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The NRN 50: Patients rewarded

The NRN 50: Patients rewarded

Back in the day when hospitals provided foodservice for patients and staff members because they had to, those meals were generally cheap but elicited complaints about being tasteless and lacking nutrition. Though a close examination of the hospital cuisine of 30 or 40 years ago might leave a bad taste in one’s mouth, things have changed radically over time.

With the advent of managed-care systems, facilities during the last 15 to 20 years were forced to change the way they operate, and they began serving retail-oriented offerings ranging from pizza to panini sandwiches to sushi. New foods and facilities formats achieved their aim of tapping the wallets of visitors and hospital workers alike. At the same time, hospitals started to wage a competitive war to attract patients and customers to their facilities through such methods as opening name-brand restaurants, offering better-quality food and hiring restaurant-caliber chefs to provide hotel-style room service.

“I’ve been in the health care foodservice business for 33 years, and the biggest change is it’s not a service anymore,” says Tony Almeida, director of food and nutrition, environmental and host services at Robert Wood Johnson University Hospital in New Brunswick, N.J.

In the retail division of the 585-bed facility, “we’ve seen big changes in the last 15 years,” Almeida says. “Mind you, hospital foodservice wasn’t considered insignificant, it was just something we had to do. We had to feed our patients, but emphasis wasn’t put on it like it is today. From the patient’s perspective, we’re expected to serve restaurant-quality food. Not only that, we don’t call them patients anymore. They are our customers.”

A survey conducted in 2007 by the National Society for Healthcare Foodservice Management found that approximately 55 percent of responding members considered more than half of the meals served at their facilities to be retail, and of that number 57 percent saw an increase in those sales from the year before.

“Providing food for employees and visitors is being looked at more now as a business,” says Lynne Ometer, director of food and nutrition at Emory Hospital in Atlanta. “As far as retail dining is concerned, we’re hearing more and more about growing profitability.”

One of the biggest changes over time, says Nitu Gupta, vice president of foodservice and nutrition for Sodexho USA’s health care foodservice division, is the move away from subsidized programs and the increase in food costs.

“A patient’s whole meal 15 years ago was less than $2,” she says. “Some programs even gave free meals to physicians and up to 40-percent discounts to hospital employees, but that has changed now that subsidies have all but disappeared. All things are driven by our clientele; our costs are dictated by the client.”

Today, Gupta notes, it is incumbent on the foodservice provider to offer great-tasting food while managing costs at the same time.

“Many hospitals have moved toward adding variety as a way of generating money and satisfying customers,” she says. “The question is how do I satisfy the customers and get them into the facility, and if I generate more revenue [at the same time], that’s extremely helpful. Ultimately, the bottom line is to sustain financially.”

Much of the variety being offered, she says, is the result of special promotions and the inclusion of healthful and flavorful menu items.

“In health care foodservice, we’re trying to create a restaurant experience through the menu, service and design,” she says. “I’ve been in the business for more than 20 years now, and we used to do some monthly events, but never did we have any [limited-time offerings] or have the mind-set we do now in terms of choices and flavors.”

Almeida agrees, saying: “Hospitals have had to become more profitable. Budgets are tighter than ever before. We have had to become even more financially responsible.”

On the retail side, Almeida—whose operation reported sales of $4 million last year, an annual increase of 80 percent—regards as one of his biggest challenges the need to raise the bar on quality in order to keep customers happy.

“Baby boomers expect more and have different wants and needs,” he says, “and it is up to us to fulfill their expectations.”

One way for hospitals to fulfill those expectations, Almeida says, is for those facilities to offer restaurant-quality chefs and menus. To do that, he says, hospitals are now showing more interest in hiring restaurant and hotel chefs.

“We as directors have been able to adjust salaries to compete with restaurants,” he says. “Our chef here makes $55,000 a year, and he’s not the highest paid guy in the state of New Jersey. A normal restaurant chef, if he’s any good, is making between $50,000 and $60,000. And then there are the benefits. Here, our benefits package exceeds anything they’re getting out there, plus it’s not as stressful an atmosphere like it is in the restaurant or hotel segments.”

Perhaps the biggest change in hospital foodservice over the past 10 years is the advent of patient room service programs. Though many directors say it can be difficult to implement if a hospital is not large enough to accommodate that kind of operation, on-demand room service also is known to contribute to higher overall customer satisfaction scores.

“There’s been a really big push for room service dining over the last 10 years and it’s really grown in the last five, maybe doubled or tripled at hospitals around the country since then,” says Almeida, who implemented the program at his facility in 2003. “When you have a room service program, customer satisfaction scores go through the roof.”

Adds Mike Goodrich, executive chef at the 450-bed Oregon Health & Science University hospital in Portland, Ore.: “Certainly room service gives more of a choice in the type of selections available to patients, and that’s a present trend. We’re under study for room service, and we’ve been in a pilot program offering patient concierge service where someone comes in, takes the order and than pops up afterward to ask if anything else is needed and if everything is OK. That’s gotten good response from both staff and patients.”

On the retail side, Goodrich says, there’s been a definite switch to more healthful menu items and a demand for vegetarian items and also for sustainable and organic fare.

He adds that huge demand last year for a sushi component caused him to hire two sushi chefs. The lowest-priced items are $4.50 and go up to $9. Last year Goodrich sold 100 sushi orders a day.

“People don’t care how much it costs,” he says. “They just want to have it.”

Almeida, who notes that the trend started about two or three years ago, also provides a sushi bar at his retail facility and sells between 35 and 40 orders per day at $7.50 to $8 per tray.

So what is the next trend for hospital foodservice, and where is the segment going over the next 10 years?

Almeida says that while the demand for great food and emphasis on customer satisfaction will remain high, the future lies with technology. He envisions patients ordering their meals from wireless devices.

Sodexho’s Gupta forecasts more retail and revenue generating options.

“As the market becomes more competitive and costs become tighter, hospitals will look at retail areas as more revenue generating than they [already] are,” she says. “With the environment so competitive, hospitals will look to differentiate themselves with things like herb gardens and chefs and upgraded facilities that look more like hotels.”

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