration), and accreditation organization standards (ie, The Joint Commission, Healthcare Facilities Accreditation Program, Det Norske Veritas Healthcare). RDNs in management of food and nutrition systems confront ethical dilemmas daily. They serve as role models exemplifying ethical business practices, professional ethics as outlined in the Academy/CDR Code of Ethics,
American Dietetic Association/Commission on Dietetic Registration Code of Ethics for the Profession of Dietetics and process for consideration of ethics issues.
and accountability for complying with organization guidelines. RDNs in management practice promote and model use of evidence-based standards and guidelines, business best practices, and effective and efficient use of human, material, and financial resources in achieving food and nutrition system objectives and outcomes.
RDNs in management roles lead the management team and employees in a systematic quality assurance and performance improvement process to monitor, evaluate, and refine processes and services to assure safe, quality, customer-centered, financially accountable food and nutrition services.
While management skills are promoted for food and nutrition practitioners in all practice areas, the SOPP for RDNs in Management of Food and Nutrition Systems focus primarily on the management of food and nutrition systems in a variety of settings in health care or other institutional settings (eg, hospitals, long-term care facilities, corrections), colleges and universities, Veteran's and military facilities, schools, and commercial settings. Management roles vary (eg, supervisor, manager, director, system director, or administrator) along with scope and size of operations (eg, unit, department, multi-department, multi-location, health care system with multiple sites, individual school or school district, and single or multiple retail venues). Responsibility areas can encompass foodservice for patients/residents/students, retail operations (eg, visitor and employee cafeteria, coffee kiosks, coffee shop, restaurant, and onsite and offsite catering), and oversight for inpatient and outpatient clinical nutrition programs and services plus additional responsibilities when in multi-department management.
Management of food and nutrition systems is a diverse, dynamic area of practice that requires RDN leaders who are effective in the management of human, material, and financial resources and visionary in navigating their programs and services through ever-changing times in health care and other business segments. Public interest in healthier eating options is growing in response to the incidence of pediatric and adult obesity, and a general interest in healthier lifestyles. Hospitals are being challenged to offer healthier food and beverage options in employee and visitor dining venues (eg, Partnership for a Healthier America: Healthier Hospital Food Initiative at www.ahealthieramerica.org [Our Partners]; Healthier Hospitals Initiative: Healthier Food Challenge at www.healthierhospitals.org). School nutrition programs have revamped menus in response to new regulations. Nutrition standards are being developed and promoted for vending, concessions, and foods provided in worksites and public spaces (eg, Centers for Disease Control and Prevention at www.cdc.gov/salt/resources.htm [Guides], National Alliance for Nutrition & Activity at www.cspinet.org/nutritionpolicy/foodstandards.html). With this heightened awareness, now is the time to seize opportunities for advancing practice and promoting the RDN's expertise in the management of food and nutrition systems.
Academy Revised 2014 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems
An RDN can use the Academy Revised 2014 SOPP for RDNs (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems (see the website exclusive Figure 1, available online at www.andjrnl.org) to:
•
identify the competencies to provide nutrition and dietetic services in the management of food and nutrition systems;
•
self-assess whether he or she has the appropriate knowledge base and skills to provide safe and effective management of food and nutrition systems for his or her level of practice;
•
identify the areas in which additional knowledge and skills are needed to practice at the competent, proficient, or expert level in management of food and nutrition systems;
•
provide a foundation for public and professional accountability in the management of food and nutrition systems;
•
support efforts for strategic planning and assist in or direct the planning and delivery of food and nutrition services and resources;
•
enhance professional identity and communicate the nature of management of food and nutrition systems and services;
•
guide the development of management of food and nutrition systems-related education and continuing education programs, job descriptions, and career pathways; and
•
assist educators and preceptors in teaching students and interns the knowledge, skills, and competencies needed to work in management of food and nutrition systems and the understanding of the full scope of this focus area of practice.
Application to Practice
All RDNs, even those with significant experience in other practice areas, must begin at the competent level when practicing in a new setting or a new focus area of practice. At the competent level, an RDN in management of food and nutrition systems has the core knowledge to manage human, material, and financial resources, and is developing more advanced management skills required for advancing the administrative ranks (eg, strategic planning, team building, marketing, conflict management, emergency management).
This RDN, who may be an experienced RDN or may be new to the profession, has a breadth of knowledge in nutrition and dietetics and may have proficient or expert knowledge/practice in another focus area. However, the RDN new to the focus area of management of food and nutrition systems may experience a steep learning curve when becoming familiar with the body of knowledge and available resources to support management of food and nutrition systems−related practice.
At the proficient level, an RDN has developed a deeper understanding of managing food and nutrition systems and is better equipped to apply evidence-based guidelines and best practices than at the competent level. This RDN is able to modify typical practices according to unique situations (eg, adapt operational processes to achieve sustainability best practices
; apply critical thinking and decision making to influence and achieve organizational goals, evaluate, and guide management team and staff in designing and adopting new work flow processes to reflect best practices; manage resources of significant value to the organization; and direct unit's emergency preparedness response during utility outage or natural disaster). An RDN at the proficient level may possess an advanced degree, additional credentials, and certifications to support management practice (eg, Academy Certificate of Training Programs: Developing Your Role as a Leader (Level I), Advancing Your Role as Leader (Level II), and Executive Management; go to http://www.eatright.org/cpd/online/).
At the expert level, the RDN thinks critically about the management of food and nutrition systems, demonstrates a more intuitive understanding of continuous process improvement in managing food and nutrition systems, displays a range of highly developed managerial and technical skills, leads strategic planning, and formulates judgments acquired through a combination of education, experience, and critical thinking. Essentially, practice at the expert level requires the application of complex food and nutrition systems knowledge, business, and dietetics knowledge, with practitioners drawing not only on their various practice and leadership experiences, but also on the experiences of RDN's in management roles and clinical RDN's in various disciplines and practice settings. Expert RDNs, with their extensive experience and ability to see the significance and meaning of the managerial role in delivering safe, quality, and cost-effective food and nutrition services and outcomes within a contextual whole, are fluid and flexible and, to some degree, autonomous in practice. They not only implement evidence–based food and nutrition management best practices, they also manage, drive, and direct departments, multiple departments, organizations, and systems, varied foodservice venues (eg, patient/resident, retail, catering, senior feeding, schools), and inpatient and outpatient nutrition programs; conduct and collaborate on research; serve as faculty in academic and culinary programs; serve on or lead multidisciplinary and interdisciplinary teams; and lead the advancement of management in food and nutrition systems.
RDNs in management of food and nutrition systems confront ethical dilemmas daily. The CDR and the American Dietetic Association reviewed and published a revised Code of Ethics for its members in 2009, with effective implementation on January 1, 2010. The fundamental principles are as follows: the dietetics practitioner conducts himself or herself with honesty, integrity, and fairness; the dietetics practitioner supports and promotes high standards of professional practice; and the RDN utilizes the principles of the Code of Ethics along with critical thinking skills to make a decision that best serves the interests of clients, employers, employees and other stakeholders.
The RDN must be familiar with standards issued by their facility's accreditation organization (eg, The Joint Commission, Healthcare Facilities Accreditation Program, Det Norske Veritas Healthcare), state and local health departments, and federal regulatory agencies.
