We started using the SuzyQ cart System recently – we did a short training session for the mental health staff.
So far, I like the SuzyQ cart mobility, the size, weight, etc, basically, I like it all. I think it is a very practical piece of equipment
Mohsen T. Saberi. MSc, RD - Manager, Patient Food Services, Sodexo, UBC Hospital August 17, 2019
My new Food Service Manager and Dietitian watched the Webinar this afternoon. I was very much impressed with your presentation and our new dietitian is very excited NOW about my vision to improve our dining service.
I am hoping we will be able to access this again to show to the rest of the management team and to the dining room committee that I am trying to form.
Thank you again
Sharon Morris, Manager of Support Services, Sunridge Place, Duncan BC August 17, 2019
Together with our Executive Director, and our Recreation & Leisure Manager, we participated in your recent webinar.
As we were watching and listening, we realized that we had a lot of room for improvement. There were a few things we had in place, but very few and we just knew that we had to gather any information we possibly could in order to implement your ideas into the dining experience for our Residents. While watching the clips where the staff were serving the Residents using the Suzy Q cart, we were very impressed with the engagement of the Residents and how they so enjoyed their freedom of choice. We do offer some choice but just not in that manner. We are so excited to get started - in closing we would like to thank you for working
hard to get your information out to those of us who certainly appreciate it and want to improve service to our Residents.”
Myrna Fahie, Hospitality Services Manager, The Birches LTC, Nova Scotia August 17, 2019
The care team is very pleased with the way meal service allows for one on one interaction prior to eating.
Care members can sit with a resident and set the mood using conversation and a gentle approach while food is being served. The SuzyQ cart System calls attention to efficient teamwork between the departments, encourages socialization of residents and strives to emulate a home like setting.
Sue Griffin, Director of Care August 17, 2019
The Windsor Elms began as a nursing home in 1966. It was first located in an older Victorian building and the Residents ate all of their meals in a central dining room. As time went on and the functional impairment of residents being admitted increased, decentralized dining was required. Suzy Q hot carts were then implemented in 1999. In 2007 we received the approval from Dept of Health and Wellness to build a new facility. We had the luxury of designing a space that would more closely mirror a home environment and align with our vision of being “the best place to live, work and visit”. When the Windsor Elms Village opened the new facility in the fall of 2010, three distinct neighbourhoods were created, each with four houses of nine residents. Each house now had its own kitchen and dining area. All food was still to be cooked in the central kitchen where it would be portioned for 12 houses of 9 residents and delivered to the houses via an insulated trolley.
One overwhelming strength of this system was its ability to provide flexible mealtimes as it allowed food to be held on a buffet warmer and served when Residents were ready for their meal. However as time progressed the limitations of this system became very apparent.
A disconnect evolved between meal service in each house and the central kitchen with the result that kitchen staff did not always receive timely feedback or have the opportunity to get to know their customers. Resident preferences were not always being accommodated nor was the kitchen made aware of dislikes. At the same time, alternates made by the kitchen to meet a Resident’s dislike were not always served by house staff who were unaware they had been sent or house staff had already made their own alternate. Communication and the central kitchen’s ability to accommodate preferences were deteriorating.
This disconnect contributed to one of the most significant drawback of the system: wastage. Containers of food were returned to the central kitchen, sometimes untouched. The considerable time spent by the cook portioning every food item into 12 containers for 12 houses was also noted, as well as the challenge of meeting requests for extra portions for certain food items.
In terms of quality of the meal service, the main concern was temperature. Food was not remaining hot, due to either the multiple transfers from kitchen to house and/or food cooling while it was plated for nine Residents.
The decision to consider returning to the SuzyQ cart System occurred after a thorough evaluation of the buffet warming system which had been in place for 2 years. Staff were overwhelming in favor of “going back” to the hot cart system. A trial of the hot cart in one neighborhood for the dinner and supper meals occurred and the evaluation was extremely positive. Residents felt the food was much hotter, there was less confusion and the House staff were able to better meet their needs because of the support of the kitchen staff plating from the hot cart. After reviewing the results of the trial, the Leadership team unanimously supported the plan to implement the hot cart system homewide in the spring of 2013.
