The Big Idea 2013: Trayless Patient Service

Renato de Leon
Food Service Director
Winchester Nursing Center
Winchester, Mass.

We have a trayless system. In a nursing system you normally do trays and then you send them out on trucks and the nurses pass them out. With the economy the way it is, I was looking to find a different way to save money. On a tray you would usually get the food of the day, which is what we thought the resident would want. So we started a trayless system. We bought some carts that we fill up with food and we go room to room and we ask the residents what they would like. I put some metal inserts into the carts and put in pizza stones that have been warmed in the oven. The stones keep the food warm in the cart.

Residents have the main meal and the alternate meal. In addition, I offer all kinds of sandwiches on a daily basis because that’s sometimes all they want. I have pizza and a cottage cheese and fruit plate. We also have pasta and sauce. They have a pretty big range of items to choose from.

On our end, we are able to save money and have less waste, and people are eating. We don’t have to use as many supplements. We were at the average of weight loss between 13% and 16%. Right now I’ve been able to take it down to 2% or 3%. With this system the residents have been able to get their voice back because now they have an option. I restructured staff and I’m now working with one less FTE. I’ve been able to save 9% on my budget since starting the trayless program. Nursing has a lot more time as well now that they don’t have to pass out trays. I’m able to serve 145 residents in 45 minutes.

The staff has more interaction with residents and they’ve gotten to know the residents better. Before, we knew them by a name on a piece of paper.  

Residents are no longer served meals on trays. Instead meals are delivered by carts and residents have more options from which to select.