The fallout from COVID-19 continues to affect the economy and slash healthcare revenue. The healthcare market is furloughing workers and cutting staff hours at a staggering rate due to reduced income streams from surgeries, radiology, heart centers, and outpatient centers. Food and nutrition departments (FNS) are coping with these challenges by adapting their services to meet patient, resident, staff, and retail service needs.
 
While still in the crisis, FNS retail in healthcare has primarily switched from cafeteria and self-service operations to grab-and-go service. Some facilities have converted part of their operations into markets, selling items like packaged meals and bulk items like eggs, bread, and toilet paper. FNS readjusted by moving front-of-house staff to back-of-house to assist with carryout production and patient services.
 
Not filling open positions and furloughing FNS staff is happening now; however, that does not mean production, service, and sanitation get curtailed. Technology can assist with labor savings through interfacing foodservice software for patients, menu planning, production, and tray assembly techniques. Remi Hayashi, RD, FSD at Queen of the Valley in West Covina, CA, has been able to avoid layoffs but has flexed staff hours by 21%. She has streamlined services to patients, café service hours, employed retail and patient technology, and adjusted staff assignments to still meet facility needs.

The way to get plated hot food loaded into carts in 30 seconds is with a POD system. POD systems expedite service quickly because all positions are working at a measured pace with no wasted steps.

Tray assembly techniques come primarily in two forms: trayline and POD (point of distribution) systems. Traylines have been around for decades. They represent a time when menus were non-select, and staffing was not a concern. Traylines cause bottlenecks due to a lack of cadence between the 6-8 positions (typical 200+ bed facility). Whereas the starter is hustling to place tray tickets, condiments, induction bases, flatware, call out orders, and place trays on the belt, the cold position adds only beverage, gelatin, salad, and dessert. The hot food positions only plate 3-4 items. That carries the bottleneck to the checker/loader who adds coffee, ice cream, and other items like chips while checking tray accuracy. Extra minutes compromises hot/cold food quality and temperatures. Finishing one tray at a time means longer serving periods.
 
The way to get plated hot food loaded into carts in 30 seconds is with a POD system. POD systems expedite service quickly because all positions are working at a measured pace with no wasted steps. The benefit of 30 seconds per tray is better temperatures and higher patient experience scores. The other significant POD benefit is labor savings. A staff of four can complete 240 meals per hour. PODs began with room service programs but now are a choice for select menu systems. Hot wells, starter stations, air curtain coolers, and beverage stations are primary POD components.
 
As with restaurant service, the key to POD service is to start by plating hot food (position 1) and placing the plates under heat strips. Sitting perpendicular to the hot wells is a two-sided starter station where starters/assemblers (positions 2,3) cover the hot food, place condiments, and cold items on the trays. Trays move to the checker (position 4), who adds coffee and loads trays into carts. There is no trayline--staff has all supplies within arm’s reach. Distributing hot plates between two starters allows for an even pace. For late trays, operators utilize half of the POD while the other half resets for the next meal.
 
A standard POD can be made into a Tri-POD by adding a single starter station, air curtain cooler and beverage station. 6 FTE’s can serve 360 trays in an hour. POD systems fit in the same space that traylines occupy. Many times, there is enough space left for tray delivery carts. Fortunately, POD equipment is portable, making remodels less complicated and expensive.  
 
Again, 4 FTE’s can produce 240 trays per hour. An FTE costs (wage/benefits) $50,000 annually. Labor savings means justification and needed ROI for POD projects. Free consultations for POD projects are available through local Dinex (CFS Brands) representatives. As with the consultations, CFS Culinary assists with the installation and implementation of Dinex POD projects.