Other strategies involve ergonomic training to assist the employees, some over 60 years old, in lifting plates and trays.

Renovation planning involved months of meetings with staff, managers, architects and experts, trying to anticipate possible glitches, Della Barba says.

"But nobody anticipated that there would be 350 grill orders," Mayer says. "That's a lot. You can't anticipate everything."

Now that the renovations have taken place, Mayer says the meetings continue. He cites "after-action" review sessions and monthly unit meetings as opportunities for staff to voice their grievances.

"It is incumbent on everyone to bring up issues," McNitt says. "It is all part of a complex puzzle--the staff has had a lot of challenges, and they continue to talk about it."

In the meantime, HUDS says change is necessarily going to be difficult.

"This is a part of the process. It certainly doesn't make you feel good," Della Barba says.

"But until systems gel--and they will--they're tired," Mayer says. "The only thing that's the same about these places is that they're called Eliot and Kirkland."