Three months after homewide implementation, Residents and staff were asked for their feedback and the advantages of the new system were plentiful. They included a more efficient meal service which in turn allowed more time for staff to interact with and support Residents and of course a hotter meal on the table. There has also been a decrease in wastage as kitchen staff became increasingly familiar with Resident preferences for favorite items as well as portion sizes. As well they have more opportunities to communicate with house staff which was noted to reduce confusion around alternates for Residents. Personalized meal service is also improving as kitchen staff plating the meals build stronger relationships with Residents and house staff. Occasionally space on the hot cart can be a challenge, particularly if there are a number of texture variations and alternates being delivered.
Overall the return to the SuzyQ cart System has allowed our meal service to become more Resident focused, with our goal being for it to become Resident-directed. This change was a fundamental step for us in our journey …..
By Denise Turnbull, RD - Director of Food Services, Windsor Elms Village, 174 Dyke Rd, Falmouth, NS August 17, 2019
As you can see in the notes attached, the patients are really enjoying the New “choice meal service” provided.
We only got complaints on our surveys before so getting positive notes from patients is a big improvement. The SuzyQ cart System is working wonderfully, and it is sooo much fun. The patients are now even asking for second cups of coffee, so we leave thermo’s of coffee on a cart in the hallway for Nursing to pour seconds. Too cool. Can’t believe the patient “happiness”. Thank you.
Gail Weleschuk, CNM, Supervisor, Patient Food Services - Tofield Health Centre, AB August 17, 2019
It’s been about a year since we purchased our first Suzy Q cart and we have recently added a third to what I now refer to as our fleet. In the beginning, I had searched far and wide for a solution to provide a higher quality of service to two of our dining rooms here at Dallas Retirement Village. These two dining rooms serve between 15-20 memory impaired residents each, one in our assisted living and the other in our skilled health care center. Since the service pantries in these areas are small, with no space for heated equipment, the previous system relied on insulated food holding carts. Food was transferred in bulk from the kitchen to the dining room, where our servers plated the meals. Unfortunately there were frequent complaints of cold food and the servers had very little space to set up their dishes, condiments, etc., making service very awkward.
It turns out that this design, which I had inherited, was never intended to be permanent but it sure lasted much too long while I searched for an alternative solution. I looked at all sorts of equipment but nothing was standing out as a satisfactory and permanent solution for the financial and space constraints. One day, not believing that there was not a product for something so simple, I sat down and searched the web for “hot food cart” and was so excited when I found the Suzy Q! It has been a bit challenging to make the space in our kitchen to store them, but they are well worth it in how they have elevated our service. The price was quite reasonable compared to potential remodeling costs, and there was no disruption of service as there would be with construction.
Our third cart was added to service the second floor in the health center. It has replaced the unattractive steam table which sat prominently in the dining room. When we began a project to improve that area esthetically, it was clear we needed to get rid of the steam table and plate warmer. Our original plan was an extensive remodel of the service pantry to allow the steam table to be located inside rather than in the dining room. This would have cost in excess of $20,000. The Suzy Q carts were working so well to improve service in the two smaller dining rooms that we chose instead to accomplish our mission in that way. Removing the steam table from that dining room leaves more space for activities between meals. The steam table had also been an unintended focal point, and adding some artwork along with a few furnishings has created a much warmer and open atmosphere.
Linda Saunders CDM, CFPP - Director of Dining Services, Dallas Retirement Village, 377 NW Jasper St Dallas August 17, 2019
The SuzyQ cart is working exactly as intended.
Residents are loving it. The cart is moving freely throughout the dining room. Just doing a few tweaks in the dining service now to make it perfect. Once we have it perfected I expect to be shopping for cart number 2. Thank you for this Suzanne. Well done on your end, it does everything you said it would.
Rob Shea, Beverly Centre Glenmore (AgeCare ) August 17, 2019
In April 2014 a Satisfaction Survey was conducted by dietitian students, who surveyed eleven randomly selected residents to assess their satisfaction with food services. Overall the results were very favorable, but opportunities for improvement were identified in the temperature of served foods and most notably, opportunities for providing more choice in the foods offered at meal times.The Regina Qu’Appelle Health Region recognized these concerns and provided funding through the Urgent Issue Action Fund for Long Term Care facilities throughout the region to purchase a number of Suzy Q carts.
