Healthcare

Delivering Meals In Long-Term Care

When it comes to feeding residents and patients in their rooms, there are a variety of ways to deliver food. You can get creative with many methods to ensure properly temped food makes it to the person(s) in your care whether you’re offering traditional/bedside service or room service.

Some might be asking, which system of meal delivery is right for you? The right answer could depend on a variety of factors. Every organization has its own goals and objectives. Every property has its own circumstances, and every unit has its own nuances and resident requirements. What we’ll do here is lay out the pros and cons of a variety of meal delivery systems. Our hope is that this will become a tool for you to help decide which system is best for you.

There are four different delivery systems that we’ll discuss here. Those are: the pellet system, delivery carts with two cabinets, delivery carts with a single cabinet, and insulated trays.

Over the last 30 years the movement of food has been primarily solved by using the pellet system- a heated base, an insulated dome, and an ambient cart. Now there are new options. Every option comes with its own set of tradeoffs. That’s why we say that the best option depends on the organization, the tradeoffs you are willing to consider, and the variables that must be accounted for.



The Pellet System

The pellet heating system is the most used system for meal service within long term care facilities. This system contains a heating system for the entrée and insulated service ware for cold items. The process begins when the base, which holds the entrée, begins to heat because it’s plugged into induction heaters. After heating the base, a heated plate is placed inside the base, the entrée is positioned on the plate, and covered with an insulated dome or cover. The entrée and cold items are then put onto trays, which in turn are placed in ambient temperature carts. These carts are delivered to the nursing stations to be passed by diet or nursing aids to the residents.

Benefits

  • Established in the Market: Pellet systems are the most used meal delivery system in long term care.
  • Relatively Low Introductory Price: The pellet system is cheaper than other options up front.

Challenges

  • Limited Temperature Hold Time: Generally, pellet systems can only hold temperature for 30-45 minutes. Additional units or alternative heating sources may be required.
  • Lack of Food Quality: Entrées dry out quickly due to the temperature variance between the heated plate and cool insulated dome, which causes condensation buildup.
  • Maintaining Cold Food Temperature: The insulation alone is responsible for keeping cold food cold, so cold items may reach room temperature quickly.
  • Cost Efficiency: The system requires proprietary bases, dome covers, and insulated ware, increasing initial and replacement costs. More cost-effective systems are available over time.


Heated and Refrigerated Meal Delivery Carts with Dual Cabinets

The concept of this system involves placing a hot portion of a meal in one cabinet and a cold portion in another cabinet, all within a single cart. Trays are then transported to rooms using this dual-temperature cart. This method includes placing hot food on one tray, covering it with a lid, and stacking it with other hot meal trays on one side of the cart. The same process is repeated for the trays containing cold food, which are stored in the refrigerated or ambient side of the cart. Upon delivery, each resident receives one hot tray and one cold tray. After meals are finished, the dirty trays are returned to the cart and taken back to the washing station.

In another variation of this process, separate carts are used for hot and cold foods. Hot meal trays are stored in a heated cart, while cold trays are stored in an ambient or refrigerated cart.

Benefits

  • Maintain Hot Food Temperatures: Having two sides to a cart meets the needs of maintaining both cold and hot food temperatures for long periods.
  • Less Expensive Trays: Standard copolymer trays are used with heated carts, reducing material costs compared to the pellet system.
  • Food Safety: This system helps prevent foodborne illness by ensuring food temperatures remain safe.
  • Multi-Functional: Dual-temperature carts with dual cabinets can also be adapted for bulk food delivery.

Challenges

  • Separate Handling of Hot and Cold Food: This system requires separate handling of hot and cold food until they’re combined on one tray. Special attention is needed to ensure ticketing systems are set up to print separate tickets for hot and cold items.
  • Up-Front Investment: This meal delivery system requires a larger initial investment, though ROI may be achieved within three years, depending on the population size.
  • Visibility: For carts with refrigeration units, height may obstruct visibility, posing challenges for some caregivers.


Heated and Refrigerated Meal Delivery Cart with a Single Cabinet Cart

Meals are served on a proprietary-designed tray that accommodates both hot and cold food transport within a single cart. During food tray preparation, cold items are placed on one side of the tray and hot items on the other. The tray is then placed in a dual-temperature cart with one side heated and the other refrigerated, separated by a divider that prevents hot and cold air from mixing. When it’s time to serve, all meal components are conveniently arranged on one tray, ready for immediate delivery.

Benefits

  • Food Safety: This system helps prevent foodborne illness by ensuring safe food temperatures.
  • Temperature Control: With one side of the cart heating hot food and the other side refrigerating cold food, temperature maintenance is optimized.
  • Simplified Process: This system reduces caregiver workload, requiring only minimal steps: plating, placing on a tray, and serving. The likelihood of meal mix-ups is minimized.

Challenges

  • System Set-Up Cost: As one of the newest systems available, it comes with a higher initial investment.
  • Tray Selection: Trays for this system are specialized and costly. Only one type of tray fits the cart’s divider, making extra or replacement trays an expensive purchase.


Insulated Trays on Non-Insulated Cart

An insulated tray on a non-insulated cart is a simple and effective meal delivery system for smaller populations. Meals are served into a single tray, then each subsequent tray is stacked on top of the previous one, creating a lid-like effect. This continues until all trays are stacked. Meals are transported on an open cart, which typically has a bottom shelf for stacked trays and a top shelf for drinks, dinnerware, or additional items. The trays contain four to six compartments for food and are insulated, allowing them to retain temperature without needing an enclosed cart. After mealtime, the trays can be stacked back on the cart for easy transport to the washing station.

Benefits

  • Cost: This system uses an affordable cart, as the trays maintain the food temperature rather than the cart itself.
  • Stable Tray Stacking: The trays interlock, providing a stable and secure stack.
  • One Tray: All food is on a single tray, minimizing the amount of dinnerware needed.

Challenges

  • Bulky Trays: These trays can be cumbersome for caregivers to handle and take up more space on the cart due to their size.
  • Short Temperature Holding Time: Trays have a shorter holding time compared to insulated carts.
  • Presentation: It can be challenging to make food look as appealing in insulated trays as on a plate.


Conclusion

There are many factors to consider when deciding which system is best for you. Your organization may decide to use a variety of systems, depending upon the requirements for the different needs you serve.

Here’s a list of things to consider:

  • What are the needs of the individuals in your different units?
  • Are your units/wings specialized? If so, what kind of challenges does mealtime pose?
  • How long are your meal periods?
  • What type of service do you conduct (traditional/bedside ordering vs room service)?
  • How large is your menu?
  • How long does it take you to serve meals?
  • Is electricity accessible throughout your property?

There is no one way to serve meals. Every organization is different, and every property presents its own unique set of challenges and services. You’ll have to do your best to find a system that mitigates the threats of foodborne illnesses, provides speedy service, and maintains food quality for your patients/residents. All these options have their place. For long-term care organizations that also feed people in cafeterias, we offer transport methods for bulk-food applications as well.

If there’s one we can help you with, please call JonesZylon!

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