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Are Sneeze Guards the Only Way to Protect Food?

They’re certainly one of the most established ways, but this just might change your perspective.

Sneeze guards. Food guards. Breath guards. Whatever the term, there seems to be a lot of mixed opinions about them, including whether they’re mandatory.

This is especially important as we move away from institutional tray service or pre-plate service, to meal service style that is mobile – either in a common dining room or down a hallway in a homelike setting of long term care. I decided to dig deeper into the food code by researching and reaching out to food safety experts to get their professional thoughts on this vague topic.

When looking at food safety, we have several tools to pull from. We use HACCP to identify and prevent hazards that could cause food-borne illness in receiving, storing, preparing and serving of food. We have food safety courses to teach us all how to handle food and take corrective action when necessary. Thirdly, we have the FDA model food code, and under the section about sneeze guards, it says;

“3-306.11 Food Display. Except for nuts in the shell and whole, raw fruits and vegetables that are intended for hulling, peeling, or washing by the CONSUMER before consumption, FOOD on display shall be protected from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; or other effective means.”

Looking closely, the FDA food code mentions food on display for the consumer to access must be protected by guards, cases or other effective means. This is not the application with mobile meal service done by trained food service staff. Also, “or other effective means” allows for dialogue about what the food safety plan is in a healthcare community. The food code makes operators responsible for the protection of food from contaminants, which is broader than just using some plexiglass, and the perception that sneeze guards “solve it all.” It requires common sense and a plan to demonstrate to health inspectors that foodservice operators know what they’re doing.

I reached out to Janet Anderberg, a Washington state health inspector. She shared that sneeze guards aren’t mandatory, but what’s more helpful is for a foodservice operator to have an active managerial control plan to show how food is protected. It is the responsibility of the food operator to know, communicate and demonstrate their food safety plan which could include:

    • Covering food with foil or lids during transportation (always recommended)
    • Not parking a mobile food cart under dripping pipes
    • Not traveling through bathrooms with a mobile food cart
    • Allowing trained foodservice staff to serve food and items (not the untrained public)
    • Keep a safe barrier of distance
    • Using roll dome covers or insert flip lids if desired
    • Using tongs versus touching food directly
    • Keeping food outside the temperature danger zone
    • Using gloves with ready-to-eat foods
    • Proper and frequent hand-washing
    • Not dragging sleeves through food
    • Temperature records pre- and post-meal service
    • If serving outside, protecting food from contaminates from above, like birds or trees
    • When serving food, only serve food and don’t do other tasks that can possibly contaminate the food

Nick Eastwood, President of Always Food Safe weighs in and states:

“Though sneeze guards can play a helpful role in protecting food, it has a limited use. They can be helpful in a self-serve buffet where we let the customer near food. It can help reduce physical contamination and also bacterial contamination from skin and hair. But apart from this, sneeze guards offer very little protection. In our Food Protection Manager course, we do not state that they are mandatory or state they must be in place. Instead, food safety is a combined effort and one needs to look at the total picture; the use of professionally trained staff, time and temperature control, avoiding cross contamination and personal hygiene are by far the most important points. From a food safety perspective, I have a very strong dislike to pre-plated food being served as time and temp abuse is one of the biggest threats to food safety. Bulk mobile service would allow for temperature control and quicker meal service.”

Colleen Zenk, Food Safety Instructor and ANFP speaker shares her thoughts:

“The [FDA] Food Code regarding sneeze guards is open to interpretation when it comes to food safety. Sneeze guards, food guards, breath guards are used to protect food from the consumer during self-service, but not mandated where foodservice personnel is doing the serving. The key issue is the staff education and training regarding how food is protected during transportation and service of food to ensure it is safe. Sometimes operators or inspectors take the easiest and least time-consuming approach when determining safety of food by looking at sneeze guards as the protection, as it saves time looking and verifying other requirements. This leads to the incorrect assumption they are mandatory. Instead operators should have a conversation with their surveyor or inspector and communicate their food safety plan, and this is helpful before one’s food service system is changed. It is important that the [FDA] Food Code is used as a guideline, and to check one’s local regulatory authority. Also, do not be afraid to have the conversation with a surveyor or inspector but develop a relationship that demonstrates that food safety is a priority.”

