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Diet & Nutrition Use Cases

Implementation Note: Diet management integrates with patient clinical data for therapeutic diet planning. Supports kitchen operations, meal tracking, and nutritionist workflows per hospital protocols.

UC-DIET-001: Create Diet Order

Purpose: Physician/Nutritionist creates diet order for admitted patient.

Property Value
Actor Physician / Nutritionist
Trigger Patient admission or diet change needed
Priority P0

Main Success Scenario: 

1. Identify patient:
   - IPD patient details
   - Current admission
2. Select diet type:
   - Regular diet
   - Therapeutic diets:
     - Diabetic diet
     - Renal diet
     - Cardiac diet
     - Low sodium
     - Soft/Liquid
     - NPO (Nil Per Oral)
3. Specify modifications:
   - Calorie restriction
   - Fluid restriction
   - Food allergies
   - Religious/cultural preferences
4. Set meal schedule:
   - Breakfast, Lunch, Dinner
   - Snacks/Supplements
   - Timing for specific conditions
5. Document clinical rationale:
   - Diagnosis-linked
   - Specific targets (e.g., blood sugar control)
6. Submit order:
   - Notify dietitian
   - Notify kitchen
7. Track order status:
   - Acknowledged
   - In preparation
   - Delivered

Acceptance Criteria: 1. [ ] Diet type templates 2. [ ] Allergy/restriction flagging 3. [ ] Meal timing configuration 4. [ ] Kitchen notification 5. [ ] Diet order in patient record

India-Specific: - Vegetarian/Non-vegetarian preference - Regional cuisine options (South Indian, North Indian) - Jain/Sattvic diet options

UC-DIET-002: Nutritional Assessment

Purpose: Conduct comprehensive nutritional assessment for patient.

Property Value
Actor Dietitian/Nutritionist
Trigger Admission or nutrition consult request
Priority P1

Main Success Scenario: 

1. Collect anthropometric data:
   - Height, Weight, BMI
   - Waist circumference
   - Mid-arm circumference
   - Triceps skinfold (if applicable)
2. Assess nutritional status:
   - Malnutrition screening (MUST, NRS-2002)
   - Recent weight changes
   - Appetite assessment
3. Dietary history:
   - Usual intake pattern
   - Food preferences
   - Meal frequency
4. Clinical correlation:
   - Relevant diagnoses
   - Lab values (albumin, prealbumin)
   - GI function
5. Calculate requirements:
   - Calorie needs (Harris-Benedict/Mifflin)
   - Protein requirements
   - Fluid needs
6. Generate assessment report:
   - Nutritional diagnosis
   - Recommendations
   - Intervention plan
7. Care plan integration:
   - Share with care team
   - Set monitoring goals

Acceptance Criteria: 1. [ ] Screening tools (MUST, NRS-2002) 2. [ ] Calorie calculators 3. [ ] Auto-pull from vitals/labs 4. [ ] Assessment documentation 5. [ ] Care plan linkage

UC-DIET-003: Menu Planning & Kitchen Production

Purpose: Generate daily menu and kitchen production requirements.

Property Value
Actor Kitchen Manager / Dietitian
Trigger Daily planning cycle
Priority P1

Main Success Scenario: 

1. Generate daily patient census:
   - Diet orders by type
   - Bed-wise meal requirements
2. Create production plan:
   - Aggregate by diet type
   - Portion counts
   - Special preparations
3. Inventory check:
   - Raw material availability
   - Shortage alerts
   - Purchase requisitions
4. Staff allocation:
   - Cooking assignments
   - Shift planning
5. Generate meal tickets:
   - Patient name, Bed number
   - Diet type
   - Special instructions
   - Delivery time
6. Quality checks:
   - Temperature logging
   - Taste testing
   - Portion verification
7. Dispatch coordination:
   - Ward-wise grouping
   - Delivery schedule

Acceptance Criteria: 1. [ ] Automated diet order aggregation 2. [ ] Production quantity calculation 3. [ ] Inventory integration 4. [ ] Meal ticket generation 5. [ ] Temperature logging

UC-DIET-004: Meal Delivery & Tracking

Purpose: Track meal preparation, delivery, and consumption.

Property Value
Actor Kitchen Staff / Ward Staff
Trigger Meal preparation complete
Priority P1

Main Success Scenario: 

1. Kitchen marks ready:
   - Meal prepared
   - Quality checked
   - Temperature logged
2. Dispatch meal:
   - Trolley loading
   - Ward assignment
   - Departure time
3. Ward delivery:
   - Nurse receives meals
   - Verifies patient list
   - Delivery confirmation
4. Patient receives meal:
   - Correct diet verified
   - Patient identification
   - Meal served
5. Consumption tracking:
   - Fully consumed
   - Partially consumed (%)
   - Not consumed (reason)
6. Feedback capture:
   - Taste satisfaction
   - Portion adequacy
   - Special requests
7. Report intake issues:
   - Alert dietitian if poor intake
   - Document concerns

Acceptance Criteria: 1. [ ] Delivery timestamp tracking 2. [ ] Consumption logging 3. [ ] Poor intake alerts 4. [ ] Patient feedback capture 5. [ ] Kitchen-ward communication

UC-DIET-005: Enteral Feeding Management

Purpose: Manage tube feeding orders and administration.

