Case Study: Elmhurst Memorial Healthcare Elmhurst, Ill.

A rebranded food and nutrition department features the state-of-the-art, multiplatform WILDFLOWER café and room service by WILDFLOWER which offers patients a restaurant-style, on-demand food delivery system.

Elmhurst-ServeryWILDFLOWER café’s stations form a U shape, which encourages customers to find their menu choices and move in a natural flow toward the cashier stations. Photos courtesy of Robert Rippe & Associates Inc., photography by Dana Wheelock PhotographyLast June, Elmhurst Memorial Healthcare (EMHC), located in Elmhurst, a western suburb of Chicago, introduced its new $450 million integrated medical campus. Located three miles south of the previous facility, the campus includes an 866,000-square-foot acute care hospital with 259 beds that serves as the centerpiece of the 50-acre integrated healthcare campus. The campus also holds the newly constructed, 80,000-square-foot Center for Health and a medical office building that connects to the new hospital.

In keeping with EMHC's adoption of the nonprofit organization Planetree's philosophy, the design focuses on the patients' experience. (Planetree is an organization that works with hospitals and healthcare facilities to develop and implement patient-centered care in a healing environment.) To promote healing of the mind, body and spirit, the hospital's extensive landscaping and grounds contain green spaces, ponds and healing gardens.

Inside, natural light and building materials create a noninstitutional ambiance. All patient rooms are private and include hotel-like amenities, such as room service and comfortable places for families to visit and stay with loved ones. To promote safety, the patient rooms are laid out identically, instead of having mirrored rooms with left-hand and right-hand orientations.

As part of the project, the food and nutrition department embarked on a rebranding of its program, which is highlighted by the WILDFLOWER café. "The WILDFLOWER concept was selected because it fit with the hospital's overall design, which was built in the Prairie School of architecture style that was most notably used by Frank Lloyd Wright, who lived in Oak Park, Ill., not far from Elmhurst Memorial Hospital," says David Reeves, MBA, director of hospitality services for EMHC.

"Collaboration was the theme of the entire design process," says Christine Guyott of Robert Rippe & Associates, the project's foodservice design consultant. "The project was challenging from a design standpoint because we were working with two architects and an owner's rep. Each architect was responsible for the overall design of different areas of the foodservice department. Everyone brought a different expertise and eye to the project. Also, the management team was challenged to develop an operational plan as if starting from a clean slate. The result was redefining how the department operates with new work stations that match new job descriptions. We wanted this

foodservice department to be viable for the next 20 to 30 years."

"In-depth work sessions with foodservice managers for patient services, retail and food production were essential for developing the operations plans and overall design," says Connie Dickson, senior operations consultant for Robert Rippe & Associates. "Discussions were lively as the design team explored multiple options, considered alternate approaches and reviewed decisions. These work sessions laid the ground work for a successful transition to the new space."

When customers walk into WILDFLOWER café, they see a wide-open space and clean sightlines, as well as digital menu boards, which display daily specials along with nutritional values. They also see culinary staff preparing menu items at the stations. The staff is supported by contemporary equipment, such as an authentic Chinese wok and a gas-fired brick pizza oven. Colorful stone countertops, handcrafted millwork facades, and subtle under-counter lighting create a restaurant-style ambiance. The café's hours of operation span from 6:30 a.m. to 7:30 p.m.

"When walking through the public spaces of the new hospital you feel like you are not in an institutional healthcare setting," says Rich Kukla, principal, Robert Rippe & Associates. "The same is true of the main dining room. It feels like you could be seated in a higher-end commercial restaurant. Bob Rippe carried the theme of the Prairie School design into the layout and counter design."

