Long Term Care Home Improved Meal Prep and Reduced Wait Times through Lean/Six Sigma Implementation

This provincial long term care system serves hundreds of residents at five pilot sites 

Reduction in resident wait time
Reduction in Care Aid non-value added time


The province had initiated a pilot project for Long-Term Care homes to improve the quality-of-life for residents in several LTC homes. Dale Schattenkirk and his team were engaged to guide their leadership teams to identify innovative ways to implement change by building internal, sustainable, change agents. This program included leadership training and consultation, as well as a training and mentorship program to create Yellow Belt level personnel who would manage quality improvement projects across the pilot sites. 


We ran an initial rapid improvement project at one of the five identified pilot sitesIt was designed to improve the dietary process to reduce resident wait times. The existing meal process from preparation to serving had resulted in continually late meals, and daily frustration for both staff and residents. To address this, our team supported the client by applying DMAIC methodology: 

  • Define: It was identified that the current meal process lacked communication, consistency, and a clear process, causing delays for residents waiting on their meals and considerable frustration for staff and clients. 
  • Measure: Different aspects of the process were measured to identify the bottlenecks, including the time required to prep meals and sort tickets, the defect rate, the temperature of the last meal served, and the overall length of the meal distribution process. 
  • Analyze: Once the data was collected, the following insights were gathered: 
    • Meal preparation was delayed as the correct ingredients were not on hand 
    • Residents were waiting for up to 80 minutes to be served  
    • Due to delays in the process, meals were not served at an acceptable temperature 
  • Improve: Three improvement projects were initiated to address the issues identified by the analysisThe goal was to increase tray line meal temperatures by 15 degrees and reduce resident wait times by 50%The three projects aimed to: 
    • Create a new serving procedure to keep mealtimes on schedule 
    • Introduce table numbering and table maps to improve visibility for servers and reduce wait times to be served 
    • Refine the current tray line process to include insulated dishes and a heated cart to keep meals at an acceptable temperature 
  • Control:  To ensure that this improved performance did not lapse, all staff were trained on the new procedures. 

Value Created

Through this project, our client learned how to conduct Lean/Six Sigma improvement projects on their own, and also realized the following benefits from this one example:   

  • Reduced resident wait times by 86%, surpassing the client’s original goal 
  • Reduced the number of special care aids required at mealtimes by 50% 
  • Redeployed some staff to other value-added activities, including more time to interact with residents 

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