Hospitals Build Better Business

Healthcare operators invest to make dining an out-of-hospital experience.

By Jamie Popp, Senior Editor -- Restaurants & Institutions, 8/1/2006

A brick-oven pizzeria is among new offerings at Stony Brook University Hospital’s MarketPlace Café. The Smokehouse is one of the stations in University of Texas Southwestern Medical Center’s new dining facility. Bakery/cafe Brioche Dorée operates in Philadelphia’s Frankford-Torresdale Hospital.

When it was time to plot out décor for University of Texas Southwestern Medical Center’s new dining room, it was clear from the start that standard issue wouldn’t do. With a goal—shared by many healthcare facilities across the country—of attracting guests who might otherwise bypass hospital-dining options for snappier alternates, plans for the space were ambitious and bold.

Windows are dramatic floor-to-ceiling expanses that overlook downtown Dallas. Tables for the 175-seat space were designed by a noted Spanish sculptor. New staff uniforms speak of professional chefs rather than line workers.

“It is a serene, modern atmosphere with light-colored wood tables and pale-green carpet that reminds me of upscale dining in Chicago or New York City,” says David Wood, senior vice president of sales and marketing at Dallas-based foodservice provider Culinaire.

The upscaling of American dining extends beyond freestanding restaurants. As consumers become more accustomed to quality at all levels, their expectations are that every meal occasion should reflect their new ideals. Hospitals are acknowledging these demands by putting money where their customers are—in renovated cafeterias with service refinements and new menu offerings.

“When we looked at the plan for the servery, it had traditional institutional-style equipment. That’s where we came up with enhancements. We thought, ‘If you can’t hide it, decorate it,’ and designed a commercial look that creates a bustling and exciting environment with made-to-order salads and other chef-prepared entrées.”

From 11 a.m. until 2 p.m., meals are prepared at five stations including deli, Global Fusion and panini operations. A behind-the-scenes kitchen is used to assist with prep work—basic tasks such as portioning meats, preparing soups, cutting vegetables. These items then are dispatched to the various stations. The goal is to give diners the feeling they are in a commercial environment, Wood says. Average lunch check is $12, a price that usually includes entrée, dessert and beverage.

Better Spaces, Better Sales

Over the past year, 25% of healthcare foodservice directors invested in kitchen renovations and 30% in cafeteria remodels, according to the New York City-based National Society for Healthcare Foodservice Management. Redesigning servery areas, replacing seating with more-comfortable designs and creating unique spaces for staff and visitors are among the ways dollars are invested.

Contractor Contributions

The University of Texas MD Anderson Cancer Center in Houston asked its foodservice provider, Aramark, to come up with alternatives to traditional hospital dining. Recent changes reflect the contractor’s findings that the most well-received cafeterias are spaces where both staff and patients can relax. Natural light, plants and soft furniture were identified as strong positives, according to its survey of healthcare workers and follow-up focus groups with employees, patients and visitors.

“Our focus at MD Anderson has been to create a series of different venues throughout campus that include space to relax and renew,” says Paul Gizara, vice president of product development at Philadelphia-based Aramark. MD Anderson is “trying to break away from the hospital environment,” he says.

From Convenience to Quality

In the past, hospital dining environments often were geared more toward convenience foods than to high-quality offerings.

At Stony Brook University Hospital in Stony Brook, N.Y., a new MarketPlace Café was created during a renovation that brought the 1980s-era facility into the 21st century. The comprehensive overhaul was quick to win favor with the foodservice department.

“We had a cafeteria that looked like something out of a bad movie,” says Suzette Smookler, Stony Brook’s administrator of food and nutritional services. “When the hospital was built, prep areas at the time were based on a fast heat-and-serve operation. There wasn’t adequate space for dish storage or for pot washing because they didn’t need much of that,” she adds.

The space was stretched beyond capacity, Smookler says; she was confident that an enhanced dining facility would increase customer counts and retail revenue. “Conceptually we wanted something that was cozier and classier than a food court and that provided a variety of stations,” she says. “We were committed to returning to cook-serve.”

The cafe, which serves between 4,800 and 5,200 guests each day, was designed to be visually appealing and easily navigated, with all serving stations visible from the entrance. A salad station, grill, bakery, brick-oven pizza operation and hot entrée station are among the options. Smookler says that with roughly 85% repeat business, her foodservice team makes it a priority to keep guest satisfaction high. For example, the number of soups rotated has more than doubled and now includes such selections as Mexican tortilla, white bean and escarole, and cream of asparagus.