The grill station and the bakery area (called grillwerks and delectables, respectively), open at 6:30 a.m. for breakfast. The area also offers a waffle station and hot cereals during this meal period. All stations fire up at 11 a.m. for lunch. The wok and brick pizza oven station serves pies; and grillwerks offers hot sandwiches. The carvers station features chef-carved items and daily specials; and the deli features gourmet sandwiches and salads. The salad bar, deli, pizza station and grill are all open for lunch and dinner. The chef's station opens only for lunch, but those menu items remain and are consolidated for the other meal periods.

WILDFLOWER café serves approximately 1,000 guests and staff each day, Monday through Friday. Transactions vary on the weekend. The licensed Starbucks operation remains open, providing fresh food and dessert options, until 8 p.m. during the week. On weekends, grillwerks and delectables remain open with limited selections.

"One of the most difficult challenges we faced was the kitchen's retail design that lagged behind the design of the surrounding areas," says Reeves. "The kitchen was boxed in, which would result in significant inefficiencies. I felt strongly that we had one opportunity to get it right. As a result, materials management, facilities management and the laboratory had to completely redesign their areas in order to meet our design need. Ultimately, it worked out well since everyone preferred the revised design of their areas more than the originals."

On one side of the U-shaped servery, one cook works the grill station, which features a charbroiler, fryer, dump station with heat lamp, three-well drop-in for cold pans, hot food well, and heated plate dispenser to prepare and serve sandwiches to order. Next to grillwerks, separated by a half wall, is the wok station and WILDFLOWER's showcase piece of equipment, the custom-built brick oven. One cook prepares small-batch and custom-made stir-fry dishes as well as freshly baked pizza and calzones, and displays the product fresh on demand. This station includes two separate refrigerated make-tables for ingredients, as well as a hot plate for the pizzas and calzones, and hot wells for the Asian-inspired menu items.

Most of the stations are staffed by one employee each with the exception of grillwerks, the deli and the salad bar, which each have two employees at lunch.

The last hot station on one side, Carvers, is close to the brick oven, providing easy access to the cook who mans this station, too. Carvers' key equipment includes a combi oven, fry station, heavy-duty six-burner stovetop, and heated marble carving board. The menu at Carvers changes daily and can feature more upscale specials such as brick-oven cedar plank salmon with mango salsa, or fresh, value-added items such as a pasta bar or taco salads.

In the middle of the servery at WILDFLOWER café, customers queue up on the side of an island that offers house-made soups or select special salads and toppings from an extensive fresh salad bar. Opposite the salad bar, guests select from a fresh display of cold meats and fresh breads at the deli on main street or order a "sizzling salad" prepared by one of the deli attendants. Across the aisle from the deli case is delectables, where customers can choose from an array of freshly baked desserts, pastries and cookies, as well as help themselves to fresh-brewed coffee or gourmet tea.

End caps on either side of the salad bar and deli counters provide guests with many grab-and-go options, such as sushi rolls, fruit cups, salads and wraps. Larger grab-and-go and beverage merchandisers sit near the fountain beverage station opposite the entrance area, in close proximity to the cashier's station.

"We selected this layout because we wanted to drive sales," Reeves says. "We wanted to lower the net cost of operation and drive revenue, and we've been successful." Since opening one year ago, revenue has increased 50 percent compared to the revenue in the previous facility.

Also contributing to the café's increased traffic is its location, adjacent to the entrance. The café is part of a retail corridor that includes the licensed Starbucks store, operated by EMHC foodservice staff, that offers foods found in most Starbucks stores.

A dishwashing area dedicated to the café sits on this floor. (The patient floor below has its own separate area for washing wares and carts.) "Having two warewashing areas keeps the warewashing separate between the lower-level kitchen and the café and eliminates having to transport soiled and clean ware between the floors," says Kukla.

A dedicated elevator links the main-floor retail foodservice to the production kitchen located on the ground level below. The ground level contains another key component of the project, the patient room service operation, which can serve up to 259 patients. This level also plays home to the catering kitchen and storeroom. "We were also able to locate the 22,225-square-foot conference center adjacent to the ground-level kitchen. This makes catering large and small functions very efficient," says Reeves.

