Milk PI/QA

My reason for choosing dairy handling as my performance improvement project was

multi-factorial. Both patients and staff were complaining that the milk often tasted 'off' and
seemed as if the it became spoiled well before the displayed expiration date. This phenomenon
has been an issue with the Prairie Farms' milk, ever since Lakeland Health changed from
Country Fresh to the former, to reduce its costs each year. In hindsight, this was a terrible idea
because of all the complaints that have been received since the switch, in addition to the loss of
money from wasted product. During the last few months of Prairie Farms milk deliveries, many
crates of milk, specifically whole milk was thrown out due to bad taste, resulting from spoilage
before the stated expiration date. There were no reported internal issues in terms of handling,
rotating, and documentation of the temperatures of delivered milk; which begs the question of
whether or not something was done to the milk throughout the delivery phase that would
result in premature spoilage. The purpose of this report is to assess the differences between
Prairie Farms and Country Fresh's milk in terms of patient satisfaction, as well as discrepancies
in milk expiration and temperature control and to improve the performance of all indicators of
quality milk.

In order to assess the validity of my findings, one must first understand how I embarked
on a five day quest to find out whether or not the staff at Lakeland is responsible for mediocre
milk quality, or if it is indeed an issue with external cofactors. Starting on Monday, September
11th, 2017, I arrived to the kitchen at 0600, under the impression that the milk delivery man
from Country Fresh would arrive between 0600 and 0800. Lakeland had just severed their
account with Prairie Farms the week before, and Country Fresh had just dropped off a small
delivery on skim milk on the 8th of September. This is done because many of the skim milks
from Prairie Farms was spoiled well before the written expiration date, so it was critical that
Country Farms stepped in, and quickly brought new milk for Lakeland's meal services. Once the
delivery finally arrived I assisted Ken, the stock employee at Lakeland, in placing the new milk
product into the second walk-in cooler and took the temperature of multiple milk cartons using
a digital probe thermometer, to assure that the milk was well below the minimum required
internal temperature of <41°F. The results from my internal temperature readings are
documented on the attached spreadsheet; beginning from the first delivery to the last day I
executed the performance improvement project, all internal temperatures of milk were below
the minimum required temp of <41°F.

Some of the differences in milk temperature documented throughout the attached

spreadsheet are indicative of checking internal temps of milk cartons at different times of each
day. For example, one day may have an internal temp of 40.2°F and the next may drop to
35.7°F; this is not an issue with the temp probe, but rather, a staff member may have just
restocked the refrigerator unit, resulting in the door being left open for a couple of minutes,
resulting in an increase in overall temperature. And conversely, when an internal temp is
relatively low one day, and high the next, this can simply result from checking the former's
temperature at an early time, or when the door has not been opened in quite some time. Many
of the dates documented in the attached spreadsheet are similar because the staff properly
rotated product by using old milk (closer expiration dates to current date) prior to milk that has
just been delivered. The data is clearly labeled throughout the spreadsheet, indicating the
temperature of the milk found in each refrigerator and the expiration dates of each carton
found within the cooling unit. On Monday and Thursday of the week of September 11th,
temperatures, expiration dates and number of cases delivered were documented, while the
other days were not applicable to the same quality assurance standards. The numbers cited
underneath each floor represent the dates found on each milk carton; for example, under
column BH for the 11th, the dates of milk for each type of product was the 27th, 15th, 26th,
16th, and 26th. Additionally, each fridge temperature was recorded and documented on the
top of each floor number and room.

I was surprised to discover that none of the temperatures that I monitored throughout
the week were above the minimum internal temperature of 41°F. This is clear evidence that the
staff at Lakeland is competent in their ability to properly store, deliver and maintain great
quality and efficacy of the milk in the hospital. Throughout the week, there may have been a
few cartons of milk that were improperly rotated, due to there being two different shipments
conflicting with each other, but I fixed any mistakes and made corrective action when
necessary. With this said, none of the internal parameters that could cause potential spoilage of
milk were met. Some of the possibilities that could have caused issues in terms of patient
satisfaction and tolerance would include poor cooling while transporting to floors, poor
rotation of product as well as the improper cooling of milk in each corresponding refrigerator
unit.

The outcome of this assignment has proved to be successful, showing direct evidence
that the staff at Lakeland shows competency in rotating stock, being aware of expiration dates,
proper handling and cooling of milk as well as the steps to take when spoilage occurs. By
executing a milk quality assurance and performance improvement project, this is a clear
indicator that all internal factors are heavily controlled, and any issues with milk quality is
strictly based on external events. By following the proposed HACCP plan I developed specifically
for Lakeland, patient satisfaction should improve and waste should be minimized.