The Suzy Q Cart enables the kitchen staff to come right out to the dining room instead of preplating the plates in the kitchen and passing them through a window for the staff to place in front of the resident. It allows the resident to be part of the experience by seeing and smelling the food about to be offered. This cart along with the supplement carts contributes to a positive dining experience as it offers home style service. It becomes resident focused as kitchen staff inform residents of their menu choices and serve them right at their table. It is not just a cart. It is a way to help us serve the meals better and provide exceptional customer service, and encourage independence and control over their own food choices while enhancing overall dignity and quality of life.
Changing the culture can be a challenge. One of our challenges was the beverage cart service at breakfast time and on weekends. Mornings are a very busy time in Long Term Care homes, the care staff are assisting residents to get up and prepare for the day and they become overwhelmed with the pressure of making sure folks are getting to the dining room in time for breakfast. To enhance the dining experience, the vision is to have care staff take the lead in offering beverages (coffee, tea, juice, milk, etc.) from the cart before the meal is being offered by the kitchen staff. With increasingly higher care needs, care staff just could not get there on time,
which led to delayed meal service and unhappy residents. With the help of the Standard Work and Replication Pod, other staff members within the facility found ways to free up some time for the care staff by changing their own routines to assist them so they could be in the dining room on time to help with the beverage cart. During the week the recreation department has taken the lead on serving from the cart until the care staff is able to get to the dining room. On the weekends, the housekeeping staff has taken the lead with the cart on Saturdays and the laundry staff has taken the lead on Sundays. We have also implemented an “All Hands on Deck” approach to helping with the dining room experience. All hands on deck doesn’t mean you have to be there physically at a certain point of care but to be supportive and help as a team member to find solutions to any challenges that may arise (example: if short staffed, please lend a hand). We as a team have also put together a binder for every week of a four week menu to assist the kitchen staff in their daily routines. Each binder consists of the following:
- Dining room seating plan
- Work standards
- Pictures and list of items to be on supplement carts (Beverage, cereal, soup, and dessert)
- Sunday to Saturday menu
- Picture of the Suzy Q cart with a diagram of which size of container goes where in the cart ,what menu item goes in it and what serving utensil is needed
- Standard recipes for each menu item
Since we started offering our residents choices, we have noticed a reduction in our food cost and waste, for example a drop in our weekly milk order by four-four liter jugs of milk. Our residents enjoy the interaction they have with the staff at meal times, and some ladies even enjoy flirting with our head cook. These changes have allowed us to focus on the resident and to understand how simple gestures of communication, being verbal and/or body are very important to the resident. We have also created a team that is resident focused and understands how communicating and working together benefits not only our residents but us as a whole.
Donna Weiss, Administrative Service Coordinator, Echo Lodge Special Care Home, Fort Qu’Appelle, Saskatchewan August 17, 2019
We have been using the SuzyQ cart at Cambridge Place since the first week of June, and we use the system Monday through Friday during lunch as we are starting with baby steps in the transition from tray service.
The introduction of the system to our Community created improvements in several areas to our Dining Services. After learning the system, our food service team came together to improve the quality of meal delivery for our residents. The SuzyQ cart encourages a more efficient manner of serving the food, the staff get to spend more time interacting with the residents and less time passing out trays. We have seen a significant positive change in the number of residents who want to eat in the dining room instead of their room.
Residents enjoy their meals again, and look forward to the personal attention they receive from staff on a daily basis. Giving the residents the ability to have some choice is the most meaningful change for us since using the SuzyQ cart system and we are very pleased with the benefits seen. And a testimony from one of our residents is “I think all of us really like the choice we have about what we eat and how much. I like that we are all served at the same time and the food is hot when it is given to us. I always come to the dining room when we have the SuzyQ cart now.
Cara Clark, RD, Administrator Cambridge Place, Lexington, KY August 17, 2019
I just wanted to reach out and let you know once again that I really enjoyed your presentation and I gained clear, obtainable vision on how I want to implement culture change in the dietary department.
I am 100% sure that this will work for us and be the solution to nearly all of our issues. Like I said, I am sold. The next step is getting everyone else on board, which I am confident that I can.
I’ve signed up our facility administrators and DON for your next scheduled webinar! I think they will have a positive reaction to it and be very receptive. Thank you for your inspiration and all of your great advice.
Claire Toups - Dietary Manager Chateau Terrebonne Health Care Houma, LA USA August 17, 2019
When I first started as a dietitian in long term care 25 years ago, dining room service looked very different than today.
Generally, in the facilities I worked, there was one large, central dining room. It could have capacity for a hundred or more residents. Meals were generally served from a stationary steamtable housed in a kitchenette at one end of the dining room. Care staff would serve the meals that were plated by the dietary staff. Plates of food were “plunked” down in front of the resident without a word. Residents were known by food texture not name.
For example, care staff would say “3 regulars and 1 minced” when asking for meals. The whole experience was rushed and very impersonal. Residents had no choice. It was a frustrating to try and change things. When I became involved in opening up three new facilities (Morgan Place, Fleetwood Place and Laurel Place), it became a priority to improve the food service. The design of the buildings changed to accommodate several small dining rooms instead of the one large one. With the help of Suzanne Quiring, plans were made to implement a food service using her mobile food carts. Suzanne was excellent at training the staff and managers on the new system. Right from the start you could see the improvements in the food service. Instead of plated meals being “plunked” in front of residents, they were now being offered choices.
Servers were trained to have a dialogue with residents prior to serving their meals. This could mean talking to them or sometimes, in case of auditory impairment or cognitive decline, just showing the resident the plated meal was enough to get feedback before serving. Residents could now choose how much they wanted or if they wanted an alternative. The biggest fear from the dietary and care staff was that it would take too much time. In the beginning, it did take a bit longer. As the staff got more proficient, the service became about the same length as the “plunking” method.. Cooks were also a bit apprehensive that there would be more leftovers. What was found was that there was no significant change but there was less plate waste as residents had more of a say of what and how much they wanted.
The change in serving system had many benefits. Residents were happier as they had choices. Staff felt more fulfilled being able to offer a more resident focused service. By interacting with the residents every meal, it has allowed them to get to know our residents individually. It has helped foster relationships with the residents in which they talk, laugh or are jus there for each other. It has brought the “humanness” back to a system that was impersonal and task focused.
The dining room environment now resembles that of a restaurant and not an institution. The change to a more resident focused food service continues to be an example of how systems can change positively without significant cost increases.
Cathy Mesner RD – Morgan Place, Surrey, BC August 17, 2019
Buffet Dining at your Door Lewis Country Nursing and Rehabilitation Center 2017 Award winner of TN State Innovation Award by TN Health Care Association
In June of 2016, the Administrator and RD were reviewing the satisfaction survey results received from Residents and families. The satisfaction level of 65% with the quality of meals was concerning. We had previously given focus to the dining experience in the dining room, transitioning to buffet style dining and developed selective menus, continental breakfast and a la carte menus that expanded the amount of choices for all residents. We were still providing the traditional pre-plated, non-selective cart service to the halls for patients who choose to have their meals in their rooms. No matter the interventions we had in place to keep the food hot, we still received complaints of cold food and not appetizing. So we decided to focus on the dining experience for patients having meals in their room and a way to make it more resident focused.
As we looked at our process the one thing that was apparent, the patients having meals in their room did not have the opportunity to see the meal, voice their choice, have control over quantity and it be hot from the steam table. This became our mission. After research we discovered the SuzyQ cart System “The Hot Food Cart” that was designed and used to serve table to table. After more research and watching the instructional video the decision was made to purchase one cart and instead of the designed use of table to table, we would use it door to door. We purchased a SuzyQ cart in July 2016. In the planning of the implementation of this dining program, we also looked at beverage and dessert delivery. A beverage cart was also purchased. The plan was to begin with one hall until we had it perfected.
Then we would expand the program. Aug 1, 2016 “Buffet dining at your door” was launched on “Highway Home” bed capacity 24, average census 18. This hall is our transitional care hall where the majority of residents are alert and oriented, so we could gather feedback on the new program. Residents who had the ability came to their doorway to view and smell the meal, and voice their choice of food and quantity. Patients who were unable to view the cart but could smell the meal, nursing staff verbally informed them of their choices and they then provided their choice and quantity. Desserts were on a separate cart for them to choose. Beverages were poured and served on request at the beverage cart. A dietary staff member served from the SuzyQ cart, and the nursing staff delivered the plates, dessert and beverage. No trays were used. We were very excited with our success providing the same dining experience for in room patients as the patients received who had their meals in the dining room. The program continued on “Highway Home” until we had it perfected, based on patient feedback, then it was introduced to “Rose Blossom Lane” in October 2016, bed capacity 24, average census 12. After perfecting the system on two halls, it was then introduced on “Holly Berry Lane” in January 2017, bed capacity and average census 12.
If the resident has company at the time of the meal, the company is offered to choose a meal also. Meal clean-up was another area that was patterned after the dining room experience. The nursing staff uses a busing cart to bus the tables in the Residents room. The program has received very positive results and many compliments from residents and families. Comments have included; treated special and feel like royalty. Review of the satisfaction survey results from residents and families January 21, 2017 indicated an increase of the satisfaction level of the quality of meals to 73%. Food complaints regarding meals on the three halls using the system are non-existent. We have seen an increase in meal consumption of the residents because they are eating what they want and the food is hot, which leads to less waste of food.
With less waste the food budget can be used more effectively to enhance the meals providing more choice and quality. This “resident focused” meal system enables residents to gain back some control of their lives. One success that comes to mind is a dementia patient on “Holly Berry Lane” who has been a struggle with decreased appetite and weight.
Most days she would consume maybe 5-10 bites of all three meals served. The day the program began on her hall she ate 100% of her first meal. She continues to consume 100% of either the lunch or dinner meal. Her weight has increased, more alert, and overall general appearance improved (face filled out and rosy cheeks again). The dietary and nursing staff also experienced positive results with the new meal delivery system. Dietary and nursing have strengthened their relationship and work as a team. This system has eliminated the likes and dislikes list since residents choose their meal. Dietary staff interaction with the residents has increased. Dietary workload decreased in tray set up, serving the proportioning the meal, beverages and desserts, then sending the meal to the hall in a food cart. Also with the busing of the tables, the dishes enter the dish room dishwasher ready, decreasing the workload of dietary staff.
Time saved is used productively to further enhance meal service such as dietary staff deliver the a la cart requests directly to the patient so it arrives hot and appetizing. Previously, the nursing staff was called to the kitchen to deliver, resulting in warm to cold food. Even resident council experienced a positive outcome for the program. In the past a lot of the resident council meeting time was consumed with food complaints, they are non-existent now. More time can be spent on planning and implementing changes in the facility culture for a more resident centered focused environment.
Plans are to expand “Buffet dining at your door” with the purchase of the second SuzyQ cart system in Aug 2017. This cart will service Wisteria Lane and Hummingbird Lane each hall bed capacity and average census 34. With this expansion, the pre-plated, non selective cart service will end in the kitchen. We will have accomplished our goal of providing all resident a meal service where they have full choice of what they want.
Celeste Blocker, RN, NHA Administrator, Lewis County Nursing and Rehabilitation Center August 17, 2019
I would like to share some of our successes with using the SuzyQ carts; I oversee two facilities one with 120 residents.
Grand manor, and Balwin Villa with 105 residents. When we did our renovation and expansion at Grand manor we purchased two carts for service in the south wing So NFS would have control over the serving of all the food.
Each cart does two floors of 16 residents a piece and the communal ding room for the north side.Over the past year, with two facilities running the exact same menu the difference has been extraordinary , happier clients , hotter food , better service, better control by NFS management, superior portioning control, better interaction with clients for food services.
The numbers are eye opening as well,, with improved control and less waste, Grand manor was 45 000 under budget while Balwin was 45000 over a difference of 90 000 dollars. For a non-profit society this is a massive savings. The savings paid for the extra staffing to serve the food. My plan for this year is to purchase 3 carts and employ them at Balwin Villa.