It’s interesting to note that there’s no scientific research showing that sneeze guards are actually effective – none can be located when a literature search was conducted. Dr. Peter Synder from the Hospitality Institute of Technology and Management weighs in and states:

“There is no reference to a food-borne illness that has ever been prevented by a sneeze guard or caused by lack of a sneeze guard. There is no research about blocking sneezes with sneeze guards. The sneeze guard is something that a sanitarian invented in about 1945, when the first food code was written. Overall, a sneeze guard does not protect against food-borne illness.”

The sneeze guard topic is one of cultural perception and we all need to know what the FDA Food Code does (and doesn’t say), the science, apply common sense, while also implementing sound and safe food serving practices. We must think bigger and broader about our food safety plan in residential care settings. Therefore, to say “you must have a sneeze guard” is too much of a simple quick answer to a more complex situation. Also, it’s very important to look at the application: mobile meal service conducted by trained food safe staff is a very different application than the general public helping themselves to food on display.

Finally, mobile meal service is working in hundreds of health care communities – whether it’s snack carts, beverage service, dessert carts, or mobile hot food carts. Our industry is working hard at changing the culture to move away from sterile, institutional living to one that more closely reflects how we live in our own homes. So I ask: Do you use sneeze guards in your own home? Why do we apply a completely different set of rules in homes where seniors live?

When we look at potential food safety situations, let’s review the risks and how they could lead to food-borne illnesses. I believe that mobile meal service actually decreases the risk of food-borne illnesses because food is hotter and it’s served immediately by trained foodservice staff. Cold trays of food aren’t sitting for long periods of time until handed out. As an industry, let’s focus on choice, interaction, and self-determination of safe food. By protecting food in numerous different ways, we can create a more positive dining experience for residents.

A special thank you goes out to Janet Anderberg, Washington State Health Inspector, Nick Eastwood with Always Food Safe, Colleen Zenk, Food Safe Instructor/Speaker, and Dr. Peter Synder for their time and expertise on the sneeze guard topic.


About Suzanne Quiring:
Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.

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Solving Labor Challenges in Healthcare Foodservice with Pride

When staff members love what they do, residents and guests love what they do, too.

It seems kind of over-simplistic to say it like that, but nothing could be closer to the truth. When staff takes pride in their jobs, when they engage with residents in authentic and memorable ways, not only will residents be happier with the overall service level of the community, but staff members will be happier, as well.

Don’t take our word for it, though. Here’s what a few labor experts had to say:

According to Deloitte’s Talent 2020 series, which surveyed 560 employees across several industries around the world, one of the top three engagement drivers for employment was the ability to do meaningful work.

The reality, though, is this statement is common sense. It’s obvious that staff members who love what they do, who are the most engaged in the process and how to improve it, are the ones who are likely motivated by the fact their work matters. The question then becomes, how?

According to the MIT Sloan Management Review and a study led by Professor Catherine Bailey called “What Makes Work Meaningful — or Meaningless,” the answer is deeply personal and individual. What’s the point of this job? It really depends on who you ask. There were some trends, though:

* Meaningful work tends to be associated with a wider contribution to society.

* Significant memories of family members when related to on-the-job experiences tended to result in feelings of worthfulness. Basically, there’s a relationship between family and job satisfaction, between what’s personal and what’s work.

* Meaningful work is not planned. Rather, unexpected moments during the workday were often the most impactful.

How does this relate to healthcare foodservice and senior care communities?

The bottom line is meaningful work is personal, interpersonal, and unexpected. So how can we empower foodservice staff members to have those types of day-to-day experiences? By putting them in the right positions.

First, it’s impossible to force our way into someone else’s head. This makes personal, independent decisions about what’s meaningful and what’s impossible. The other two factors, though, are certainly doable.

