UNC hospitals switch to restaurant-delivery model to offer more options for patients
Dec 30, 2012 (The News & Observer (Raleigh - McClatchy-Tribune Information Services via COMTEX) --
When Angelo Mojica took over food service seven years ago at UNC hospitals, the number of patients satisfied with their meals was 11 percent.
Incidentally, Mojica reports a Wendy's inside one of the five hospitals on the Chapel Hill campus was the highest grossing Wendy's franchise in the Southeast.
Mojica has since transformed the hospitals' food. He got rid of the Wendy's, opened a Starbucks and developed 20 different restaurant concepts inside the food courts throughout the hospitals. Now patients order off a 20-page menu featuring 90 dishes from any of those "restaurants," such as green beef curry from Red Ginger, shrimp and cheesy grits from Continental Traders and a carnitas burrito from Bandoleros.
As a result, a private survey commissioned by the hospital now shows 99 percent of patients are satisfied with their meals.
Mojica claims this restaurant-delivery model of hospital food service is the first-of-its-kind in the country. He's just begun consulting with a hospital system in California about how they can adapt the system.
His cooks receive culinary training, cook from scratch more often and even employ "sous vide" -- a technique used at fine-dining restaurants -- to cook vacuum-sealed burgers, chicken breasts and salmon filets in a simmering water bath. The method creates moist meat that staff only need to sear on the grill to finish, reducing the time it takes to get food to patients.
This is just the latest example of a trend -- sometimes called " the amenity wars" -- among hospitals across the country.
Hospitals are competing for patients and so are offering better food, valet parking and even day spa services. Jessica Marchand, director of food and nutrition services at Raleigh's WakeMed Hospital, explained the trend this way: "We shop for hotels and now we can shop for hip replacements."
Another reason hospitals are trying to offer a better patient experience is that the Affordable Care Act requires a patient satisfaction survey. A hospital's public survey results are tied to 1 percent of its Medicare reimbursement. It's unclear how much food influences those survey results since patients aren't asked a specific question about food. Instead, they are asked about the friendliness of the staff, cleanliness of the facility, noise level and general questions about customer service. But food service managers at several Triangle hospitals cited the Medicare reimbursement as a reason to improve their hospital's food.
For UNC hospitals, almost $5 million is at stake annually.
The Triangle isn't immune to this competition. It is home to Duke University Health System, which among others owns Duke Raleigh Hospital, UNC's system, which owns Rex Hospital in Raleigh, and WakeMed, which has hospitals in Raleigh and Cary. (Last year, WakeMed and UNC settled a hostile takeover bid by WakeMed to buy Rex.)
The competition for patients extends into the kitchen, as part of the evolution of hospital food service.
The old model was that all patients got the same meal, adjusted to their dietary restrictions, three times a day. The next iteration allowed patients to order off a menu a day ahead but the food was still delivered at the same time every day. Both models could waste a lot of food if patients didn't like what they were served or the food came when a patient wasn't in the room. As a result many hospitals are moving toward a room-service style model where patients order what they want to eat when they want to eat it. UNC has taken it a step further with its restaurant-delivery model, offering dozens of menu options whenever patients want to eat.
Triangle hospitals are trying to up their game when it comes to food for patients, visitors and staff. Raleigh's Rex Hospital has started offering afternoon tea to patients with bedside delivery of chocolate-dipped strawberries, scones and an assortment of teas. An Au Bon Pain recently opened inside WakeMed's Raleigh hospital, offering their all-time favorites such as rotisserie chicken and a California salad with turkey and raspberry vinaigrette. And Duke University Hospital in Durham will transition to a room-service style model after a $15 million renovation to its kitchens next summer, said Ed Chan, the hospital's general manager for food services.
Like a high-class hotel
At about 11 a.m. on a recent Thursday, Mojica took his daily tasting tour, randomly sampling food at the hospital's retail locations. At Bandoleros, a Chipotle-like concept, he tastes the machaca, a spicy braised beef with a cilantro lime jasmine rice. At Red Ginger, a Pan-Asian restaurant, he takes a bite of chicken Penang, a Thai red curry dish. Usually, Mojica is joined by the hospital's executive chef, Shawn Dolan and associate retail manager, Ryan Miller. They are looking for problems. "We want to catch it early before our customers catch it," Mojica said.
On this day, Dolan and Miller join him later at the Overlook Cafe to sample chili, chicken tortilla soup, pepperoni pizza, soft pretzels, sausage-stuffed baguettes and low-fat cookies. (Two of those chocolate chip cookies are delivered to all patients every Wednesday, recipe included.)
Mojica explained that for years he had been asking his superiors for two dozen more employees to move patient food service to a room-service style model. At the same time, he was developing all these retail concepts offering sushi, breakfast sandwiches, paninis, smoothies and more. He and his staff figured out that they could add nine employees to staff a call center and start offering what was being served on the retail side to patients.
All the retail food is cooked in satellite kitchens around the hospitals. So Mojica has a few portions of the retail offerings brought down to the main kitchen, where patients' meals are prepared. So when the patient orders a California roll or fried chicken, it's available.
"You would have 15 to 18 maximum entrees for room service programs," Mojica said. "We have 90 entrees."
Plus, food costs dropped 5 percent since the program launched in April, an annual savings of about $300,000. And the private survey commissioned by the hospital shows patient satisfaction with the food jumped from the low 80s to 99 percent.
Dave MacDougall of Fayetteville had an eight-day stay earlier this month after hurting his head and wrist in a fall. MacDougall said he never ordered the same thing twice. Instead, he opted to explore the menus, enjoying a red wine-marinated London broil with au jus one day, an orange-glazed pork tenderloin on another day, and French toast, pancakes and an omelet for breakfasts.
"You always hear people saying how horrible hospital food is," MacDougall said. "This was much more like staying at a high-class hotel."
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