Wayne Maki, Executive Chef & Food Service Administrator Excel Society August 17, 2019
I am pleased to write this letter of recommendation for a SuzyQ cart that we purchased October 2018.
We are primarily using this cart for our Meals on Wheels program but also use it for catering functions. In addition it has been a hot holding replacement when one of our steamtable units was under repair.
The benefits of this cart are many: easy to care for stainless steel construction, cutting / service board, heated drawers, ease of movement and emptying the water out of the hot holding wells.We are primarily using the SuzyQ cart for our MOW production making it an important piece of equipment in our main kitchen. In addition to this we use it as a mobile catering cart for functions in other areas of the Manor.
We have used it for dining room service while a steam table unit was under repair. With the heated drawers available, there would be sufficient room for all our menu choices of the day. The cart itself is a very presentable piece of equipment and easy to move. Residents were pleased to have their food served closer to the actual seating area in the dining room. Each of our dining rooms presently has its own kitchenette for meal service but I can easily see that moving to a mobile food cart service would be a positive option for us in the future. We have had no maintenance or warranty issues to date.
The cart comes with a comprehensive training manual on use and care. Customer service follow-up is surprising and appreciated. We rarely, if ever, have received customer service follow-up for other equipment that we have purchased. For these numerous reasons I would definitely recommend this equipment.
David Rhodes, Food Service Manager Maxville Manor, Ontario August 17, 2019
“The numbers are eye opening as well,, with improved control and less waste…we have a savings of $90,000 – for a non-profit society this is a massive savings. The savings paid for the extra staffing to serve the food. My plan for this year is to purchase 3 carts and employ them at another site.”
Executive Chef & Food Service Administrator, Excel Society
“Residents were happier as they had choices. Staff felt more fulfilled being able to offer a more resident focused service. By interacting with the residents every meal, it has allowed them to get to know our residents individually. It has helped foster relationships with the residents in which they talk, laugh or are jus there for each other. It has brought the “humanness” back to a system that was impersonal and task focused. The dining room environment now resembles that of a restaurant and not an institution. The change to a more resident focused food service continues to be an example of how systems can change positively without significant cost increases.”
RD – Morgan Place
“A testimony from one of our residents is “I think all of us really like the choice we have about what we eat and how much. I like that we are all served at the same time and the food is hot when it is given to us. I always come to the dining room when we have the SuzyQ cart now.”
Cara Clark, RD, Administrator – Cambridge Place
“Since we started offering our residents choices, we have noticed a reduction in our food cost and waste, for example a drop in our weekly milk order by four-four liter jugs of milk. Our residents enjoy the interaction they have with the staff at meal times, and some ladies even enjoy flirting with our head cook. These changes have allowed us to focus on the resident and to understand how simple gestures of communication, being verbal and/or body are very important to the resident. We have also created a team that is resident focused and understands how communicating and working together benefits not only our residents but us as a whole.
Administrative Service Coordinator, Echo Lodge Special Care Home
“The patients are really enjoying the New “choice meal service” provided. We only got complaints on our surveys before so getting positive notes from patients is a big improvement. The SuzyQ cart System is working wonderfully, and it is sooo much fun. Can’t believe the patient “happiness”. Thank you.”
Supervisor, Patient Food Services – Tofield Health Centre
“The SuzyQ cart System allowed for improved interaction and relationship between the dietary and nursing staff, as they started to work more together at serving our residents the better. Our food and beverage waste has decreased as well, which means we are saving money. Our cooks for the first time are leaving the kitchen and serving residents direct, which has allowed them more understanding of the needs of our residents. The cart moves very easily, and we love it. The table side dining has allowed the staff to spend time before and after with the resident, engaging them in their meal choice and receiving feedback in the moment. As soon as the blessing for the meal and the staff is complete, the lids come off with a flourish and the steam escapes causing excitement as they anticipate the choices to come. Thank you for your passion and investment in our residents satisfaction.”
Manager of Dining Experience, Menno Housing Society
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