Food arrives at the loading dock on the ground level in close proximity to the kitchen. Staff distribute food to the four walk-in coolers and freezers and the dry storeroom and later to the various prep stations as needed. Five upright refrigerators store food closer to the prep and hot cook areas so staff has easy access whenever they need products.

Preparation for room service begins at 5:30 a.m. Patient room service hours run from 6:30 a.m. to 6:30 p.m. Patients call in their orders to the room service call center at their convenience. Call center attendants take orders, screen diets, work with patients on their diet restrictions, answer any questions and enter the food orders into the diet office software. Tickets then print out on the room service line. Food production staff place hot entrées on heated plates, which then are kept warm through the use of induction base technology. Staff assemble cold and ambient items and match them with the hot items. They place finished trays into the carts for delivery.

Room service attendants deliver to patients on the first through fifth floors within 45 minutes from the moment they order. "We're actually delivering trays in 35 minutes," Reeves says. "As part of this time, it takes about 10 minutes to place food on the trays before they go into the carts."

The room service menu contains all selections for breakfast, lunch and dinner. The breakfast menu includes hot and cold cereal; eggs cooked to order in omelets and breakfast sandwiches; French toast and buttermilk pancakes; sides of skillet potatoes, bacon and sausage patties; bakery items; and fruit and yogurt. For lunch and dinner, the menu includes soups; salads such as chef's salad, grilled chicken Caesar salad, and a seasonal fruit plate; hot entrées, including savory chicken breast, oven-roasted turkey and gravy, Yankee pot roast, grilled salmon with tomato and yogurt dill sauce, Asian stir-fry, cheese enchiladas, pasta primavera, and baked macaroni and cheese; sides of mashed potatoes and gravy, whipped sweet potatoes, steak fries, baked potato chips, wild rice pilaf, steamed rice, green beans, broccoli and carrots, dinner rolls and garlic breadsticks; deli sandwiches and wraps; and grilled items such as burgers, and cheese and chicken breast sandwiches. Personal pizzas and desserts are included among the lunch and dinner menu options, too, as are a full range of beverages.

To support production of the room service menu, catering and the WILDFLOWER café, the culinary staff uses kettles holding five, 10, 20 or 40 gallons to prepare soups and sauces, a grill to mark meats, combi ovens to steam vegetables and roast meats, and five-, 20- and 40-quart mixers for mashed potatoes, dough and cake mixes.

For room service, staff use small casserole dishes and other containers to portion the food before placing these products, along with some bulk food, into a blast chiller for rapid cooling to meet health department regulations. Staff store food for the room service menu adjacent to the cook's line where staff fill their production needs based on patient orders. "This ensures efficient and adequate inventory for cooks to access when processing patient orders," Reeves says.

To fulfill patient orders coming in from the call center, the entrées that were pre-prepped and staged beforehand are now easily accessible by cooks who quickly cook or bake the items in high-speed ovens that use induction, convection and microwave technology. The cooks also practice more traditional cooking methods, such as charbroiling, grilling, sautéing on a six-burner stove, and steaming and roasting in the double-stack combi oven.

"We conducted a lot of research before deciding to go with room service and selecting the type of system," Reeves says. "Room service requires about a 7 percent increase in labor, but we have a tremendous increase in revenue from the retail operations, so our net cost is lower than at the previous facility."

Also on the lower level is a flight-type dishmachine with a self-contained pulper to reduce solid waste. In addition, cleanup is assisted by a cart-wash station and a three-compartment sink with a pot and pan agitator. "There is space available to add a pot- and pan-washing machine in the future," says Kukla.

Reeves and his staff couldn't be more pleased with the new foodservice operation. They continue to develop new menus and polish their customer service so they can exceed patients' and other customers' expectations. Since the equipment is an integral part of their operation, they work hard to keep it clean and maintained so the operation can function smoothly and efficiently.

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