Foodservice Management – By Design

Meal Service and Menu Style

Corresponds with LEARNING PLAN 1

1

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

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

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

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

Centralized Meal Service

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

Decentralized Meal Service

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

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

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

Cook-Serve

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

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

Trayline Service Steps

Food Service Management-By Design • Meal Service and Menu Style • Learning Plan 1

• Meal ticket or trayline ID card prepared per client1

• Meal tickets are grouped by dining location2

• Staff send tickets/ID cards down trayline for assembly3

• Food items/supplies organized by station on trayline4

• Items appropriate for diet are added to tray5

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

Trayline Service Delivery OptionsSoftware Advantages Today’s software can

» Track temperatures» Control rethermalization» Generate reports

Food Service Management-By Design • Meal Service and Menu Style • Learning Plan 1

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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: