1. Foodservice Management – By Design Meal Service and Menu Style Corresponds with LEARNING PLAN 1 1

2. Objectives Describe different styles of service commonly used in the industry Discuss the changing culture of meal delivery services Relate how the style of service impacts the style of menu Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

3. Today’s Dining Service Options are Expanding Senior Living Communities or Continuous Care Retirement Communities (CCRC)  Traditional large dining rooms  Small neighborhood concept with room service  Country club style dining rooms  Steakhouse concept Business Restaurant Manager Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

4. Today’s Dining Service Options are Expanding Hospital Service  Typical trayline  High end room service with specialty dining options Corrections School Foodservice Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

5. Style of Service Needs and preferences of clients Physical design of kitchen Location of dining rooms or service areas Requirements for off-site service (if any) Food Service Management-By Design Meal Service and Menu Style Learning Plan 1 Mission and goals of the organization Staffing resources Budget and operating costs Timing requirements for service Considerations to determine the best foodservice style for your facility

6. Centralized Meal Service  Food is prepared in large quantities for either satellite kitchens or a cook-chill process  Food is portioned onto trays in a central location Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

7. Decentralized Meal Service  Food comes from a production center/main kitchen for reheating (rethermalizing) prior to service  Food is distributed to other locations for plating Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

8. Cook-Chill Cook Chill  Prepared in advance  Blast chilled or frozen for service at a later time  Distributed for reheating in bulk (or)  Pre-plated cold and reheated prior to service  Equipment must support the service and delivery model  Temperature control from time of assemble to delivery is critical Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

9. Brain Break Food at this hospital is prepared up to two days ahead, plated, cooled in a blast chiller, and refrigerated. On the service day, the plates are sent via cold carts to small kitchens on each floor to rethermalize and garnish. What type of service is this?  Centralized Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

10. Cook-Serve  Meals are produced and served immediately  Basic temperature control systems are  Insulated trays  Heated base systems  Instant heating systems  Insulated transportation carts (NOTE: Insulated trays, heated base systems and transport carts are not viewed by Centers for Medicare & Medicaid Services (CMS) as a home-like dining experience) Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

11. Trayline Service Trayline System  Most common meal assembly process in acute care and many senior living communities  Moves through an assembly line  Trays move on a conveyor belt or skate wheel system Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

12. Trayline Service Steps Food Service Management-By Design Meal Service and Menu Style Learning Plan 1 Meal ticket or trayline ID card prepared per client 1 Meal tickets are grouped by dining location 2 Staff send tickets/ID cards down trayline for assembly 3 Food items/supplies organized by station on trayline 4 Items appropriate for diet are added to tray 5

13. Trayline Service Delivery Options Bulk rethermalization system  Large pans to be heated and portioned Tray rethermalization system  Hot and cold sides Specialized rethermalization  Requires specialized dinnerware Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

14. Trayline Service Delivery Options Software Advantages Today’s software can  Track temperatures  Control rethermalization  Generate reports Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

15. Other Service Options to Provide More Home-Like Atmosphere Pantry Service  Food is prepared in a central kitchen  Plated and served to clients from pantry  Can support any menu format Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

16. Other Service Options to Provide More Home-Like Atmosphere Room Service options  Pre-defined meal for clients unable/unwilling to select their meal  Menus selected by the client; served from a traditional trayline (served at defined times)  Meals on demand with traditional room service concept Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

17. Other Service Options to Provide More Home-Like Atmosphere Table-Side Service  Hot well service station in dining room where food is plated and served directly to clients  Neighborhood concept in senior living where clients are served from a home or residential-looking kitchen Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

18. Other Service Options to Provide More Home-Like Atmosphere Buffet Style Service  Creates an atmosphere of choice  May require extra help for clients not able to manage walking and carrying a plate Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

19. Other Service Options to Provide More Home-Like Atmosphere Restaurant Style Service  Dining service staff waiting on tables  Food ordered and delivered in courses  Food plated in dining room  Specials such as sandwiches, salads, desserts offered tableside from cart Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

20. Other Service Options to Provide More Home-Like Atmosphere Cafeteria Service  Used in schools, employee dining rooms, commercial feeding, or correctional facilities  May offer a scramble concept with optional food choices  Usually a cash-based operation Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