Property Value
Actor Physician / Dietitian / Nurse
Trigger Patient requires enteral nutrition
Priority P1

Main Success Scenario: 

1. Physician orders enteral feeding:
   - Feeding route (NG, NJ, PEG, PEJ)
   - Formula type
   - Rate and duration
2. Dietitian calculates:
   - Calorie goals
   - Protein targets
   - Fluid from feeds
3. Create feeding schedule:
   - Bolus vs. continuous
   - Flush volumes
   - Rate progression
4. Nursing administration:
   - Verify tube position
   - Set up feeding pump
   - Monitor tolerance
5. Tolerance monitoring:
   - Residual volumes
   - Abdominal distension
   - Diarrhea/vomiting
6. Adjust as needed:
   - Rate changes
   - Formula changes
   - Transition planning
7. Document feeding log:
   - Volume delivered
   - Tolerance notes
   - Calorie/protein achieved

Acceptance Criteria: 1. [ ] Enteral formula database 2. [ ] Pump rate calculations 3. [ ] Tolerance documentation 4. [ ] Feeding log 5. [ ] Goal vs. actual tracking

UC-DIET-006: Parenteral Nutrition Order

Purpose: Order and manage total parenteral nutrition (TPN).

Property Value
Actor Physician / Clinical Pharmacist
Trigger Patient requires IV nutrition
Priority P1

Main Success Scenario: 

1. Assess TPN need:
   - NPO status
   - GI dysfunction
   - Malnutrition severity
2. Calculate TPN requirements:
   - Calories (dextrose, lipid)
   - Amino acids (protein)
   - Electrolytes
   - Vitamins, Trace elements
3. Create TPN order:
   - Component concentrations
   - Total volume
   - Infusion rate
4. Pharmacy review:
   - Stability check
   - Compatibility verification
   - Compounding plan
5. Administration:
   - Central line verification
   - Filter use
   - Rate settings
6. Monitoring:
   - Blood glucose (q6h initially)
   - Electrolytes
   - LFTs (weekly)
   - Triglycerides
7. Adjust and transition:
   - Daily reassessment
   - Transition to enteral when able

Acceptance Criteria: 1. [ ] TPN calculator 2. [ ] Pharmacy workflow integration 3. [ ] Monitoring protocol 4. [ ] Lab tracking 5. [ ] Transition planning

UC-DIET-007: Dietary Counseling

Purpose: Provide patient education on therapeutic diets.

Property Value
Actor Dietitian
Trigger Discharge planning or outpatient consult
Priority P2

Main Success Scenario: 

1. Identify counseling need:
   - New diagnosis (diabetes, CKD, cardiac)
   - Pre-discharge education
   - Follow-up reinforcement
2. Prepare counseling materials:
   - Diet-specific guidelines
   - Sample meal plans
   - Food lists (allowed/avoid)
3. Conduct counseling session:
   - Explain diet rationale
   - Demonstrate portion sizes
   - Address questions
   - Cultural adaptations
4. Provide take-home materials:
   - Printed diet sheet
   - Mobile app recommendations
   - Recipe suggestions
5. Document counseling:
   - Topics covered
   - Patient understanding
   - Follow-up plan
6. Schedule follow-up:
   - OPD nutrition follow-up
   - Telemedicine option

Acceptance Criteria: 1. [ ] Diet education templates 2. [ ] Multi-language materials 3. [ ] Counseling documentation 4. [ ] Digital material sharing 5. [ ] Follow-up scheduling

India-Specific: - Regional food adaptations - Fasting practices consideration - Vegetarian alternatives - Cost-effective meal planning

UC-DIET-008: Kitchen Hygiene & FSSAI Compliance

Purpose: Maintain food safety standards and regulatory compliance.

Property Value
Actor Kitchen Manager / Quality Team
Trigger Daily operations / Audit
Priority P1

Main Success Scenario: 

1. Daily hygiene checks:
   - Staff health screening
   - Hand hygiene compliance
   - Uniform/PPE check
2. Food safety monitoring:
   - Temperature logging (storage, cooking, serving)
   - FIFO compliance
   - Expiry date checks
3. Equipment maintenance:
   - Refrigerator temperatures
   - Pest control status
   - Equipment calibration
4. Sample retention:
   - Retain food samples (72 hours)
   - Label with date/time/meal
   - Secure storage
5. Documentation:
   - Daily checklists
   - Incident reports
   - Corrective actions
6. Audit preparation:
   - FSSAI license display
   - Staff training records
   - Inspection-ready documentation

Acceptance Criteria: 1. [ ] Digital checklist completion 2. [ ] Temperature logging integration 3. [ ] Sample retention tracking 4. [ ] FSSAI compliance checklist 5. [ ] Audit report generation

India-Specific: - FSSAI Schedule 4 compliance - NABH dietary services standards - Food handler training (FoSTaC)

Document Owner: Dietetics HOD / IT Lead
Last Updated: 2024-12-09
Related: Bed Management | Pharmacy | Billing