The breadth and depth of an RDN's knowledge, including mentoring opportunities offered by the Academy and several dietetic practice groups provides the tools to make quick, validated decisions.
Indicators for the SOPP (Figure 1, available online at www.andjrnl.org) for RDNs in Management of Food and Nutrition Systems are measurable action statements that illustrate how each standard can be applied in practice. Within the SOPP for RDNs in Management of Food and Nutrition Systems, an “X” in the competent column indicates that an RDN who is managing food and nutrition systems is expected to complete this activity and/or seek assistance to learn how to perform at the level of the standard. A competent RDN in management of food and nutrition systems could be an RDN starting practice after registration or an experienced RDN who has recently assumed a management role in a food and nutrition department or food/foodservice organization. An “X” in the proficient column indicates that an RDN who performs at this level has a deeper understanding of management of food and nutrition systems and has the ability to modify their practice to meet the needs of patients/clients/customers in various situations. An “X” in the expert column indicates that the RDN who performs at this level possesses a comprehensive understanding of the requirements and expectations for effective management of food and nutrition systems and a highly developed range of skills and judgments acquired through a combination of experience and education. The expert RDN builds and maintains the highest level of knowledge, skills, and behaviors, including leadership, vision, strategic planning, business principles, ethical practices, research, and credentials.
Standards and indicators presented in online Figure 1 (available at www.andjrnl.org) in boldface type originate from the Academy's Revised 2012 SOPP for RDs
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.
and should apply to RDNs in all three levels. Several indicators developed for this focus area not in boldface type are identified as applicable to all levels of practice. Where an “X” is placed in all three levels of practice, it is understood that all RDNs in management of food and nutrition systems are accountable for practice within each of these indicators. However, the depth with which an RDN performs each activity will increase as the individual moves beyond the competent level. Several levels of practice are considered in this document; thus taking a holistic view of the SOPP for RDNs in Management of Food and Nutrition Systems is warranted. It is the totality of the individual's practice that defines the level of practice and not any one indicator or standard.
RDNs should review the SOPP in Management of Food and Nutrition Systems at regular intervals to evaluate their individual focus area management, food and nutrition knowledge, skill, and competence. Regular self-evaluation is important because it helps identify opportunities to improve and/or enhance practice and professional performance. This self-appraisal also enables RDN managers of food and nutrition systems to better utilize these Standards in the CDR Professional Development Portfolio process and each of its five steps for self-assessment, planning, improvement, and commitment to lifelong learning
(Figure 3). RDNs are encouraged to pursue additional training, regardless of practice setting, to maintain currency and to expand individual scope of practice within the limitations of the legal scope of practice, as defined by state law. RDNs are expected to practice only at the level at which they are competent, and this will vary depending on education, training, and experience.
RDNs are encouraged to pursue additional knowledge and skill training, and collaboration with other RDNs in management of food and nutrition systems to promote consistency in practice and performance and continuous quality improvement. See Figure 4 for case examples of how RDNs in different roles, at different levels of practice, may use the SOPP for RDNs in Management of Food and Nutrition Systems.
Figure 3Application of the Commission on Dietetic Registration Professional Development Portfolio Process.
How to Use the Standards of Professional Performance (SOPP) for Registered Dietitian Nutritionists (RDNs) (Competent, Proficient, Expert) in Management of Food and Nutrition Systems as part of the Professional Development Portfolio Process
The Commission on Dietetic Registration Professional Development Portfolio process is divided into five interdependent steps that build sequentially upon the previous step during each 5-year recertification cycle and succeeding cycles.
1. Reflect
Assess your current level of practice and whether your goals are to expand your practice or maintain your current level of practice. Review the SOPP for RDNs in Management of Food and Nutrition Systems document to determine what you want your future practice to be and assess your strengths and areas for improvement. These documents can help you set short- and long-term professional goals.
2. Conduct learning needs assessment
Once you have identified your future practice goals, you can review the SOPP for RDNs in Management of Food and Nutrition Systems document to assess your current knowledge, skills, behaviors, and define what continuing professional education is required to achieve the desired level of practice.
3. Develop learning plan
Based on your review of the SOPP for RDNs in Management of Food and Nutrition Systems, you can develop a plan to address your learning needs as they relate to your desired level of practice.
4. Implement learning plan
As you implement your learning plan, keep reviewing the SOPP for RDNs in Management of Food and Nutrition Systems document to reassess knowledge, skills, and behaviors and your desired level of practice.
5. Evaluate learning plan process
Once you achieve your goals and reach or maintain your desired level of practice, it is important to continue to review the SOPP for RDNs in Management of Food and Nutrition Systems document to re-assess knowledge, skills, and behaviors and your desired level of practice.
a The Commission on Dietetic Registration Professional Development Portfolio process is divided into five interdependent steps that build sequentially upon the previous step during each 5-year recertification cycle and succeeding cycles.
Figure 4Case Examples of Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems.
Role
Examples of use of Standards of Professional Performance (SOPP) documents by Registered Dietitian Nutritionists (RDNs) in different practice roles
Food Systems Management Director
The director is responsible for the overall operation of foodservice and nutrition providing quality, nutritious food to the customer. The SOPP is used to delineate the functions of the foodservice department to provide effective and efficient service within the financial parameters. Skills are used to develop an organization that works with other departments and practices team management within. The director recognizes the SOPP as a tool to assess specific competencies and assign tasks to personnel at different levels of performance. The RDN utilizes the SOPP to strategically plan his or her professional development activities, enhancing growth experienced in tenure at the facility.
Retail Manager
The retail manager is responsible for meal service for staff and visitors. This service may include a cafeteria, physicians private dining, coffee shops, kiosks, catering, gift shops, and convenience stores. The RDN retail manager uses the SOPP for self-assessment to identify continuing education activities to increase business and marketing skills to support evaluation and modification of existing processes and programs to enhance customer service outcomes, budget, and volume targets.
School Foodservice Manager
The school foodservice manager oversees a foodservice operation that provides meals to children in multiple settings (Head Start to grade 12). The manager is responsible for following all local, state, and federal laws, regulations, and standards. This RDN manager uses the SOPP to review performance outcomes for a manager in a foodservice operation and to identify knowledge and skills for competent practice to guide review of work processes. The SOPP indicators identify knowledge and skill areas for investigation for applicability to the school foodservice setting and to use for personal continuing education plans and supervisory staff development.
Clinical Nutrition Manager
The clinical nutrition manager is an RDN in management practice who has the responsibility to oversee medical nutrition therapy provided to clients and their families. The RDN reviews available resources for the patient population for both inpatients and outpatients.
Patient Service Manager
An experienced clinical RDN new to the patient service manager role is responsible for overseeing patient foodservice operations, which include planning regular and modified diet menus, preparation of supplemental feedings, patient menu system, meal tray and snack preparation and delivery. The RDN uses the SOPP to evaluate personal performance with new responsibilities to identify areas for knowledge and skill development to incorporate into personal development plans. The RDN uses the SOPP to identify areas for obtaining mentoring from a more experienced manager in order to enhance skills and to help with problem-solving operational issues not covered in policies and procedures.
Educator of Health Professionals
The RDN educator of health professionals teaches, demonstrates procedures, and plans for internships and advance degree opportunities for the students. The RDN uses the SOPP to develop program goals and course learning objectives that prepare students for the profession. Students view and understand the practice level expectations for practitioners. Using the SOPP in this manner allows the students to develop skills to meet the standards.
In some instances, components of the SOPP for RDNs in Management of Food and Nutrition Systems do not specifically differentiate between proficient-level and expert-level practice. In these areas, it was the consensus of the content experts that the distinctions are subtle, captured in the knowledge, experience, and intuition demonstrated in the context of practice at the expert level, which combines dimensions of understanding, performance, and value as an integrated whole.
A wealth of knowledge is embedded in the experience, discernment, and practice of expert-level RDN practitioners. The knowledge and skills acquired through practice will continually expand and mature. The indicators will be refined with each review of these Standards as expert-level RDNs systematically record and document their experience. The experienced practitioner observes managerial and clinical events, analyzes them to make new connections between events and ideas, and produces a synthesized whole. Practice exemplars provide outstanding models of actions of individual RDNs in management roles and the professional and leadership activities that have enhanced customer services and food and nutrition systems, operations, and outcomes.
Future Directions
The SOPP for RDNs in Management of Food and Nutrition Systems is an innovative and dynamic document. Future revisions will reflect changes and advances in practice, dietetics education programs, and outcomes of practice audits. The authors acknowledge that the three practice levels may require more clarity and differentiation in content and role delineation, and that competency statements that better characterize differences among the practice levels is a goal with each revision. Creation of this clarity, differentiation, and definition are the challenges of today's RDN managers of food and nutrition systems to better serve tomorrow's practitioners and their patients, clients, and customers.
Individual practitioners as well as the profession must take responsibility for the future of RDNs in management of food and nutrition systems. Management knowledge and skills should be valued and nurtured in every practitioner.
In 2003, the Academy House of Delegates conducted a dialogue session on “The Future of Management in Dietetics,” which resulted in the creation of a task force and a campaign to promote management in nutrition and dietetics. In 2010, a House of Delegates dialogue session addressed “Management and Leadership Across Practice” with identified guiding principles for individuals and the Academy to emphasize leadership and management skills, including the Academy's development of a management or leadership credential or certification program (see http://www.eatright.org/cpd/online/ for available certificate programs). The need for strong leadership and management skills in advancing the profession and the roles of individual practitioners continues to be a focus of Academy initiatives, as was stated by Mary Cluskey and colleagues: “The future demands food and nutrition professionals who can function at many levels in achieving outcomes. The success of food and nutrition professionals may be contingent upon their continuing to enhance their knowledge of and competency in management.”
The May 2012 supplement to the Journal of the Academy of Nutrition and Dietetics compiles nine previously published articles, some cited in this article, into this resource titled “Management in the Dietetics Profession: Building a Framework for Success.”
RDNs in management of food and nutrition systems face complex situations and ever-challenging tensions involving effective utilization of manpower resources, mechanical equipment, financial management, material production, and time constraints to produce optimal products. Addressing the unique needs of each situation and applying standards appropriately is essential to providing safe, timely, person-centered, ethical, quality care and service. All RDNs are advised to conduct their practice based on the most recent edition of the Code of Ethics, the Scope of Practice in Nutrition and Dietetics, the Scope of Practice for RDs, and SOPP for RDs. The SOPP for RDNs in Management of Food and Nutrition Systems is a complementary document and is a key resource for RDNs at all knowledge and performance levels. These standards can and should be used by RDNs in management practice in daily practice to consistently improve and appropriately demonstrate competency and value as providers of safe and effective nutrition and dietetics care and services. These standards also serve as a professional resource for self-evaluation and professional development for RDNs focusing on management of food and nutrition systems practice. Just as a professional's self-evaluation and continuing education process is an ongoing cycle, these standards are also a work in progress and will be reviewed and updated every 5 years. Current and future initiatives of the Academy as well as advances in the management of food and nutrition systems and services will provide information to use in these updates and in further clarifying and documenting the specific roles and responsibilities of RDNs at each level of practice. As a quality initiative of the Academy and the Management of Food and Nutrition Systems Dietetic Practice Group, these standards are an application of continuous quality improvement and represent an important collaborative endeavor.
These standards have been formulated to be used for individual self-evaluation and the development of practice guidelines, but not for institutional credentialing or for adverse or exclusionary decisions regarding privileging, employment opportunities or benefits, disciplinary actions, or determinations of negligence or misconduct. These standards do not constitute medical or other professional advice, and should not be taken as such. The information presented in these standards is not a substitute for the exercise of professional judgment by the health care professional. The use of the standards for any other purpose than that for which they were formulated must be undertaken within the sole authority and discretion of the user.
Supplementary Data
Figure 1Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) in Management of Food and Nutrition Systems. Note: The term customer is used in this evaluation resource as a universal term. Customer could also mean client/patient, client/patient/customer, resident, participant, consumer, or any individual, group, student/intern, or organization the RDN provides service.
Standard 1: Quality in Practice The registered dietitian nutritionist (RDN) provides quality services using a systematic process with identified leadership, accountability, and dedicated resources. Rationale: Quality practice in nutrition and dietetics is built on a solid foundation of education, credentialing, evidence-based practice, demonstrated competence, and adherence to established professional standards. Quality practice requires systematic measurement of outcomes, regular performance evaluations, and continuous improvement.
Indicators for Standard 1: Quality in Practice
Bold Font Indicators are Academy Core RDN Standards of Professional Performance Indicators
The “X” signifies the indicators for the level of practice
Each RDN:
Competent
Proficient
Expert
1.1
Complies with applicable laws and regulations as related to his or her area(s) of practice
X
X
X
1.2
Performs within individual and statutory scope of practice
X
X
X
1.3
Adheres to sound business and ethical billing practices applicable to the setting
X
X
X
1.3A
Serves as a role model for ethical behavior
X
X
X
1.3B
Prepares appropriate charges according to services provided
X
X
X
1.3C
Develops orientation and professional development activities for staff on ethics
X
X
1.3D
Establishes protocols/algorithms for making judgment call on professional/ethical behavior and consequences as related to billing practices
X
1.4
Utilizes national quality and safety data (eg, Institute of Medicine, National Quality Forum, Institute for Healthcare Improvement, state or US Food and Drug Administration [FDA] Food Code, Occupational Safety and Health Administration [OSHA]) to improve the quality of services provided and to enhance customer-centered service
X
X
X
1.4A
Evaluates data from various quality-assurance processes
X
X
X
1.5
Utilizes a systematic performance improvement model that is based on practice knowledge, evidence, research, and science for delivery of the highest-quality services
X
X
X
1.5A
Utilizes critical performance measures to monitor effectiveness and safety of service
X
X
X
1.5A1
Monitors effectiveness of systematic performance improvement program for area of responsibility
X
X
1.5A2
Designs a systematic performance improvement process for department/program
X
1.6
Participates in or designs an outcomes-based management system to evaluate safety, effectiveness, and efficiency of practice
X
X
X
1.6A
Involves colleagues and others, as applicable, in systematic outcomes management
X
X
X
1.6A1
Promotes active participation of stakeholders
X
X
X
1.6A2
Participates in interdepartmental quality assurance and performance improvement initiatives
X
X
X
1.6A3
Develops and implements an outcomes management system to evaluate effectiveness and efficiency of practice
X
X
1.6A4
Determines and involves stakeholders in the implementation and evaluation of an outcomes-based management system
X
X
1.6A5
Analyzes variations in processes utilizing root cause analysis protocols
X
1.6B
Utilizes indicators that are specific, measurable, attainable, realistic, and timely (S.M.A.R.T.)
