Challenges Facing Today’s Healthcare Foodservice Director

Ensuring patient satisfaction, recruiting and retaining talent, and dealing with “green” issues are some of the challenges facing today’s healthcare foodservice operators, write Dan Henroid (r.), director of nutrition and foodservices, and Jack Henderson, associate director of foodservice operations, at the University of California, San Francisco Medical Center.

By Staff -- Foodservice Equipment & Supplies, 4/1/2007

Associate Director of Foodservice Operations, University of California, San Francisco Medical Center, San Francisco jack.henderson@ucsfmedctr.org

Director, Nutrition and Foodservices, University of California, San Francisco Medical Center, San Francisco dan.henroid@ucsfmedctr.org

The challenges facing healthcare foodservice management teams continue to increase as institutions revise the types of services and amenities offered to patients, visitors and guests. Oftentimes functioning in older facilities, foodservice departments need to adapt their production and service systems to meet these demands. The financial performance of the healthcare institution frequently limits the resources available to foodservice departments to adapt their systems. Another significant challenge lies in the fact that while planning and implementing system upgrades, foodservice departments must continue to serve patients and customers without interruption. It is during these times that coordination with foodservice equipment suppliers becomes an integral part of assisting healthcare foodservice directors in overcoming their daily operational challenges.

Patient Satisfaction Focus Continues to Grow
Meeting and, perhaps, exceeding patient and customer expectations pose the most significant challenges to healthcare foodservice professionals, without a doubt. Patients and their family members expect to have immediate access to resources and services. Healthcare foodservice departments have responded with service models using combinations of a unit-based host/hostess, spoken menu, bedside menu entry, and room service systems to provide patients the opportunity to select menu items as close as possible to the time of delivery. A survey by The National Society of Healthcare Foodservice Management (HFM) indicates that 25 percent of HFM members use hosts or hostesses to get patient menu selections. Another 22 percent offer a hotel-style room service program while another 17 percent expect to convert to room service within the year. Hospital efforts to provide the services and amenities that are commensurate with upscale hotels continue to drive many of these conversions.

Determining what types of food and services equate to desired levels of patient satisfaction represents a related challenge. Many institutions use external patient satisfaction tools to gauge their progress. Conversions to room service often take a significant amount of resources. The necessary capital funds to adapt equipment and facilities for these systems tend to be easier to acquire compared to the labor necessary to provide optimal customer services for meals. Before investing in these systems, healthcare foodservice directors must build a strong business case for requesting additional full-time equivalents (FTEs) from hospital administration. Competition for additional labor remains fierce and, most typically, is the limiting factor in a healthcare foodservice department's ability to move towards providing individual attention to patients as part of meal service. This process should include an assessment of the different patient populations within the institution to determine their respective needs, and a projection of the expected improvement in patient satisfaction that will occur.

Emphasis on patient-centered care models continues to decline. Previously, many food and nutrition departments lost FTEs to nursing for common tasks such as passing meal trays. When implementing such programs as room service, for example, healthcare foodservice directors in these departments must now take back these responsibilities to maintain control over the entire process. Recovering the labor to assume these responsibilities is proving to be rather difficult.

Though many healthcare foodservice departments are not in the process of converting to more personalized service, the industry's service standard is clearly changing. Directors will need to further convince their administrations that they still provide quality food and service if their patient satisfaction scores decrease. This is because patients will evaluate them in light of their experiences at other industry facilities that may have room service. Besides personalized foodservice models, other methods exist to improve patient satisfaction.

Talent Acquisition and Retention
A key component of programs such as room service is having the ability to serve individual, made-to-order food portions rather than large-quantity production. This shift requires different skill sets that are lacking in many cooks who currently work in healthcare foodservice departments. Foodservice directors must decide whether to retrain these individuals or recruit new ones with restaurant and/or culinary experience. Recruiting and retaining culinary-trained professionals continue to be a challenge. Healthcare foodservice directors used to be able to rely on better hours, benefit packages and working conditions as selling points to chefs to offset differences in salaries between what they could offer and what chefs could make in the restaurant industry. These selling points have diminished as competition for labor to work in all types of foodservice establishments has increased with a shrinking labor pool. Commercial foodservice establishments now offer better work hours and more competitive benefit packages to retain their chefs.

This intense labor competition in foodservice also extends to hourly employees. As demographics in the United States shift and the pool of work opportunities in foodservice shrinks, pressure to acquire and retain talent for more personal foodservice in healthcare will continue to increase.

Taking Care of Employees
Though pleasing patients and visitors has always been part of the healthcare foodservice operation, a new focus is being placed on satisfying employees in the healthcare institution in order to retain staff. Employees expect quick service and discounts on food and other amenities. Turnkey cashless systems will be essential to facilitate transactions, increase retail food sales, and help manage discount programs. According to the HFM survey, 46 percent of members' facilities use cashless systems, with half of the same respondents offering employee discounts.

Most healthcare employees have limited time for meal breaks. The number of "grab 'n go" concepts continues to increase. Foodservice departments will need to explore opportunities that take service to areas closer to where people work rather than relying on employees to go to the main cafeteria. Online menu-ordering programs are a potentially significant component of these types of services so cash is not handled outside of secure areas. Department directors will require these advance orders to be pre-paid. The computer systems that provide these services must be flexible enough to meet individual needs. Directors also will expect that these new cashless systems integrate with existing computer foodservice management and point-of-sale applications so as to minimize the number of separate systems that would need to be maintained.

Other programs designed to assist employees with everyday tasks such as dry cleaning, shoe repairs and car service will offer healthcare foodservice departments new opportunities to expand their services. Through these employee programs, departments can add services such as home meal replacement, customized decorated cakes, gift baskets and catering.

Marketing and Promotion of Products and Services
To acquire resources for new programs and services, healthcare foodservice directors are becoming much more savvy at marketing their departments. Beyond traditional marketing strategies, departments will need to explore new channels to inform people about their departments. Dynamic internet and intranet web sites will become an integral part of these efforts. Customers and employees will expect to find out information about food and nutrition services from their computers. As a result, food and nutrition departments will need to develop systems that provide this information more efficiently. Cafeteria and catering menus will need to be available in real-time with menu selections and pricing.

Make It Green
Healthcare foodservice directors will place more emphasis on the potential impact on the environment.

The energy efficiency of new foodservice equipment and facilities will be a key criterion for many future purchasing decisions. Recognized energy-efficiency standards for equipment such as Energy Star, will be given increased emphasis even if comparable equipment costs less. The University of California system is considering green building guidelines for new facilities that comply with LEED standards. These guidelines would extend to focusing on purchasing food grown in close proximity to its campuses and medical centers to minimize fuel consumption to deliver the product.