How can senior care communities put staff in intimate situations that remind them of their own families? How can healthcare foodservice operators give team members the opportunities to have serendipitous experiences in their day-to-day tasks? By creating situations where staff members are around the residents.

In foodservice this means getting the team out of the four walls of the kitchen and into the dining room.  When staff members interact with their guests and a community can adopt a service approach to the dining experience, the work becomes more meaningful and more personal.  Have the staff interact directly with the residents, ask questions, and really actually talk to them!  This increases team engagement, staff retention, and resident satisfaction – it’s a win-win-win!


Learn more and continue the conversation.

Take the dining experience quiz which only takes a few minutes to fill out.  Afterwards, you’ll learn tips and tricks on where you can improve and you’ll also have the opportunity to coordinate a call with Suzanne to discuss your results.


Contact Suzanne for her webinar, “Bringing Back CHOICE to Residents” where you’ll learn how to:

  • Reduce high food waste by 30-50%
  • Serve significantly hotter food to residents
  • Eliminate multiple food preference lists to track and maintain
  • Improve customer service to residents
  • Improve overall meal satisfaction
  • Exceed CMS regulations and align with best practices (Pioneer Network, Eden Alternative)
  • Implement methods that are working in 800+ healthcare communities at all levels of care in North America


About Suzanne Quiring:
Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.

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5 Things to Consider When Converting Underutilized Space

With the foodservice giants having raised the standard of an exceptional café experience, you may be considering incorporating a “café” type concept in an underutilized space such as a lobby or corner area of your facility to generate revenue away from your current foodservice operation.

“You only get one chance to make a first impression.”

This adage also resonates to life in the foodservice realm. With countless cafés, restaurants and fast food establishments aplenty, the consumer is inundated with deciding where to eat, drink and spend their money. Enticing the attention and business of today’s consumer can be captured with a little ingenuity that creates a unique one-of-a-kind “experience.”

With the foodservice giants having raised the standard of an exceptional café experience, you may be considering incorporating a “café” type concept in an underutilized space such as a lobby or corner area of your facility to generate revenue away from your current foodservice operation.

Location– Determine the best location for your “café concept”; a lobby may be the perfect location or consider a space that’s currently away from your cafeteria where there’s existing foot traffic and may be a viable location to set up. Study traffic patterns, get feedback from students and visitors, do your research before moving to the next step.

 

Decide on Space Requirements – Careful research and consideration should be taken when designing your space. Define your long-term goals and have a clear idea on how you will best utilize the space. Go on a research expedition and visit local eateries to view equipment, traffic flow, and aesthetics. This will greatly help in the design phase.

 

Equipment – Consider self-contained mobile retail equipment concepts that fit the space and offer flexibility in terms of the ability to easily move the counters to another location if the particular location selected isn’t profitable. Also, think about using equipment that provides flexibility such as a basic open kiosk platform or larger size configuration made up of several counters. It’s important to select equipment based on capacity, labor, anticipated maintenance costs of operating the space and initial cost of the equipment.

 

Menu selection will drive “the customer experience” and researching your options prior to the design phase is key. It’s important to remember that the menu creates an “image” of your establishment and needs to be an extension of the design you’re trying to portray. Menu planning to meet current trends and food prep required will drive the menu. Will you be serving prepackaged prepared items or will you be implementing a menu made-to-order style concept such as paninis, made-to-order sandwiches, noodle bars, specialty coffee and snacks, etc.?

 

Merchandising/Signage – Because a dining experience is more than great food, food display and merchandising can drive revenue and participation. Creative merchandising can capture missed sales opportunities, maximize profitability and increase customer satisfaction and repeat business. There are 4 key elements to successful merchandising; by incorporating these into your retail dining operation you can enhance your foodservice operation and ultimately increase sales.

By making a concerted effort in the research phase, you will be able to effectively implement a successful revenue generating stream in an underutilized area that will compliment your retail dining program.

For a 30 minute consultation with a Multiteria representative who can walk you through the design and implementation steps to provide food and beverage service in a remote area, contact us today!

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Practical and Proven Ways to Maximize the Dining Experience

Practical and Proven Ways to Maximize the Dining Experience

These are key principles in culture change conversations and represent values that we all know are important in daily living.  But when it comes to the dining room, these virtues are often missing.

For decades, meal service has typically been done by tray service, pass-through window, or a stationary kitchen set-up. Staff take many steps to deliver meals. Items are often pre-poured or pre-plated by staff using preference lists because they just “know the resident.” Staff then simply set meals down in front of residents without really talking to them. This method is often referred to as restaurant-style serving, but if I went into a restaurant, and staff assumed they knew what I wanted, without asking, I wouldn’t leave a tip or return. Residents unfortunately don’t have this luxury, as this is now their home. Too many assumptions are made on behalf of the resident, and this is a fundamental problem in our industry.

Here are some easy and practical ideas on how to honor choice, increase variety, and set up self-directed dining, all which meet CMS regulations.

    • Start an Enhanced Dining Committee or Learning Circle with family, residents, and staff to evaluate and recommend ways to improve the dining experience. The goal is to evaluate the dining experience for self-determination, décor, flow, and make suggestions as a team.

 

    • Put management on a coffee serving rotation so they have a regular weekly presence in the dining room, not just passing through, but actually being present for the meal hour.

 

    • Have serving staff circulate through the dining room and offer second helpings. Meal service should be at least one hour from start to finish.

 

    • Make continental breakfast available from 6:30 am – 10 am, along with a hot breakfast option. A relaxed breakfast is becoming the industry standard.

 

    • Send out an anonymous survey to get feedback about the dining experience from family, residents, and staff. You might be surprised what you learn!

 

    • Show residents the menu choices on sample plates before food is plated, and then let them decide if and how much they would like to be served.

 

    • Offer breakfast on demand where waffles, French toast, or omelets are made to order in the dining room with an action station.

 

    • Have the cook wear a chef jacket, and equip the serving staff with crisp, clean serving aprons and name tags. It gives a professional appearance, and the residents love knowing and interacting with the people who are responsible for making their meals.

 

    • Make salad plates in front of the resident directly from a mobile food cart. Offer a variety of choices of salad toppings.

 

    • Stimulate their senses by plugging in a bread maker machine and filling the air with the aroma of fresh-baked bread.

 

    • Allow for open seating so that residents have the flexibility to sit wherever they wish with the company they choose.

 

    • Encourage staff to eat their meals in the dining room with the residents. To encourage socialization, some communities give discounted meals to employees who participate in this way.

 

    • Turn off the TV and play music that’s from the era of the residents (1920’s-1950’s); don’t play “Top 40” simply because the staff enjoys it.

 

    • Have a “Question of the Day” on the dining room table to help facilitate conversation (e.g., What was your first job? What was your favorite vacation and why?). Encourage staff to ask residents and each other this question.

 

    • Use caution on how quickly employees clear the dining room to prevent residents from feeling rushed out of their space. Allow the residents to linger, and staff to find other tasks to do. Leave the dirty dish cart out of the dining room until all residents have left.

 

    • Institutional gloves and hairnets look terrible. Instead, wash hands and use serving utensils, unless staff members are directly touching the food with their hands. Always follow food safety principles.

Summing It Up

On a daily basis, residents should have the flexibility to choose what, if, and how much they would like to eat and drink in their own home. It is our job as CDMs to provide nourishing and timely meals, but not to choose for residents.

How would you rate your community’s dining experience? Is your meal service system honoring a person-centered philosophy? What way are you currently doing your meal service and why?


Learn more and continue the conversation.

Take the dining experience quiz which only takes a few minutes to fill out.  Afterwards, you’ll learn tips and tricks on where you can improve and you’ll also have the opportunity to coordinate a call with Suzanne to discuss your results.