21. Other Service Options to Provide More Home-Like Atmosphere C-Store  “Convenience Store”  Often offered in today’s CCRCs  May be a coffee kiosk or sandwich counter Multiple Venus  Some CCRCs offer several venues such as  Coffee bars, smoothie bars, fresh bakery, white linen steakhouse, full-service bar Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

22. Brain Break How does adding room service as an option meet CMS guidelines?  Provides clients with more choices Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

23. Other Service Options Satellite Foodservice  Becoming more common due to expense and space needs of a production kitchen  Food is delivered in bulk for reheating and service such as congregate senior meal sites  May also be used for home delivered meals for shut-ins and elderly Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

24. Service Concerns and Issues Trayline Service  Who delivers trays to clients?  This task may be the responsibility of either nursing or dining services staffs  Must be available to distribute tray  How are trays verified to reach the correct client?  Two “patient identifiers” such as client name, medical record number, date of birth, or photos  Guideline from The Joint Commission (TJC) and recommended by World Health Organization (WHO) and CMS Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

25. Service Concerns and Issues How are diet changes handled? Who helps the client open packaging or get the tray set up? How are substitutes or adjustments made? When and how often are temperatures checked? Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

26. Service Concerns and Issues All service options require  Training  Timing  Review schedules to assure they are reasonable and coordinate with client schedules  CMS requires a maximum of 14 hours between supper and breakfast Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

27. Service Concerns and Issues  Communication  When nursing staff are involved, there may be delays in delivering due to other clinical tasks  CDM must communicate with nursing supervisor or administrator to assure effective meal delivery systems  Coordination  Between nursing, therapy, and foodservice departments Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

28. Culture Change Adding new venues or moving to a different service style may require a culture change Culture change begins with a change in language  Examples  Use elder or older adult instead of elderly  Napkin or clothing protector instead of bib  Individual care instead of institutional care Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

29. Culture Change Culture change in dining  Driven by regulations to implement person-centered, client- driven dining programs  Requires communication and support from all departments and clients  May have some resistance Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

30. Menu Options Length of menu cycle  Depends upon length of stay  Hospital menu cycle may be 5 days  Senior living may be 3-6 weeks  Odd number of weeks (e.g., 5 weeks) work better for community and employee cafeterias Vary the venue with grills, salad bars, etc., to eliminate boredom with menus Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

31. Brain Break Why would a two- or four-week cycle be less appealing to long-term care clients?  Because the same menu would be served every two or four weeks. This may result in appetite fatigue. Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

32. Selective Menus Improves client satisfaction and enhances client-centered dining programs Clients have the option of making choices in advance Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

33. Selective Menus Pre-Select  Typically a printed menu with choices for breakfast, lunch, and dinner Table-Side Select  Menu may be posted and clients select at the dining table Spoken  Client may be asked prior to service time Food Service Management-By Design Meal Service and Menu Style Learning Plan 1 Restaurant Variation  May be a list of standard choices such as a sandwich in place of the main entrée Cafeteria  Standard choices plus daily features Buffet  Often centered around a daily feature or portion-controlled items such as chicken breasts or fish fillets Types of Selective Menus

34. Non-Selective Menus Typically a daily feature item such as Baked Chicken, Mashed Potatoes, Mixed Vegetables Offered for those who choose not to make their own selection More often occurs in nursing home or assisted living Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

35. Accommodating Client Menu Selection Need to accommodate specific diet orders; client preferences still exist Establish policy for the situation where clients choose foods that are contrary to the therapeutic diet  Food substitutions must be equal to or similar in nutritional content (CMS regulations)  Educate client on their medically ordered  Always refer to the clinical nutrition staff when client preferences conflict with the diet order)  In addition, document any changes and maintain the medical records Food Service Management-By Design Meal Service and Menu Style Learning Plan 1

36. Brain Break Broccoli Winter Squash Fresh Tomatoes Food Service Management-By Design Meal Service and Menu Style Learning Plan 1 Pea Pods or Mashed Sweet Potatoes Romaine Lettuce (1 cup) or Kale Salad Coleslaw or Asparagus Spears According to the Figure 1.11 (Food Substitutions), name an acceptable substitution for the following: