Dining as a Catalyst
Liberating Care & Navigating Change
©
Rhythms of Daily Living
A Service of Choice
Aligning Experiences – Expectations – Resources – Outcomes
Session Objectives

Present



Discuss




Transition Experience
Integration of Key Factors
Tradition & Transition
Provide


Concept of Dining as Catalyst
Key Factors for Transition
Process for Transition
Outcome

Create Documented Process for Community Program Transition
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Assumptions
Envision the Future, Honor the Tradition
 Imposition of Dining
 Until the Experience Dining is Resident Centered,
a New Culture will not Take Deep Root
 What is Current Does Not Work As Well As It
Can & Should

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Presentation Points
Review Changing Factors of Environment &
Constituencies
 Review Demographics
 Define Assumptions
 Introduce Choice Dining Concept &
Implementation Process
 Discuss Culture of Service, Leadership, Choice
 Identified Measurable Indicators

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Changing Demographics
More Couples
 More Choice & Selection
 More Control
 More Flexibility
 Experience Consumers
 More Knowledgeable of CCRC Living
 Healthier – Wellness Important
 Seamless Experience
 Broader Constituencies

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Assumptions
Imposition of Dining
 Transition is for All Levels of Living
 Choice is a Key for Quality of Living/Work
 Operational Evolution Enabling Culture
Transformation
 Requires Servant Leadership

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Must Rising Acuity Levels Mean Lower
Dining Quality ?
©
Independent Living
Nutrition Quality
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Assisted Living
Food Quality
Memory Enhanced
Service Quality
AAHSA - Quality Through Community
Skilled Nursing
Life Quality
7
Bridging The Quality Gap
Serve The Resident, Not The System


The System – Individual Preparation, Bulk Service
 Prepare Individual Menu Items For Storage
 Place On A Tray For Transport To Feeding Area
 Transport and Leave In Cart
 Distribute and Unwrap At Scheduled Meal Time
The Alternative – Bulk Preparation, Individual Service
 Prepare Menu Items In Bulk
 Transport To Dining Room Servery
 Plate Individually and Serve Upon Request
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How Do You Individualize Care?
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
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What Are Community Strategic Objectives?
What Is The Vision for Community Dining
Experience?
What Is History of “Transformation” Projects?
What Are Constituency Most Important
Experiences?
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Rhythms of Daily Living
The core of RDL is the opportunity to exercise choice – residents’
for how they choose to live their day and staff choice for care
delivery. This creates a collaborative coalition of residents and
caregivers working together in a living environment. RDL
facilitates the delivery of care, the experience of living and the
dignity of self-determination.
RDL is a management principle that aligns the natural rhythms of
residents and the support they need. The organizing principle
of RDL is that people should be able to make meaningful
choices in their daily lives – on their own or with assistance.
RDL relies on caregivers to help define and achieve outcomes
that balance individual choice and system efficiency.
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Choice Is The Way We Live
“Some facilities studied, usually the lower turn-over
ones, were in the process of thinking about how to
increase individualized care. For example, the
researcher asked, what are you doing if anything
about resident choice. ‘We are looking at it. Ideally,
we want them to eat when they want. We encourage
them to tell us what care they want, a shower or bath,
or to get up when they want.”
Page 5-49 Appropriate of Minimum Nurse Staffing Ratios in Nursing Homes, Phase II Final Report prepared by
Abt Associates for the Centers for Medicare and Medicaid Services, December 2001.
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STAGES of RDL
1.
2.
Readiness GAP Analysis
 Establish clear understanding among all
constituents (residents, staff and
administration) as to the program impact on
6 principle areas.
Culinary Capacity
 Establish a servery on the resident floor
where all meals can be finished, plated and
served.
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Stages of RDL
3.
4.
Individualized Service
– Establish a service program without the tray
system. Meals are plated in the servery
when the resident is in the dining room.
Choice is based on pre-ordered menu
items, however time of service is not
flexible.
Point of Service Menu Choice
–Establish the opportunity for the resident to
choose alternate items during meal service.
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Stages of RDL
5.
6.
7.
Schedule Choice I[1]
 Establish the opportunity for residents who are
self-sufficient and independent to dine at a time
of their choosing, within established service
times.
Schedule Choice II
 Establish the opportunity for residents who
require assistance with dining but are able to
determine when they would like to dine to do so
within established service times.
Venue Choice (If Appropriate)
 Establish the opportunity for residents to choose
alternate places to dine.
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Assessment Points for RDL
Implementation
Stages are defined against the requirements of:
 Administration: fiscal, management and leadership
considerations
 Regulatory: compliance criteria (grouped by clinical and
operational considerations)
 Systems: software programs, forms, policy & procedures,
protocols
 Personnel: staffing requirements, training, HR. The impact
on each care disciplines is identified by department
 PP&E: Property, Plant & Equipment necessary to perform
the tasks and functions
 Community: Communications, Resident & Family
education; community collaboration
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What Are Your Experiences?
Obstacles
 Structure of ordering
 Staff resistance to change
 Inadequate staffing
 Training of staff to new tasks
 Management of change (fair process)
 Need to educate the staff in the process of change
 Clear explanations of the reasons/outcomes of changes
 How changes will impact staff security and knowledge
of job tasks and resident served
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The ROI Of A Dining Experience
Building “Experience Equity”
Dining establishes the daily quality of life for all members of a senior living community.
The culture defined by the dining experience resonates with and dictates that of the
entire community. The dignity and joy of making self-determined choices are at the
core of any good dining experience.
BAD DINING
EXPERIENCE
GOOD DINING
EXPERIENCE
High Staff Turn-Over/Contract Labor =
High Costs & Poor Morale/Service
High Staff Retention = Lower Labor Costs
High Food Waste/Use of Supplements =
High Food Cost
Low Food Waste/Elimination of
Supplements = Lower Food Costs
Low Appetite/Unanticipated Weight Loss =
High Care Costs
Healthy Appetite = Lower Care Costs
Poor Image = Higher Marketing Costs and
Lower Income
Great Dining Program = Lower Conversion
Costs & Higher Occupancy
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Contact Information

Dan Look



3605 Sandy Plains Road
Suite 240-269
Marietta, GA 30066
dcl@dm-resources.com
 www.dm-resources.com
 770-565-4006

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"For every complex, difficult problem,
There is a simple solution.
And, it is probably wrong!"
H.L. Mencken
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