Is that what your residents ordered?

Picture yourself in your favorite restaurant. You review the menu and settle on a choice, only to be disappointed when the meal arrives. The entree might not be what you interpreted it was from the name, or the food isn't the level of quality you anticipated. Is this identical scenario occurring with your residents?

Ensuring that residents get what they order is the key to quality dining in long term care. Superficially, it sounds simple enough. But is it really? So much more goes into the quality picture than just pleasing the resident at the table. Quality food products delivered, the internal quality monitoring program of the foodservice department, a resident-friendly menu and computer menu management programs all have an important role in ensuring your residents get what they order.

Assure quality in purchasing

Quality begets quality. Starting out with quality meats, produce and other staples can increase the likelihood of quality at the point of service. Working with your purveyors and setting specifications of the grade and quality that is expected, you then are assured that you are starting with the minimum level of quality you desire.

While many foodservice directors prefer to order over the Web and see their sales representative once every couple of months, that can ultimately be a costly convenience. The directors say they don't have time to spend talking to the sales representative or the sales rep isn't doing anything for them.

Meeting weekly with an interested sales rep won't be a waste of your time. That sales rep works for you and your residents. If that person isn't bringing the quality you desire--ample cost savings, and new products--hire someone else.

According to Liz Sells, foodservice director at Susquehanna Nursing Center in Johnson City, N.Y., "I don't have the time not to deal with salespeople. They are my link to quality." Moreover, taking advantage of food brokers that show up at your doorstep could be a cost saver and menu idea generator. "They can often show you items that you may have to wait for the next food show to see and sample," she said. "Frequently, food brokers, or the middlemen between the manufacturers and distributors, can give you rebates and gratis cases to try."

Internet ordering locks you into the product listing of items that are on your contract and finding new products can be cumbersome. Sells pointed out that by using the vendor books and negotiating prices if the item is not on your contract, you gain access to a multitude of products that you might not have known existed. "It also can open the door to a larger variety of grades and levels of quality within food categories." This can be a cost reducer in the long run. For example, you can use a high quality sweet corn for a vegetable, but might be able to use a lower grade for soups and casseroles. Sells said, "Here again is where meeting with that sales rep each week and communicating to them what your needs (saves) you from resident complaints in the end. Communication is the key to maintaining food quality."

Sells offered a common sense tip. "Strongly consider buying cases of produce and not splits to ensure that you are getting the quality specifications you request."

Relying on the truck packer to pick out the best lettuce, tomatoes and cucumbers for you is a long shot. The more produce is handled, the more likely it will bruise and have a shorter shelf life. A salad made of rusty lettuce, squishy tomatoes and limp cucumbers will likely result in a cry in unison from your residents,

"This is not what I ordered."

Internal quality monitoring includes checking and inspecting item quality on all food deliveries, standardized recipes, test trays and satisfaction surveys. Once you start with a quality food item, monitor the process throughout to ensure a quality product at the point of service.

Sells counseled, "Don't be afraid to inspect the refrigerated trucks your food arrives on, or call to see that your purveyor is HAACP certified." Frequent test trays and taste testing can reveal when quality has not been maintained in the preparation or cooking process. It is better for staff to find that a product differs in quality, than to have residents determine it without the staff's knowledge.

Satisfaction surveys completed by the residents are a wonderful way of getting valuable feedback about menu items and quality of the foods served. This gives you and your residents an opportunity to act.

What is Ohio hash? If you don't know, then your residents won't either. Writing menus that are clear or include brief descriptions of out-of-the-ordinary items can improve resident satisfaction. Call the chicken and rice casserole what it is, not Ohio hash. Or, if Ohio hash somehow sounds more elegant, offer a brief description. "Offering a one or two sentence description of the entrees helps people make their selections without calling and asking how the item is made," said Sharon M. Glosson, RD at Central Texas Medical Center in San Marcos.

If the residents aren't getting what they ordered, then much of it will go to waste. Much that is done to cut costs, such as using lower grades and more processed products only inflate costs.

Christina Hasemann, Ph.D, a registered dietician, b the president/CEO of NY-Penn Nutrition Services, Inc., in Binghamton, N.Y., and an adjunct instructor at Broome Community College and Morrisville State College (Norwich).