X
X
X
1.6B1
Differentiates long-term and short-term goals to measure progress
X
X
X
1.6C
Defines expected outcomes
X
X
X
1.6C1
Utilizes institutional expectations to set desired outcomes
X
X
X
1.6C2
Utilizes industry standards and institutional expectations to set desired outcomes
X
X
1.6D
Measures quality of services in terms of process and outcomes
X
X
X
1.6D1
Identifies appropriate measures of quality for the process and outcomes
X
X
1.6D2
Modifies quality measures as needed based on outcomes and/or new needs
X
X
1.6E
Documents outcomes
X
X
X
1.6E1
Uses a systematic process for collecting and reporting outcomes data
X
X
X
1.7
Identifies and addresses potential and actual errors and hazards in provision of services
X
X
X
1.7A
Complies with local and state regulations and interpretive guidelines
X
X
X
1.7B
Complies with Hazard Analysis and Critical Control Points guidelines
X
X
X
1.7C
Orients staff to the importance of food safety practices
X
X
X
1.7D
Develops and implements training programs on food safety standards and department policies and procedures
X
X
X
1.7E
Completes risk analysis in food and nutrition services
X
X
1.7E1
Utilizes results of risk analysis to plan departmental activities to improve food safety outcomes
X
X
1.7F
Determine root-cause analysis of errors and hazards
X
1.8
Compares actual performance to performance goals (eg, Gap Analysis, SWOT Analysis [Strengths, Weaknesses, Opportunities, and Threats], PDCA Cycle [Plan-Do-Check-Act])
X
X
X
1.8A
Reports and documents action plan to address identified gaps in performance
X
X
X
1.8A1
Compares actual performance to expected outcomes
X
X
X
1.8A2
Uses appropriate analytical tools to evaluate and enhance services
X
X
X
1.8A3
Designs interventions to improve processes and services
X
X
1.8A4
Participates in peer comparison of services (benchmarking)
X
X
1.8A5
Evaluates on a continuous basis, improving services based on measureable outcomes
X
X
1.9
Evaluates interventions to improve processes and services
X
X
X
1.9A
Analyzes benchmark data
X
X
X
1.9B
Interprets benchmark data related to program processes
X
X
X
1.9C
Implements change in the process and re-measures
X
X
X
1.9D
Takes action when discrepancies exist between actual performance and expected outcomes
X
X
X
1.9E
Interprets benchmark data, addressing variances
X
X
1.10
Improves or enhances services based on measured outcomes
X
X
X
1.10A
Reviews current literature and industry trends to identify best practices
X
X
X
1.10B
Improves the industry by publishing outcomes and best practices to enhance industry outcomes
X
X
Examples of Outcomes for Standard 1: Quality in Practice
•
Actions are within scope of practice and applicable laws and regulations
•
Use of national quality standards and best practices are evident in customer-centered services
•
Performance indicators are specific, measurable, attainable, realistic, and timely (S.M.A.R.T.)
Results of quality improvement activities direct refinement and advancement of practice
Standard 2: Competence and Accountability The registered dietitian nutritionist (RDN) demonstrates competence in and accepts accountability and responsibility for ensuring safety and quality in the services provided. Rationale: Competence and accountability in practice includes continuous acquisition of knowledge, skills, and experience in the provision of safe, quality patient/client-centered service.
Indicators for Standard 2: Competence and Accountability
Bold Font Indicators are Academy Core RDN Standards of Professional Performance Indicators
The “X” signifies the indicators for the level of practice
Each RDN:
Competent
Proficient
Expert
2.1
Adheres to the Code of Ethics
X
X
X
2.1A
Champions ethics in all areas of practice
X
X
X
2.1B
Interprets and shares ethics guidelines as applicable to areas of responsibility
X
X
2.2
Integrates the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) into practice, self-assessment, and professional development
X
X
X
2.2A
Uses the SOPP as a guide for management and leadership, self-evaluation, and professional development
X
X
X
2.2B
Uses the SOPP to develop and implement a plan to advance practice to a higher level of competence
X
X
X
2.3
Demonstrates and documents competence in practice and delivery of patient/client/customer-centered service
X
X
X
2.3A
Implements quality practice by following an evidence-based/best practice approach that includes adhering to credentialing, licensure, and regulatory requirements; competency standards; policies, procedures, and practice guidelines
X
X
X
2.3B
Models customer service behaviors in delivering patient/client/customer-centered service
X
X
X
2.3C
Incorporates customer service competencies into staff development and performance evaluations
X
X
2.3D
Defines competencies for patient/client/customer-centered service in areas of responsibility
X
2.4
Assumes accountability and responsibility for actions and behaviors
X
X
X
2.4A
Acknowledges and corrects errors
X
X
X
2.4B
Monitors accountability and behaviors for areas of responsibility
X
X
2.4C
Defines corrective actions for critical errors and behaviors in areas of responsibility consistent with organization policies
X
X
2.5
Conducts self-assessment at regular intervals
X
X
X
2.5A
Identifies needs for professional development
X
X
X
2.5B
Evaluates level of practice to determine whether additional skill sets and knowledge are needed for advancing practice
X
X
X
2.5C
Reviews skills and knowledge to determine whether they meet future market expectations
X
X
X
2.6
Designs and implements plans for professional development
X
X
X
2.6A
Documents professional development activities in career portfolio
X
X
X
2.6A1
Develops a plan to acquire knowledge and skills to meet future market expectations
X
X
X
2.6B
Documents professional development activities as per organization guidelines
X
X
X
2.6C
Maintains continuing education and lifelong learning in current areas of practice
X
X
X
2.6D
Assesses staff needs for professional development and develops opportunities for growth and training
X
X
2.6E
Designs career development programs in conjunction with organization and community needs
X
2.7
Engages in evidence-based practice and utilizes best practices
X
X
X
2.7A
Evaluates evidence-based practices for application to services provided (eg, healthy eating guidelines, sustainability practices, use of social media for consumer outreach)
X
X
X
2.7B
Applies evidence-based practice models in areas of responsibility
X
X
X
2.7C
Shares research data and activities to meet patient's/client's needs
X
X
X
2.7D
Designs new practice models for testing and application
X
X
2.7E
Promotes best practices to staff and other professionals internally and externally
X
2.8
Participates in peer review of self and others
X
X
X
2.9
Mentors others
X
X
X
2.9A
Seeks opportunities to serve as a mentor for management staff, entry-level management RDNs; dietetic technicians, registered; interns; and students
X
X
X
2.9B
Serves as preceptor for dietetic students, interns, and culinary students/apprentices
X
X
2.9C
Establishes mentoring and internship opportunities for entry-level RDNs and students/interns
X
X
2.9D
Serves as a mentor or preceptor outside of the profession
X
X
2.9E
Promotes the RDN food systems management role at the local, state, and national level
X
X
2.10
Pursues opportunities (education, training, credentials) to advance practice in accordance with laws and regulations and requirements of practice setting
X
X
X
2.10A
Acquires knowledge related to specifics of management practice
X
X
X
2.10A1
Uses major management publications to increase knowledge
X
X
X
2.10A2
Acquires knowledge of trends in systems, technology, research, equipment, and sustainability practices (eg, energy, water, waste management) to apply in practice
X
X
X
2.10B
Applies knowledge of regulatory issues (eg, health department rules and regulations, OSHA, Centers for Medicare and Medicaid Services [CMS]), and accreditation program standards (eg, The Joint Commission, Health Facilities Accreditation Program, Det Norske Veritas Healthcare) to management practice
X
X
X
2.10C
Expands scope of practice with increased job responsibilities
X
X
2.10D
Functions with autonomy within organization or practice
X
X
2.10E
Provides leadership to multiple departments/units
X
X
2.10F
Maintains expert knowledge base as applied to professional practice
X
Examples of Outcomes for Standard 2: Competence and Accountability
•
Practice reflects the Code of Ethics
•
Practice reflects the Standards of Practice and Standards of Professional Performance
•
Competence is demonstrated and documented
•
Safe, quality, patient/client-centered service is provided
•
Self-assessments are conducted regularly
•
Professional development needs are identified
•
Directed learning is demonstrated
•
Practice reflects evidence-based practice and best practices
•
Relevant opportunities (education, training, credentials, certifications) are pursued to advance practice
•
Commission on Dietetic Registration recertification requirements are met
Standard 3: Provision of Services The registered dietitian nutritionist (RDN) provides safe, quality service based on customer expectations and needs, and the mission and vision of the organization/business. Rationale: Quality programs and services are designed, executed, and promoted based on the RDN's knowledge, experience, and competence in addressing the needs and expectations of the organization/business and its customers.
