Running head: CQI PROJECT 19

Appendix C. Written Data Collection Tool

Data Collection Tool

Day:____________________________________________
Number of diet office clerks: ________________________
Number of tray line employees: ______________________
Number of hosts: _________________________________
Total number of late trays:__________________

Tray 1:
Diet type:______________________
Time call was made:__________________
Time tray assembly started:______________
Time cold food plated:____________________
Time hot food plated:_____________________
Time tray placed on cart:___________________
Time tray left kitchen:_____________________
Time tray arrived at patient room:___________
Total time for tray 1 delivery:_______________

Tray 2:
Diet type:___________________________
Time call was made:_____________________
Time tray assembly started:_______________
Time cold food plated:____________________
Time hot food plated:____________________
Time tray placed on cart:__________________
Time tray left kitchen:____________________
Time tray arrived at patient room:___________
Total time for tray 2 delivery:______________

Tray 3:
Diet type:____________________
Time call was made:____________________
Time tray assembly started:_______________
Time cold food plated:____________________
Time hot food plated:_____________________
Time tray placed on cart:__________________
Time tray left kitchen:____________________
Time tray arrived at patient room:__________
Total time for tray 3 delivery:______________
Running head: CQI PROJECT 20

Appendix D. Compiled Data in Excel Sheet

Day (in
March) Total Trays Delivered Late Number of Hosts
1 83 3
2 100 4
3 63 4
6 74 4
7 43 4
8 34 3
9 29 4
10 45 3
13 12 4
14 39 4
15 11 4
16 60 4
17 2 4
20 18 3
21 8 4
22 11 3
23 16 4
24 26 3
27 28 3
28 17 3
29 36 3