Measuring the success of the MarketPlace Café, Smookler says: “In 2000, our retail operations were doing $3.3 million in sales. Today, it’s $5.6 million.”

The new space also allows for meetings and special events. In one area of the dining room, Smookler insisted on a movable wooden wall system with glass panes for reconfiguring rooms for more private dining.

“That smaller environment makes it feel cozier,” she says. “The acoustics are better in areas that have movable wooden walls.”

Paying the Price

The evolution of customer expectations puts high demands on the cafeteria at the University of Alabama Medical Center in Birmingham, according to Al Stridiron, vice president of branded services at Gaithersburg, Md.-based Sodexho USA.

“What customers are saying—and this is a radical change—is they are willing to pay for quality,” he explains, adding that simple cosmetic changes don’t go far enough. “If you only create ambience, the customer sees through that unless you also change the food.”

Enhancements to the dining experience include more adventuresome menu items with added emphasis on made-to-order selections. “Any time we can change from a nonservice to service environment, customers love that.”

For instance, Stridiron says operators use induction ovens for made-to-order meals. At action stations, chicken breasts offered with a choice of sauces and other fresh ingredients are prepared in front of guests. This “turns it into an experience for customers,” he says.

Market Cafe at St. Anthony’s Medical Center in St. Louis, which opened several years ago in the hospital’s Heart and Ambulatory Services Center, has a built-in advantage of a high-impact setting. Two of its exposures are grand cityscapes so when it came to designing the dining facility, the surroundings served as focal point. The cafe’s interior design, pleasant background music and such offerings as freshly ground coffee help create a simple, sophisticated environment, according to Linda Seffens, director of nutrition services.

Menu, too, plays an important role in employee and patient perceptions of the cafe. Building on the St. Louis theme, many of the food choices are locally born and bred.

“We offer an eclectic menu that represents favorite items from the area,” Seffens says. P’Sghetti’s Pasta & Sandwiches, Roly Poly Sandwiches and Ted Drewes Frozen Custard are among the concepts with which the hospital works, Seffens says.

On the Menu

A glance at menu offerings provides tasty evidence that healthcare fare holds its own with the best.

• Duke Hospital, Durham, N.C.: Asiago crusted chicken; Mongolian chicken noodle bowl; Carolina barbecue-pork sliders; Caribbean potato salad; barbecue-beef brisket
• El Camino Hospital, Mountain View, Calif.: Vietnamese pho noodle bar; tofu with seasonal vegetables; lean peppered pork loin; vegetable and cheese frittata; Korean ribs
• Lancaster General Hospital, Lancaster, Pa.: Pierogi with caramelized onions; artichoke, red pepper and feta cheese pizza; Mediterranean tilapia; Mykonos chicken sandwich
• Port Huron Hospital, Port Huron, Mich.: Carved flank steak; fish tacos; Italian wedding soup; grilled sweet-and-sour chicken; white chicken chili; beef-and-tomato goulash
• Whidbey General Hospital, Coupeville, Wash.: Roasted eggplant-and-portobello sandwich stack with greens, tomatoes and fresh mozzarella; yakisoba salad; spinach lasagna blanco with ricotta and fontina cheeses, spinach and tomatoes; chile relleno casserole with salad and cornbread; shrimp Louie

Planning Match Points

How do hospital foodservice directors make decisions about the type of facility to build? At The Ohio State University Medical Center in Columbus, Administrative Director Mary Angela Miller has codified the process, eliminating a scattershot approach that can lead to underutilized spaces or those that are stretched beyond capacity.

Working with Envision Strategies, an outside consulting group, the hospital targeted revenue needs and then created metrics for staffing, production and hours of operation. For areas projected to tally $200,000 in annual revenue, vending has been determined to be the optimal choice. Spaces that can support $200,000 to $400,000 are steered to coffee carts or kiosks that are staffed by one person. Food production is handled off site and the kiosk is operational for one shift.

Projections in excess of $1,500,000 are required for a full-service cafeteria or food court.

Consider the size of the facility when bringing in a franchise, says David Ortega, Sodexho’s district manager at Philadelphia’s Frankford-Torresdale Hospital. Brioche Dorée—a French bakery/cafe chain—opened a unit on the hospital’s campus in October.

“If a facility is fewer than 100 beds, it’s difficult to bring in a franchise because of fees and royalties,” he says. “But there’s better margin on something that’s upscale.”