Indicators for Standard 3: Provision of Services
Bold Font Indicators are Academy Core RDN Standards of Professional Performance Indicators
The “X” signifies the indicators for the level of practice
Each RDN:
Competent
Proficient
Expert
3.1
Contributes to or leads in development and maintenance of programs/services that address needs of the customer or target population(s)
X
X
X
3.1A
Aligns program/service development with the mission, vision, and service expectations and outputs of the organization/business
X
X
X
3.1A1
Employs management knowledge and leadership skills effectively and efficiently to meet the department and organization strategic plan
X
X
X
3.1A2
Manages functional units in areas of responsibility
X
X
X
3.1A3
Directs functional units in areas of responsibility
X
X
X
3.1A4
Prepares staff for necessary change
X
X
X
3.1B
Utilizes the needs, expectations, and desired outcomes of the customer (eg, patient/client, administrator, client organization[s]) in program/service development
X
X
X
3.1B1
Applies creative thinking and decision making to influence and achieve organization goals and objectives
X
X
X
3.1B2
Participates in organizational development of quality improvement programs and strategic and business planning
X
X
3.1B3
Uses complex decision-making skills at a higher level of risk to the organization (eg, new program development impacting broader organization, complex changes in service delivery models, opening/closing units of operation)
X
X
3.1B4
Defines departmental standards to support the organization's efforts for excellence
X
X
3.1C
Proposes programs and services that are patient/client-centered, culturally appropriate, and minimize health disparities
X
X
X
3.1D
Makes decisions and recommendations that reflect stewardship of time, talent, finances, and environment
X
X
X
3.1D1
Maintains budgetary control
X
X
X
3.1D2
Maintains statistical reports, performance reports, and financial data
X
X
X
3.1D3
Monitors storage procedures for temperature control, sanitation, and safety of food and supplies
X
X
X
3.1D4
Compares received items against specifications and invoices
X
X
X
3.1D5
Manages resources of significant value
X
X
3.1D6
Creates teams to address quality, productivity, and operational issues to achieve desired performance outcomes
X
X
3.1D7
Leads the process of developing, monitoring, and evaluating the use of guidelines, programs, resources, and change
X
X
3.1D8
Prepares operating budget and capital requests
X
X
3.1D9
Compares operating budget data with budget forecast and reconciles discrepancies
X
X
3.1D10
Conducts financial analysis and audits for all financial functions (eg, budgets, products, supplies, and equipment)
X
X
3.1D11
Writes specifications for food supplies and equipment
X
X
3.1D12
Maintains cost controls to meet budget projections
X
X
3.1D13
Represents the organization on purchasing groups consortium
X
X
3.1D14
Implements an inventory system that meets the organization's needs
X
X
3.1D15
Selects vendors and/or purchasing groups to meet financial plan, budget, and sustainability of products
X
X
3.1D16
Evaluates the need for an ingredient control system for production
X
X
3.1D17
Determines priorities and funding sources for implementation of programs and equipment purchases for food and nutrition
X
X
3.1E
Designs emergency preparedness program
X
X
3.1F
Develops contingency plans for emergencies and disasters, bioterrorism, and pandemics for the safe and sanitary production and service of food to personnel, volunteers, and customers
X
X
3.2
Promotes public access and referral to credentialed dietetics practitioners for quality food and nutrition programs and services
X
X
X
3.2A
Contributes to or designs referral systems that promote access to qualified, credentialed dietetics practitioners
X
X
X
3.2B
Refers customers to appropriate providers when requested services or identified needs exceed the RDN's individual scope of practice
X
X
X
3.2C
Monitors effectiveness of referral systems and modifies as needed to achieve desirable outcomes
X
X
X
3.3
Contributes to or designs customer-centered services
X
X
X
3.3A
Assesses needs, beliefs/values, goals, and resources of the customer
X
X
X
3.3A1
Conducts surveys, focus groups, or uses other assessment tools to determine customer needs
X
X
X
3.3A2
Designs needs assessment tools to survey target audiences for program development
X
3.3A3
Uses analytic tools to interpret needs of target audiences
X
3.3B
Utilizes knowledge of the customer's/target population's health conditions, cultural beliefs, and business objectives/services to guide design and delivery of customer-centered services
X
X
X
3.3B1
Designs a marketing program for food and nutrition service operations
X
X
3.3C
Communicates principles of disease prevention and behavioral change appropriate to the customer or target population
X
X
X
3.3C1
Develops menus that are evidenced-based for disease treatment and prevention
X
X
X
3.3C2
Advocates behavioral nutrition principles to target audiences related to disease treatment and prevention
X
X
X
3.3C3
Applies knowledge and principles of disease prevention and food science for diverse populations
X
X
X
3.3C4
Utilizes current food science principles for recipe development, food production, and service
X
X
X
3.3C5
Develops programs for target audiences in relation to nutritional interventions addressing disease treatment and prevention
X
X
3.3D
Collaborates with customers to set priorities, establish goals, and create patient/client/customer-centered action plans to achieve desirable outcomes
X
X
X
3.3E
Involves customers in decision making
X
X
X
3.3E1
Interviews customers to determine needs
X
X
X
3.3E2
Communicates decisions affecting customers with appropriate tools
X
X
X
3.4
Executes programs/services in an organized, collaborative, and customer-centered manner
X
X
X
3.4A
Collaborates and coordinates with peers, colleagues, and within interdisciplinary teams
X
X
X
3.4A1
Works in interdisciplinary teams to coordinate areas of responsibility
X
X
X
3.4A2
Leads interdisciplinary teams in areas of responsibility
X
X
3.4B
Participates in or leads in the design, execution, and evaluation of programs and services (eg, nutrition screening system, medical and retail foodservice, electronic health records, interdisciplinary programs, community education) for customers
X
X
X
3.4C
Develops or contributes to design and maintenance of policies, procedures, protocols, standards of care, technology resources, and training materials that reflect evidence-based practice in accordance with applicable laws and regulations
X
X
X
3.4C1
Ensures compliance with established policies, procedures, protocols, standards of care, technology resources, and training material that reflect evidence-based practice
X
X
X
3.4C2
Develops policies, procedures, protocols, standards of care, technology resources, and training that reflect evidence-based practice
X
X
3.4D
Participates in or develops process for clinical privileges required for expanded roles and enhanced activities (eg, implement physician-driven protocols to initiate or modify orders for diet, nutrition supplements, dietary supplements, enteral and parenteral nutrition, nutrition-related laboratory tests, and medications) consistent with state practice acts, regulations, organization policies, and medical staff bylaws, if applicable
X
X
X
3.4E
Complies with established billing regulations and adheres to ethical billing practices
X
X
X
3.4E1
Develops pricing standards for goods and services for customers
X
X
X
3.4E2
Authorizes pricing for products, services, and menu items
X
X
3.4E3
Establishes methodologies for cash handling and billing procedures
X
X
3.4F
Communicates with the interdisciplinary team and referring party consistent with the Health Insurance Portability and Accountability Act (HIPAA) rules for use and disclosure of customer's personal health information
X
X
X
3.4F1
Complies with HIPAA concepts in areas of responsibility
X
X
X
3.4F2
Communicates to staff HIPAA concepts for areas of responsibility
X
X
X
3.4F3
Develops programs for HIPAA compliance for areas of responsibility
X
X
X
3.5
Utilizes support personnel appropriately in the delivery of customer-centered care in accordance with laws, regulations, and organization policies
X
X
X
3.5A
Assigns activities, including direct care to patients/clients, consistent with the qualifications, experience, and competence of support personnel
X
X
X
3.5A1
Ensures adequate staffing for areas of responsibility
X
X
X
3.5A2
Schedules support personnel for meeting needs of patients/clients/customers
X
X
X
3.5A3
Adjusts staffing of support personnel to meet organization mission and needs
X
X
3.5B
Supervises support personnel
X
X
X
3.5B1
Coaches support personnel to meet organization mission
X
X
X
3.5B2
Provides developmental training for support personnel
X
X
X
3.5B3
Conducts performance review of support personnel according to organization policy
X
X
X
3.5B4
Disciplines support personnel due to evidence of noncompliance with department or organization policy
X
X
X
3.6
Designs and implements food delivery systems to meet the needs of customers
X
X
X
3.6A
Collaborates on or designs food delivery systems to address nutrition status, health care needs, and outcomes, and to satisfy the cultural preferences and desires of target populations (eg, health care patients/clients, employee groups, visitors to retail venues)
X
X
X
3.6A1
Provides highest-quality service based on requirements of the facility, customer expectations
X
X
X
3.6A2
Utilizes manpower, machines, money, and innovative approaches to exceed both internal and external customers'/clients' needs and expectations
X
X
X
3.6A3
Applies knowledge and skills to determine the most appropriate action plan
X
X
X
3.6A4
Implements meal service delivery systems for all customers
X
X
X
3.6A5
Directs catering events
X
X
X
3.6A6
Ensures safety of clients/customers in relation to facility design and operation
X
X
3.6A7
Designs meal service delivery systems for all customers
X
X
3.6B
Participates in, consults with others, or leads in developing menus to address health and nutritional needs of target population(s)
X
X
X
3.6B1
Serves well-prepared, safe, hot and cold foods to customers to meet their needs and wants
X
X
X
3.6B2
Develops standardized recipes; modifies for individual and group needs and acceptability
X
X
X
3.6B3
Develops master menus with modifications to address health and nutrition needs of target population(s)
X
X
X
3.6B4
Evaluates menus for acceptability, compliance with nutritional parameters, cost, and sustainability
X
X
X
3.6B5
Monitors and evaluates healthy promotion menu for sales and marketing outcomes; realigns to improve program
X
X
3.6C
Participates in, consults, or leads interdisciplinary process for determining nutritional supplements, dietary supplements, enteral and parenteral nutrition formularies, and delivery systems for target population(s)
X
X
X
3.6C1
Collaborates with interdisciplinary team in the development of medical nutrition formularies and supply sources
X
X
3.7
Maintains records of services provided
X
X
X
3.7A
Documents according to organization policy, standards, and system including electronic health records
X
X
X
3.7A1
Applies Hazard Analysis and Critical Control Points principles to provide safe and sanitary food and supplies; emphasizes that employees follow personal hygiene codes
X
X
X
3.7A2
Maintains records of food safety and sanitation in accordance with government regulations and accrediting agency standards
X
X
X
3.7B
Implements data-management systems to support data collection, maintenance, and utilization
X
X
X
3.7B1
Utilizes information technology to improve operations
X
X
X
3.7B2
Determines needs for improvement in data-management systems
X
X
3.7B3
Evaluates cost/benefit of new or replacement data-management systems
X
3.7C
Uses data to document outcomes of services (eg, staff productivity, cost/benefit, budget compliance, quality of services) and provide justification for maintenance or expansion of services
X
X
X
3.7C1
Compiles data for benchmarking outcomes of service
X
X
X
3.7C2
Utilizes forecasting methods to save resources
X
X
X
3.7C3
Interprets benchmarking data to explain outcomes of services
X
X
3.7C4
Develops forecasting methodologies
X
3.7C5
Chooses the best food production system
X
3.7D
Uses data to demonstrate compliance with accreditation standards, laws, and regulations
X
X
X
3.8
Advocates for provision of quality food and nutrition services as part of public policy
X
X
X
3.8A
Communicates with policy makers regarding the benefit/cost of quality food and nutrition services
X
X
X
3.8A1
Determines needs for new programs, equipment, or systems to support food and nutrition services
X
X
3.8A2
Conducts cost benefit analysis of new programs, equipment, or systems for food and nutrition services
X
X
3.8B
Advocates in support of food and nutrition programs and services for populations with special needs
X
X
X
3.8B1
Collaborates with interdisciplinary teams to advocate for appropriate services for populations with special needs
X
X
3.8C
Participates in food safety and security advocacy activities
X
X
X
Examples of Outcomes for Standard 3: Provision of Services
•
Program/service design and systems reflect organization/business and customer needs and expectations
•
Customers participate in establishing goals and customer-focused action plans
•
Customers needs are met
•
Customers are satisfied with services and products
•
Evaluations reflect expected outcomes
•
Effective screening and referral services are established
•
Customers have access to food assistance
•
Customers have access to food and nutrition services
•
Support personnel are supervised when providing nutrition care to customers
•
Ethical billing practices are utilized
Standard 4: Application of Research The registered dietitian nutritionist (RDN) applies, participates in or generates research to enhance practice. Evidence-based practice incorporates the best available research/evidence in the delivery of nutrition and dietetics services. Rationale: Application, participation and generation of research promote improved safety and quality of nutrition and dietetics practice and services.
Indicators for Standard 4: Application of Research
Bold Font Indicators are Academy Core RDN Standards of Professional Performance Indicators
The “X” signifies the indicators for the level of practice
Each RDN:
Competent
Proficient
Expert
4.1
Accesses and reviews best available research/evidence for application to dietetics practice
X
X
X
4.1A
Reviews current literature and industry trends to identify best practices
X
X
X
4.1B
Demonstrates understanding of research design and methodology
X
X
X
4.1C
Understands how to interpret results and study outcomes
X
X
4.2
Utilizes best available research/evidence as the foundation for evidence-based practice
X
X
X
4.2A
Encourages the use of evidence-based tools and resources as the basis for integration into current practice
X
X
X
4.2B
Interprets current research as applicable to practice
X
X
4.3
Integrates best available research/evidence with best practices, clinical/ managerial expertise, and customer values
X
X
X
4.3A
Applies evidence-based research results as a foundation for practice
X
X
X
4.3B
Participates in the implementation of new knowledge and research in dietetics
X
X
X
4.3C
Supports staff awareness and incorporates evidence-based practices into program policies, protocols, and staff development
X
X
4.3D
Leads the development of program protocols, policies, procedures, and staff development programs and materials
X
4.4
Contributes to the development of new knowledge and research in nutrition and dietetics
X
X
X
4.4A
Maintains awareness of research in nutrition and dietetics through a variety of resources (eg, Evidence Analysis Library) and continuing education activities
X
X
X
4.4B
Identifies research issues/questions related to areas of responsibility
X
X
X
4.4C
Participates in or conducts research following ethical standards
X
X
X
4.4D
Shares best practice ideas/interventions that improve foodservice systems
X
X
4.4E
Participates in practice-based research networks
X
X
4.4F
Designs market research in practice field to determine best practice and customer expectations
X
X
4.4G
Participates in studies on management topics for publication
X
X
4.4H
Initiates research relevant to management practice as the primary investigator or as a collaborator with other members of the team
X
4.4I
Designs and conducts research projects to investigate opportunities to improve foodservice processes
X
4.4J
Designs and implements research studies to examine the benefits on cost/quality from enhanced foodservice processes
X
4.4K
Creates a culture supporting management-based research
X
4.4L
Contributes significantly to body of knowledge regarding food and nutrition systems management
X
4.5
Promotes research through alliances and collaboration with food and nutrition and other professionals and organizations
X
X
X
4.5A
Encourages professional staff to join pertinent professional organizations to promote evidence-based practice
X
X
X
4.5B
Actively participates in professional organizations to promote evidence-based practices
X
X
X
4.5C
Assumes a leadership role in professional organizations on the local or regional level to promote evidence-based practice and research
X
X
4.5D
Assumes a leadership role in professional organizations on the national level
X
Examples of Outcomes for Standard 4: Application of Research
•
Patients/clients receive appropriate services based on the effective application of best available research/evidence
•
Best available research/evidence is used as the foundation of evidence-based practice
•
Evidence-based practice, best practices, clinical and managerial expertise, and patient/client values are integrated in the delivery of nutrition and dietetics services
Standard 5: Communication and Application of Knowledge The registered dietitian nutritionist (RDN) effectively applies knowledge and expertise in communications. Rationale: The RDN works with and through others to achieve common goals by effective sharing and application of their unique knowledge, skills, and expertise in food, nutrition, dietetics, and management services.
Indicators for Standard 5: Communication and Application of Knowledge
Bold Font Indicators are Academy Core RDN Standards of Professional Performance Indicators
The “X” signifies the indicators for the level of practice
Each RDN:
Competent
Proficient
Expert
5.1
Communicates current, evidence-based knowledge related to a particular aspect of the profession of nutrition and dietetics
X
X
X
5.1A
Communicates current evidence-based management knowledge to staff and others
X
X
X
5.2
Communicates and applies best available research/evidence
X
X
X
5.2A
Demonstrates critical thinking and problem-solving skills when communicating with others
X
X
X
5.2B
Shares performance objectives during orientation of new employees and on routine basis with all staff
X
X
X
5.2C
Demonstrates the ability to integrate new knowledge into program processes
X
X
5.2D
Provides professional development opportunities in critical thinking for staff
X
X
5.2E
Demonstrates the ability to apply new knowledge of management systems in new and varied contexts at an advanced level
X
5.3
Selects appropriate information and most effective method or format when communicating information
X
X
X
5.3A
Utilizes communication methods (ie, oral, print, one-on-one, group, visual, electronic, and social media) targeted to audience
X
X
X
5.3A1
Shares information with staff using respectful, supportive methods
X
X
X
5.3B
Uses information technology to communicate, manage knowledge, and support decision making
X
X
X
5.3B1
Accesses electronic health records within work setting consistent with responsibilities, if applicable
X
X
X
5.3B2
Participates in or determines electronic foodservice management systems used in operations (eg, purchasing, inventory management, recipe and menu development and nutritional analysis, patient/resident services [eg, room service systems], retail venues [eg, cash registers, catering billing, event room scheduling])
X
X
5.4
Integrates knowledge of food and nutrition with knowledge of health, social sciences, communication, and management in new and varied contexts
X
X
X
5.4A
Provides effective interpretation of management systems to staff
X
X
X
5.4B
Articulates effective interpretation of management systems to interdisciplinary teams and community
X
X
5.5
Shares current, evidence-based knowledge, information with patients/clients, staff, colleagues, and the public
X
X
X
5.5A
Guides patients/clients, staff, students, and interns in the application of knowledge and skills
X
X
X
5.5B
Assists individuals and groups to identify and secure appropriate and available resources and services
X
X
X
5.5B1
Defines and makes available to staff and clients reliable sources of information
X
X
X
5.5B2
Utilizes social media to convey accurate information to staff and clients following professional and organization guidelines
X
X
X
5.5B3
Presents information at appropriate level of understanding of patients/clients and staff
X
X
X
5.5C
Utilizes professional writing and verbal skills in communications
X
X
X
5.5C1
Utilizes appropriate written and oral language in all communication
X
X
X
5.5C2
Uses written communication tools that succinctly informs staff and colleagues of important information
X
X
X
5.5C3
Demonstrates professional writing skills in communicating new knowledge and research in nutrition and dietetics
X
X
5.6
Establishes credibility and contributes as a resource within the interdisciplinary health care and management team promoting food and nutrition strategies that enhance health and quality of life outcomes of target populations
X
X
X
5.6A
Creates a positive, patient/client/customer-focused work environment by leading teams with courtesy, focus to detail and commitment
X
X
X
5.6B
Cultivates internal and external networking relationships that foster both individual and organizational goals
X
X
X
5.6C
Utilizes formal and informal communication methods to maintain employee awareness of personal and departmental improvements
X
X
X
5.6C1
Recognizes personal achievement of staff within the department and facility
X
X
X
5.6D
Demonstrates ability to communicate strategies to improve patient/client/customer satisfaction
X
X
5.7
Communicates performance improvement and research results through publications and presentations
X
X
X
5.7A
Shares performance improvement and research data and activities to meet staff and patient's/client's/customer's needs
X
X
X
5.7B
Publishes performance improvement results in organization newsletter
X
X
X
5.7B1
Publishes performance improvement results in community publications
X
X
5.7B2
Presents process improvement results in professional newsletters or journals or through presentations
X
5.7C
Presents evidence-based research at the local level
X
X
X
5.7D
Writes for food-management publications
X
X
5.7E
Serves in a leadership role for foodservice-management publications (eg, reviewer, editorial board, editor)
X
5.8
Seeks opportunities to participate in and assume leadership roles in local, state, and national professional and community-based organizations
X
X
X
5.8A
Serves in a leadership role in professional dietetics, food, foodservice-related associations and organizations
X
X
X
5.8A1
Serves in a leadership role in local dietetics, food, foodservice, or community organizations
X
X
X
5.8A2
Serves in a leadership role in state affiliate dietetics, food, foodservice, or community organizations
X
X
5.8A3
Serves in a leadership role in professional organizations related to food and nutrition management
X
5.8B
Contributes food systems management expertise to community-based organizations, advisory boards, nonprofit organizations addressing food system issues (eg, local food system, community health initiatives, food insecurity, sustainability)
X
X
5.8C
Participates in food systems management program planning at the state and national level
X
X
Examples of Outcomes for Standard 5: Communication and Application of Knowledge
•
Expertise in food, nutrition, and management is demonstrated and shared
•
Information technology is used to support practice
•
Individuals and groups:
•
Receive current and appropriate information and customer-centered service
•
Demonstrate understanding of information received
•
Know how to obtain additional guidance from the RDN
•
Leadership is demonstrated through active professional and community involvement
Standard 6: Utilization and Management of Resources The registered dietitian nutritionist (RDN) uses resources effectively and efficiently. Rationale: The RDN demonstrates leadership through strategic management of time, finances, facilities, supplies, technology, and human resources.
