At a Glance Name: Baptist Health Medical Center-Little Rock; Baptist Health Rehabilitation Institute No. of licensed beds: 800 (Hospital); 120 (Rehabilitation Institute) Authorized foodservice FTEs: 175.7 Cafeteria volume: 4000-4200 transactions daily 2002 cafeteria revenue: $3.95 million Trays produced per meal: 650-700 Trays produced per minute: 6.5 Renovation Project Team: Master Plan and Foodservice. Design: The Hysen Group; Architect: The Wilcox Group

Before the renovations at Baptist Health Medical Center in Little Rock, there was the kitchen at Emanuel Medical Center in Turlock, CA. Before Turlock, there was the new kitchen and deli at the Community Hospitals of Central California in Fresno. And before Fresno, there was the renovation at Riverside Hospital in Columbus, Ohio.

Indeed, if you were to look at the details in Charlotte Mosqueira’s resume, it might seem her career as a hospital foodservice director has taken her from one renovation to another. In fact, that’s probably not too far from the truth.

That experience in managing hospital foodservice operations while also overseeing major construction projects has paid real dividends at the Little Rock Medical Center, the largest facility in the Arkansas Baptist Health system. That’s where Mosqueira has spent the last five years overseeing a complex renovation that has entailed rebuilding virtually every part of the 800-bed hospital’s primary kitchen, even as the facility continued normal operations.

Aging infrastructures

Baptist Health is the state’s most comprehensive healthcare service provider, with more than 80 facilities that include medical centers, family clinics, therapy and wellness centers. Mosqueira’s department manages the foodservice for both the main Medical Center in Little Rock and its Rehabilitation Institute; it also provides bulk food to some satellite operations on and near its Little Rock campus.

The main campus buildings were built 30 years ago in the construction heyday of the healthcare industry. It was a time when hospitals were fully reimbursed for operational costs and there was relatively little concern about FTE counts or their relation to production facility design.

As is the case with many major hospitals, more than a decade of downsizing and department re-engineering austerity have taken their toll on Baptist Health’s foodservice facilities. Its aging infrastructure had reached a point where major reconstruction was required in many key areas both to meet code requirements and to enable it to achieve planned productivity increases in the future.

In terms of foodservice facilities, “it has been clear since the early 90’s that a major renovation was going to be required,” says Glenyce Feeney, a former IFMA Silver Plate winner and Baptist Health’s system director, nutrition and foodservices.

“It was also clear that much of the equipment that needed to be replaced would have to be selected in the context of an overall plan, rather than by ‘in kind’ specifications, which hospital policy had generally required in the past.”

With that objective in mind, Feeney is the one who hired Mosqueira five years ago to run foodservice operations at the medical center and to help in designing and overseeing the major reconstruction effort she saw ahead.

Getting in phase

Changing demand patterns and the facility’s growth as a major regional service provider had long since begun to overtax servery space that had originally been built to handle only half the number of customers the department now serves daily. In comparison to dining facilities available at newer facilities in the system, the servery at the main Baptist Health campus was typically so over-crowded and over taxed during peak meal periods that it had become a workplace quality issue.

And while the need to update front-ofthe- house facilities was obvious to staff and visitors, the foodservice department knew that the production facilities that were behind the scenes had even more immediate needs.

There, major structural repairs were needed for the floors, walls and ceilings. Cooking equipment, fryers, kettles and refrigeration equipment all needed replacement. Three different brands of dish machines and a tray washer were in place, all of them old, and all demanding excessive maintenance.

Among other challenges, the kitchen’s central exhaust system required major asbestos abatement and needed to be completely rebuilt. Assuming that approval could be obtained to move forward with a major renovation, abatement requirements promised to complicate and extend every phase of the kitchen’s remodeling.

“While we agreed the serveries badly needed an upgrade, we made the case that we needed to increase our production capacity to adequately support them before we could undertake redesigns that would almost certainly increase production demand,” Mosqueira says.

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