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Meals or Milkings?

Clint Maun, CSP

A healthcare organization spends six hours per day of the resident’s life involved in pre, actual or post dining experiences. These six hours surround their three meals a day. That’s not counting the time associated with any nourishment/snack rituals. It’s important to note that everything in a healthcare organization of importance is "hubbed" or executed around a successful dining experience. In a healthcare organization, we continue to complete therapies, generate activities, execute skin checks, medication passes and other clinical assessments around the mealtime.

It is a fact that six hours of a resident’s 14-hour day (when they’re not asleep) is spent in dining experiences. For a healthcare facility to be successful, it must make sure those dining experiences are:
    1. Team-oriented.
    2. A seamless set of services.
    3. Efficiently and effectively completed for purposes of customer satisfaction, regulatory compliance and reimbursement.
    4. Delivered without a great amount of fragmentation, turf or territory problems.

Today’s healthcare facility should be successful in regulatory compliance issues primarily associated with the dining experience. If you look at top deficiencies affecting regulatory compliance, they occur very near or during the dining experience. In addition, you’ll also find that most reimbursement issues that impact our organizations now and into the future (PPS) have direct associations with the dining experience. It is also important to note that the dining experience sets up how many individual family members view our delivery of service. When they visit their loved ones in the facility they ask, "How was the meal?" That makes them involved with the meal experience.

The dining experience will bring out a total team effort or "turf monsters" fighting over territory. It involves the two biggest departments, nursing and dietary, to implement a genuine attempt to successfully and seamlessly deliver the dining experience. All of the therapists, activities, housekeepers and administrative staff are involved in this process also. We are suggesting that if the dining experience is not a true dining experience then it becomes a "three milk cow herdings" per day. In other words, you can almost count on it becoming a fragmented mess because you look at it as merely an assembly line process where each person or group has their thing to do.

This "milking" experience is nothing close to a "dining" experience. The milking experience sets up finger pointing, turf, territory, incomplete services, poor delivery, cold food when it should be hot, bad documentation, and lingering mealtime involvement which affects efficiency and overall morale concerns for employees and customers (including customer's families). It is important that the interdisciplinary approach to a dining experience occur as soon as possible. If an organization is finding itself involved with turf or territory issues throughout the day, it needs to take a hard look at the three dining experiences. If they are not team-oriented, the stage is set for fragmentation, turf or territory issues throughout the day. It also sets the tone for poor reimbursement and regulatory compliance now and definitely into the future.

It is vital for Administrators and other key leaders to be involved in the dining experience. We believe if it begins "bad" at breakfast, then we should set a team-based leadership approach to ensure we don’t have any more turf, territory or fragmentation at lunch. If you can’t complete a successful dining experience at breakfast, then it sets the tone for the other two meals throughout the day. It also determines on how we’re going to complete vital activities in the first seven hours of the day. These seven hours set up the attitude for the remaining 17 hours. The dining experience is critical to the success of the organization, and it requires immediate and proactive leadership involvement from all levels of the organization (including the possibility of actually being involved in assisting with meal delivery). It also includes the required commitment by corporate, regional and board individuals to support a proactive dining experience for our customers.

The value of the meal experience and what people believe to be important for the money they spend, their choice of a facility and their image of that facility is in direct proportion to how the facility takes the time to develop the team-oriented process that must occur to ensure the dining experience is a true dining experience and not a "herding" ritual that is completed three times per day.

Meals or milkings? I guess the choice is yours to do the evaluation for your organization.