About Suzanne Quiring:
Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.

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What Is a Self-Determined Meal, and How It Will Help You with Resident Reviews?

It’s important to understand the importance of customer reviews and how foodservice impacts the overall score a healthcare center or senior community receives.

According to the Pioneer Network Dining Standards, not only does foodservice play a key role in optimizing well-being, it can have a direct impact on review scores. If people are happy with their living environment (and meals are a key focus!), then review scores and census results increase.

So what’s the easiest way to achieve better reviews?

Simple. Make your customers happy.

Meal times are some of our most cherished moments, not just for senior citizens, but for humans in general.

For our aging populations living in senior communities, this fact is even truer, though. With limited mobility or cognition, in many cases meals can break up the day and be moments of clarity, satisfaction, sociability and interest!

But what makes a meal interesting? How can operators make foodservice more engaging and fun? How can residents be empowered?

By allowing them to “self-determine” their meals. Self-determined meal service is basically another way to say choice.

Traditionally, pre-portioned meals are delivered to the table on domed plates. Also, food items and portion sizes are decided in the back-of-the-house based on perceived meal preference lists or in some cases medical needs.

Instead, self-determined meal service brings the selection process to the table, to be made by the guest.

If you stop and think about it, it’s a pretty logical concept, but most senior care communities don’t offer foodservice in this capacity. It’s usually just tray service or pre-plated service. Here are the benefits that self-determined meal service offers:

IMPROVED INTAKE

When you have a style of meal service that allows for residents to choose the items and portions they want, they are more likely to eat more of the meal. Food is only nourishing if residents consume it. Therefore, when food is presented in a better way, there is improved intake, less risk of malnutrition, and better overall energy levels. A win for everyone!

Which brings us to another point…

STAFF ENGAGEMENT

Implementing a meal system that embraces choice makes residents happier, but in turn, staff members become more engaged with the people they serve. Meals become less like a chore and more like hospitality. In addition to talking to residents about the food selections, staff can also talk to them about what’s going on in their lives.

Bringing choice to the dining experience with engaged staff members not only results in happier residents, but staff members that feel empowered and that they’re actually making a difference in a resident’s life.

And speaking of empowerment…

RESIDENT CHOICE

When residents in a senior care community go to the doctor or receive medical care, it so often involves something they have to do. “You need to take this pill twice a day or you cannot do ‘this or that’ until your hip heals.” The sad fact is choice is often taken away from us as we age.

This doesn’t have to be the case with meals, too. The most anticipated times of the day should be interesting and engaging, and residents should have a choice as to how they want to enjoy those times. Don’t feel like having the broccoli today? Opt for the asparagus instead, or choose no vegetable at all. Why plate a vegetable that a resident isn’t going to eat and will just get thrown out? Choice can be a different option, or choice can be the size of the serving, or choosing, “No, thank you.” Just providing that choice can make someone’s day and may just change their lives.


Is your community providing a truly self-directed experience? Are you enjoying the benefits listed above? We have an easy and free way for you to find out.

Take the dining experience quiz to see tips and tricks on where you can improve.


About The Author, Suzanne Quiring:
Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.

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Language and Culture Change: Are You Still Using the “F” Word at Work?

“The difference between the almost right word and the right word is really a large matter–’tis the difference between the lightning bug and the lightning.” – Mark Twain

To be honest, I didn’t realize how the power of my everyday words negatively impacted an institution where I worked. Now, on reflection, I’m actually embarrassed by my new-found knowledge, but I take heart from an Oprah quote: “When we know better, we do better.”

My challenge now to myself, and I hope my fellow colleagues working in Health Care Communities, is to constantly perform a language check-up.

Recently, there’s been a great deal of research done on how our choice of words impacts our work environment and directly influences our behavior. Other workplaces have had to change their language usage. For example, prisons are now Correctional Centers, stewardesses are now flight attendants, dietary is now culinary services. Likewise, our words in Residential Care need to be reflective of what we want to offer, which is a more normal and home-like atmosphere. Often traditional nursing homes represent a culture that needs changing, and changed language needs to be an integral part of it.

