Mary O'Connell: Home Healer

She may be pulled in six directions at once, but there's nothing frenetic about Mary O'Connell, MS, RD, director of food and nutrition services at 213-bed United Odd Fellow & Rebekah Home located in the Castle Hill section of The Bronx. In fact, judging by her fine sense of humor, you'd never know that her daily to-do list is in a constant state of flux. "Everything changes direction every day," she cheerfully admits. "If you're very 'bank-like,' you're in trouble."

This year is just a bit more complex than most. O'Connell is overseeing the construction of a brand new kitchen that is slated to open in June 2007. She's working closely with the architects and the construction crew, to make sure that not only will some elements of her "dream kitchen" be included (the affordable ones, that is) but that those she was taking for granted will be incorporated without a hitch as well.

Seeing the light: One feature that is not on the drawing boards is the tray line. O'Connell slowly but steadily transitioned this not-for-profit facility to buffet service during the better part of her first year on the job almost seven years ago. "It was a standard tray line operation here in November 1999, with disposable trays, plates and utensils," O'Connell recalls.

"I'd previously worked with Aramark and they did buffet service for a portion of the meals at some accounts. Since I'd seen staff and resident satisfaction improve greatly, my plan here was to do the same and get my employees out of the basement kitchen."

By June 2000, having purchased dishes, utensils, two heated carts (like steam tables on wheels) and a dishwasher, she had buffet service running on two floors; by August it had been implemented in all four dining rooms on three floors with no additional employees needed.

Nursing role: O'Connell's equally new-to-the-facility administrator was willing to take a chance on her idea, but winning over the staff took understanding and patience. "At first, the staff was very nervous with the buffet concept," she says. "They couldn't imagine not having trays and having to go to the floors and see the residents. Now, most of the foodservice staff of approximately 30 full- and part-time employees are in the dining rooms and several announce the menu out loud to the approximately 43 residents in each venue. They're behind the buffet table where they plate up the entree and hand it to the nurse who has previously shown the residents the main and alternate selections displayed on little carts they wheel to each table."

Since the dining rooms are also the facility's day rooms, the foodservice staff can get in and set the tables with placemats, napkins and utensils 45 minutes before service. But no food is put on the tables until a licensed practical nurse (LPN) or certified nurses aide (CNA) is present in order to avoid a person touching another's food.

"Residents can see and smell the hot foods on the carts," O'Connell explains. "The nurse (or aide) has a selection of the main and alternate entrees and can go to the cook and ask for two vegetables instead of the starch portion, or a sandwich if that's what the resident wants. Typically, four to six people are seated per table and no one transports their own meals."

Sensory turn-on: O'Connell believes the staff was bored with the "same old, same old" job before, but now, when they see the smiles on the residents' faces, they feel they're doing something important. "And the residents are empowered by this sensory approach to food," she says. "Perhaps they didn't know what a Monte Cristo (sandwich) is, but now they can see the choices."

It's almost impossible to put a dollar amount on the savings, if any, that the switch from tray line to buffet service has accrued, O'Connell contends. But she does know that the total menu revamp created more choices of better quality and plate waste has decreased since residents are making their selections at the time of service. Ongoing, albeit informal, reports of the Food Committee that O'Connell instituted in 2000 reflect increased resident satisfaction. They're especially pleased that "hot food" is now served "hot" since the previous long delays in passing trays have been eliminated. They also see how their suggestions are being implemented.

"There was a Resident Council in place when I arrived, but that dealt with lots of issues," she says. "I wanted a committee to just focus on food and to be able to go into detail. Now, about 30 to 50 residents attend our quarterly meeting, whoever is alert, verbal and wants to taste some new recipes is welcome."

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