Indicators for Standard 6: Utilization and Management of Resources
Bold Font Indicators are Academy Core RDN Standards of Professional Performance Indicators
The “X” signifies the indicators for the level of practice
Each RDN:
Competent
Proficient
Expert
6.1
Uses a systematic approach to manage resources and improve operational outcomes
X
X
X
6.1A
Develops staffing model to meet service and facility needs and accountability for resources
X
X
X
6.1A1
Implements staffing model
X
X
X
6.1A2
Develops job analysis, job descriptions to meet service needs
X
X
X
6.1A3
Implements job descriptions that meet regulatory requirements
X
X
X
6.1A4
Administers performance evaluations in area of responsibility for effective job development and improved performance
X
X
X
6.1A5
Conducts orientation, in services education, and training to support employee performance
X
X
X
6.1A6
Provides staff coaching and corrective action as appropriate
X
X
X
6.1A7
Terminates staff when job performance does not meet performance standards and/or competences
X
X
X
6.1A8
Plans and uses time prudently
X
X
X
6.1A9
Champions diversity and generational differences in team building to create a climate of inclusion and dynamic creativity
X
X
X
6.1A10
Applies negotiation and risk-management skills in contract and labor relations
X
X
6.1B
Develops procedures for evaluation and documentation of resource use and needs
X
X
X
6.1B1
Participates in renovation or new construction of department including layout, design, and equipment selection
X
X
X
6.1B2
Determines equipment cleaning/functional ability and preventative maintenance program
X
X
X
6.1C
Leads in strategic and operational planning
X
X
6.2
Quantifies management of resources in the provision of nutrition and dietetics services with the use of standardized performance measures and benchmarking as applicable
X
X
X
6.2A
Controls the use of measurable resources in the provision of services based on a budget
X
X
X
6.2A1
Implements strategies for expense adjustments in relation to volumes and organizational goals
X
X
X
6.2A2
Coordinates purchasing contracts to optimize food, equipment, and supply cost savings
X
X
X
6.2A3
Investigates opportunities for local purchasing of produce
X
X
X
6.2A4
Evaluates the staffed hours needed to meet the production and service needs
X
X
X
6.2A5
Compares the human resource assets with potential technology available to meet production needs
X
X
6.2A6
Designs strategies for adjusting expenses in relation to volumes and organizational goals
X
X
6.3
Evaluates safety, effectiveness, productivity, and value when planning and delivering services and products
X
X
X
6.3A
Develops processes to promote effective, timely delivery of products and services
X
X
X
6.3B
Designs a programmatic approach to promote a culture of safety in the area, including education and performance evaluation
X
X
X
6.3C
Implements a programmatic safety plan, including an area-specific safety task force
X
X
X
6.3D
Complies with local, state, and federal regulatory agencies (eg, CMS, OSHA) and accreditation organizations (eg, The Joint Commission) as related to safety standards
X
X
X
6.3E
Implements programs for the control of microbial, chemical and physical hazards following the state or FDA Food Code
X
X
X
6.3F
Assesses and designs worksites and layouts to maximize productivity, ergonomic improvement, and safety
X
X
6.3G
Evaluates food production and service workflows against published workflow best practices
X
X
6.4
Participates in quality assurance and performance improvement (QAPI) and documents outcomes and best practices relative to resource management
X
X
X
6.4A
Participates in QAPI program for department
X
X
X
6.4B
Seeks input from interdisciplinary team and others where responsibilities are shared
X
X
X
6.4C
Shares QAPI program with administration and interdisciplinary team
X
X
X
6.4D
Measures outcomes
X
X
X
6.4E
Follows accreditation survey quality standards
X
X
X
6.4F
Develops QAPI program for area of responsibility
X
X
6.4G
Authors articles and training programs for food and nutrition industry publications
X
6.5
Measures and tracks trends regarding patient/customer, employee, and stakeholder satisfaction in the delivery of products and services
X
X
X
6.5A
Administers satisfaction surveys to appropriate audiences
X
X
X
6.5B
Uses systemic process to collect data
X
X
X
6.5C
Analyzes data using basic statistical processes (eg, Likert scale)
X
X
X
6.5D
Uses data to improve services and utilize resources as appropriate
X
X
X
6.5E
Designs or joins customer satisfaction benchmarking programs
X
X
X
6.5E1
Publishes customer satisfaction survey methodology in appropriate food and nutrition publications
X
X
6.5F
Implements a continuous improvement effort program
X
X
X
6.5G
Designs productivity measures for department
X
X
X
6.5H
Implements measures of productivity
X
X
X
6.5I
Documents results of related productivity studies
X
X
X
6.5J
Refines program as necessary
X
X
X
Examples of Outcomes for Standard 6: Utilization and Management of Resources
•
Documentation of resource use is consistent with operation
•
Data are used to promote, improve, and validate services
American Dietetic Association Standards of Professional Performance for Registered Dietitians (Generalist and Advanced) in Management of Food and Nutrition Systems.
Academy of Nutrition and Dietetics Quality Management Committee and Scope of Practice Subcommittee of the Quality Management Committee
Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.
American Dietetic Association/Commission on Dietetic Registration Code of Ethics for the Profession of Dietetics and process for consideration of ethics issues.
R. M. Berthelsen is dean of health, biological & sports science, Iowa Western Community College, Council Bluffs.
W. C. Barkley is general manager and foodservice director, Sodexho Healthcare Management, The Children's Hospitals and Clinics, Kansas City, MO.
P. Oliver is director of nutrition, UCLA Healthcare, Los Angeles, CA.
V. McLymont is director of food and nutrition services, Memorial Sloan-Kettering Cancer Center, New York, NY.
R. Puckett is program director, Dietary Manager Training, Division of Continuing, Distance, and Executive Education, University of Florida, Gainesville.