Nancy Fox wrote in her book, “The Journey of a Lifetime: Leadership Pathways to Culture Change in Long-Term Care,” that “our entire industry has developed a language that is demeaning and depersonalizing both of the Elders we serve and the hands-on staff who care for them. What we know is that language can and does influence us. Language is a powerful tool. When used in a positive way, it can inspire people. When used negatively, it can hurt. But when it becomes a part of a culture and is simply mindless, that is when we speak the words without understanding their impact, it is dangerous. When we awaken to the fact that this kind of language has seeped into our culture and is now actually driving our attitudes and beliefs, we can begin to change our language to shape a new culture.” (p. 82)

“When we know better, we do better.” – Oprah Winfrey

There are also some excellent points made in the paper titled, “The Power of Language to Create Culture,” by Bowman, Ronch, and Madjaroff, (2016), which encourage us all to consider our choice of words.

Here’s a quick summary of some of their topics that I found most helpful. To help us change our language, here are some practical suggestions:

•  Purchase laminated cards, the size of a business card from The Institute for Caregiver Education for staff team members. These cards say “Language is the key to the soul. Because of this, it is important to choose our words carefully. To help transform our “facility” into a true community, try using the following:

          1.  Use “Home” or “Community” instead of facility.
          2.  Address and refer to people by name, not diagnosis or job function.
          3.  Avoid excessive medical terminology when talking to residents or co-workers without a clinical background.
          4.  Don’t just bark orders. Try to explain the “why” of what you are asking for.
          5.  Think “Equalize Everyone.”

•  Create a group of leaders to use examples of the new language – allow them to be the “teachers” who get it and can give feedback in a respectful way. Learning new beliefs and a new way of talking takes time. Be patient but clear.

•  The best way for a person to learn a new language is to speak it. Leaders need to encourage people to use the new language so it becomes automatic.

•  Instead of Director of Dietary, maybe change to Culinary Services Team Leader

•  Leaders and teachers need to keep reminding people that learning a new language requires three kinds of knowledge to take hold:

          1.  know it (facts/information)
          2.  know why (motivations and beliefs)
          3.  know how (the new words/concepts/language are spoken) to become dominant.

•  When you hear language that dishonors people in communities, be on the lookout for opportunities to reframe someone’s experience so that their beliefs and language can be changed. Reframing means to change the way we interpret or give meaning to an event, so when a person in a nursing home is called “resistant,” reframe it to “making a choice”

•  The best strategy of all: use it, use it and then use it some more. Changing language and culture take time and concerted effort so giving people a new vocabulary list is just one part of the job, but following through and accountability are critical. Empower the team to make it happen and that everyone is responsible for accountability. (Ronch, 2003)

healthcare language choice

Please do check in with yourself. Listen to the care partners at your workspace. Be an example. Make others accountable. Changing culture means changing our language. So, do you need to stop saying the “F word?”? Facility, that is.


Are you saying the right things in your community? Are you creating a home-like atmosphere? Take our quiz to find out where you can improve.


Reach out to Suzanne to set up a webinar all about “Bringing Back CHOICE to Residents” where you’ll learn how to:

  • Reduce high food waste by 30-50%
  • Serve significantly hotter food to residents
  • Eliminate multiple food preference lists to track and maintain
  • Improve customer service to residents
  • Improve overall meal satisfaction
  • Exceed CMS regulations and align with best practices (Pioneer Network, Eden Alternative)
  • Implement methods that are working in 800+ healthcare communities at all levels of care in North America


About Suzanne Quiring:
Suzanne Quiring, RD, CDM, CFPP has worked in residential care for over 25 years and has her Continuing Care Administrator designation. She has assisted over 800 healthcare centers and improved their meal programs with tableside service. She is the inventor of the “SuzyQ Cart System” by Lakeside. She has spoken at conferences throughout North America and is passionate about self-directed dining.