A Cure for the Common Cafeteria
Hospital foodservice moves from commodity to perk, and directors revamp menus, remodel facilities and seek out culinary talent.
By Kate Leahy, Associate Editor -- Restaurants & Institutions, 5/15/2007
 Chef Judith Hallisey believes serving fresh vegetables and wholesome grains is an important part of patient recovery.  Chef Ed Striebe brings experience in commercial kitchens to Gifford Medical Center.  John Hofman of University of Wisconsin Hospital and Clinics (l.) has grown sales with offerings such as freshly made breads and pastries. |
Neal Lavender oversees foodservice at a dynamic property that includes 22 banquet rooms and 866 beds; it offers five brands of coffee and valet parking. Last year he increased retail sales by 11% while increasing revenue from conference services by $30,000.
No, Lavender is not food-and-beverage director for a busy hotel. Rather, he’s director of food, nutrition and conference services at Presbyterian Hospital of Dallas. The four-block campus has ratcheted up guest satisfaction in part by improving patient meal-delivery systems and providing better dining opportunities for staff and visitors. Between 2002 and 2006, cafeteria customer counts grew 38%, and check averages increased to $3.39 from $2.53.
Perhaps more significant, however, is how integral foodservice has become to the hospital—an indication not only of Lavender’s achievements but also of the healthcare segment’s overall potential. As hospitals compete for patients and talent, having amenities such as high-quality foodservice leads to higher satisfaction rates.
"Administrators are figuring out that you have to run hospitals like hotels to compete," Lavender says. "Foodservice can become a strong focal point."
Hospital Kitchen Competition
This is a significant change from when healthcare providers pared foodservice to bare-bones operations and "hospital food" was a pejorative cliché. Although the transition is gradual and not without challenges (many foodservice directors still grapple with outdated kitchen facilities designed for batch cooking, not the à la carte preparations that contemporary menu items demand) the mood is upbeat and progressive: Many hospitals are spending money on improvements.
Half of respondents to the 2006 membership survey from New York City-based National Society of Healthcare Foodservice Management (HFM) plan to remodel their facilities in the next few years. Makeovers not only provide a glossy new space in which to operate, they also help operators better address the most important priority facing this sector: serving better food.
For some, this means it has never been a better time for a trained chef to work in healthcare foodservice. Ed Striebe, a former chef-instructor at New England Culinary Institute in Montpelier, Vt., and current hospitality and food services manager of Gifford Medical Center in Randolph, Vt., sees it this way: "Healthcare is really taking a look at their food as a viable part of their patients’ recovery. Hospitals are saying, ‘Let’s hire culinarians.’ Chefs are saying, ‘You know what? I can make a difference here.’"
Fresh Ideas, Fresh Approach
Gifford Medical Center is hardly alone in turning to chefs with commercial backgrounds. At Summa Health System in Akron, Ohio, Chef Tony Mohseninia, whose background includes a stint with Wolfgang Puck restaurants, runs upscale restaurant Virtues. Judith Hallisey, foodservice director at the Cancer Treatment Centers of America (CTCA) Midwestern Regional Medical Center in Zion, Ill., and a graduate of The Culinary Institute of America in Hyde Park, N.Y., demonstrates healthy-cooking techniques to patients and staff.
Hiring commercially trained chefs has spurred demand for higher-quality products. Striebe buys local Vermont produce whenever he can and offsets the higher cost by buying conventionally grown basics such as carrots and onions. Swedish Covenant Hospital in Chicago switched to grass-fed beef and cage-free eggs. And CTCA’s Hallisey works with a produce distributor to stock her walk-in with organic vegetables and fruits.
"The first time I went into hospital foodservice, there were casseroles, ground beef, frozen vegetables—it was always frozen," Hallisey recalls. "Presentation is everything. If it doesn’t look good, no one’s going to eat it." Improving quality requires support from hospital management, which, in Hallisey’s case, allocates $20 a day per patient for food. "We have a great administration," she says. "They care about their patients, and they don’t tell me that I’m spending too much money on food."
Yet heightened expectations—from fresh, seasonal meal preparations to room service—also mean foodservice staffs can be stretched thin.
"We’re doing more with less staff," says Susan Coleman, director of food and nutrition services for Medical Center of Lewisville in Lewisville, Texas.
John Hofman, director of foodservice for University of Wisconsin Hospital and Clinics in Madison, agrees. "Employee training and development is going to be more of an issue because we’re being asked to do more with less," he says.
Going Gourmet
What to do when designing a new hospital? Plan for a foodservice department capable of turning out restaurant-quality fare. At least that’s what planners did at Bailey Medical Center in Owasso, Okla., which opened in November 2006.
Dietary and Catering Manager Ryan Woodward, who held management positions at Pei Wei Asian Diner, owned by Scottsdale, Ariz.-based P.F. Chang’s China Bistro, runs the foodservice department much as he would a commercial operation. He oversees The Bistro, the hospital’s on-site cafeteria, as well as a thriving banquet business. The hospital also serves an average of 50 patient meals a day, a number predicted to increase to more than 200 as the hospital establishes itself.
For room service, Woodward is developing menus for patients who have dietary restrictions with Executive Chef Barry Rashford, who has a background in upscale hotel restaurants. Healthy-cooking demonstrations also are being rolled out, and Woodward and Rashford are committed to ensuring that all dishes, whether served to patients or to banquet guests, are made with fresh product.
"I had no experience with hospital food," admits Woodward. "But patients are paying a lot of money. The room charge alone is $400 a night. I don’t know hotels that would charge that and not provide good food and service."
The foodservice quality at the hospital has received an unexpected though welcome response. A conference center Bailey Medical Center originally planned for doctor seminars has become a popular banquet facility, with four weddings and a rehearsal dinner booked for this summer. Banquet business in turn offsets the costs of higher ingredients for patient meals.
This brings accounting challenges, Woodward says. Nashville, Tenn.-based Ardent Health Services, which owns the hospital, wasn’t accustomed to accounting for catering revenue, though Woodward thinks this soon will change.
"Hospitals are set in their ways of doing things. But the trend is that more people are going to expect these kinds of services."
Room Service Ramps Up
It’s certain that quality doesn’t come just from having chefs in the kitchen. Trends also point to the lasting power of room service, particularly with many hospitals switching from tray lines to room service.
"It really does drive patient satisfaction, and it’s not at its peak yet," says John Hofman, director of foodservice at University of Wisconsin Hospital and Clinics in Madison.
Susan Coleman, director of food and nutrition services at the Medical Center of Lewisville in Lewisville, Texas, plans to roll out a room-service program next year, but it is not an easy transition. "You have to field phone calls, you have to have extra cooks, the food has to be ready and someone has to know how to prepare it," she says.
Other medical facilities are testing alternatives to room service. Presbyterian Hospital of Dallas rolled out a modified room-service program called deluxe dining in its 108-bed OB/GYN ward. An attendant helps patients make meal choices and then enters orders into a handheld terminal. A docking station with hot food on one side and cold food on the other maintains temperatures until deliveries can be made.
Although the method is not quite room service, "it’s the personal attention that makes a really big difference," maintains Debbie Mouser, the hospital’s patient services manager. "We’re talking with the patients. If they don’t like something, we can solve it right there."
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