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ORAL – Dysphagia Food Safety Management

4 Dec 2019

ORAL – Dysphagia Food Safety Management System is a 3 layer approach to providing a consistent service of food suitable for dysphagia diets.

The system is applied at 3 layers of operations:

• Strategic planning
• System management
• Technical operation

The system has been created to give stakeholders involved in the production and supply of food for people with dysphagia clarity on how to systematically approach and manage this provision.

Development of the system

Initially work was carried out on how to create foods suitable for dysphagia. It was clear early on that there needed to be some validation tool to test food textures. UK standardisation of food suitable for dysphagia diets gave some advice on this, however some terminologies and testing checks were vague.

The development and adoption of the IDDSI Framework has given far greater clarity due to objective testing methods and we have used this validation tool in the development of our system. The IDDSI Framework is by far the clearest, this simple to use and it being adopted globally.

ORAL – Food Production

By using the IDDSI Framework we have been able to catalogue a vast number of ingredients and compile a comprehensive list of methods, techniques, processes and equipment that would allow the foods to be served at all the IDDSI Levels for food.

This cataloguing of foods and production methods carried out for fruits, vegetables, meat and poultry, fish and shellfish, starchy carbohydrates, pulses and legumes, as well as component dishes and whole meals.

We took this vast data and simplified it so that it could be used practically, whether domestically, in healthcare settings or in manufacturing. The results of this work clearly showed it’s value across all these settings and the process has been termed ORAL:

• Observe
• Reform
• Audit
• Label

Our work within a range of settings has given us a clear understanding of the application of ORAL as an approach to making foods for dysphagia diets.

One of the aspects developed within ORAL is the ability to manage the outcome of the food being made. It has highlighted a clear approach to decision making and introduced standardised auditing points during production that control outcomes.

ORAL – Dysphagia Food Safety Management

Although there is a need to educate and train people in how to make food that is suitable for dysphagia diets there is also a need for operations to set up and standardised approach systematically, and for managers and auditors to scrutinise the process.

We applied the principles we had established within the initial ORAL food processing system to the ability to manage production in a wider context.

It is clear that the same approach, applied to ingredients and dishes, can be used to manage a whole system.

In this case the system manages observation, reforming, auditing and labelling so that technicians can follow a systematic process and mangers and auditors can scrutinise easily.

ORAL – Strategic Planning

The development of ORAL – Food Processing and ORAL – Dysphagia Food Safety Management allows settings involved in the production of foods suitable for dysphagia diets to standardised their approach with manageable processes that can be measured.

It is clear that it’s integration into an organisation needs strategic planning if other aspects within the setting can affect the safe delivery of dysphagia food.

This requirement has led to the application of ORAL to strategic planning. ORAL is able to underpin policy maker thinking to ensure all aspects of the process is considered.

Strategic Implications

In order to provide consistently safe foods suitable for people with dysphagia, from assessment to the plate, ORAL – Dysphagia Food Safety Management highlights and allows the management of:

All stakeholders roles within the system

The scope of key roles to be defined

Critical interactions between roles

Safety mechanisms to suppprt the operation

Training and resource needs

Critically ORAL brings the knowledge and expertise of how to make safe food that is suitable for people with dysphagia.

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