What is in this article?:
Consultants say the best strategy for maintaining a top food quality reputation combines a proactive perception measurement and management program with quality improvement and quality assurance standards.
The Case of the Nightmare Review
Barry Schlossberg remembers how that workday in the last week of June 1997 began: with the exhilarating announcement that he had been named corporate foodservice director for the new partnership of Beth Israel and St. Luke’s-Roosevelt hospitals. He also remembers how it ended: with a cover story on New York’s Best Hospitals in an issue of New York magazine he picked up at a Pennsylvania Station newstand to read on the train ride home.
Schlossberg, who had been running Beth Israel Health Care System’s foodservice for 11 years, read a positive review of his own program in the article before his eyes found the sentence, “But the food at St. Luke’s-Roosevelt is absolutely horrible.”
“Well, it was pretty obvious right then that we had a serious public relations problem and that things were going to have to change,” Schlossberg recalled recently. “New York magazine was well-read and this issue would be circulated to all the doctors and hospitals in the city.”
When the St. Luke’s-Roosevelt vice-president overseeing foodservice walked into Schlossberg’s office the next day, “I asked him to give me six months to turn it around and, if he did, I promised he’d never see that kind of review again.”
Having worked in the New York metropolitan area healthcare environment for so long, Schlossberg already was familiar with the background of St. Luke’s-Roosevelt’s foodservice department.
“The hospital had gone through some difficult economic times, there had been major layoffs in the medical center, and somewhere along the way, the push to reduce labor had led the administration to a decision to go to a nonselect menu heavily reliant on convenience foods,” he says.
Under the gun to send an immediate, loud message that the foodservice would improve, Schlossberg moved quickly to introduce choices in the menu.
“We couldn’t add any labor, of course, so we reworked the existing staff. Two hot entrées and a cold alternate appeared on the lunch and dinner patient menus within the first month. Within several months, to-order room service and menu choices were implemented for breakfast. Within the first six months, scores on Press-Ganey, a popular healthcare customer survey system that is relied on industry-wide to measure customer satisfaction, had improved by seven percentage points.”
The turnaround in food and service quality from the devastating 1997 review is still underway, according to Schlossberg. The biggest decision aimed at improving quality and control was the move to centralize all patient food production for the entire Continuum Health Care System (which includes Beth Isarel, St. Luke’s-Roosevelt, and three other New York-area hospitals) in the huge cook-chill facility that had been standing unused at St. Luke’s-Roosevelt. Directors from all affected units were brought together last summer to construct the new menu. Production equipment was moved from Beth Israel to St. Luke’s-Roosevelt, cooks were transferred, tray lines redesigned, rethermalization systems improved and training sessions scheduled.
The new restaurant-style patient menu offering 10 choices at lunch and dinner was introduced in February.
In a total reversal from the former reliance on convenience foods, all items except pizza and lasagna are produced from scratch. “In the old system, even the meatloaf was a convenience food,” says Schlossberg. “Now, when we have mashed potatoes on the menu, we start with raw, unpeeled potatoes.”
“It was a slow night at the city desk...”
The decision to offer newly formulated burgers in the Denver Public Schools was totally justifiable and the switch had been extensively student-tested and student-approved, but the media fall-out was potentially devastating.
In blind taste tests, students at all grade levels in all areas of the city had said they preferred the burgers which, unknown to them, contained small amounts of prune puree.
“We had been working with the California Prune Board on other product testings and we had been using prune puree very successfully in the baked goods we serve in the schools. The addition of the puree reduced the fat content and kept the product more moist,” says Donna Wittrock, foodservice director for Denver Schools. “When the Prune Board wanted us to sample meat products containing puree, we saw no problem with it.”
The burgers hadn’t made it onto the school menus last September when the California Prune Board released news of the successful student taste tests on a national news wire service. The story was picked up by Denver’s Rocky Mountain News and a reporter phoned Wittrock for more details about the new formulation of the burgers. That interview resulted in a local newspaper article with a very positive spin, according to Wittrock.
But then local talk radio hosts picked up the story and all chances of maintaining positive coverage flew off the airwaves. Wittrock says, “there were jokes about kids needing more bathroom breaks because of all the prunes in the burgers and there was talk about the mystery meat being served in the schools. I got calls from my managers all across the district that kids weren’t buying the hamburgers. At certain schools the numbers dropped from 200 hamburgers a day to 20. The word was getting around and we saw the impact on sales.”
Wittrock had legitimate reasons to taste test the new burgers. “We get prune puree through the government commodity program, so there are cost advantages to using it,” she says.
“You’ve got to keep in mind that the puree constitutes only three to five percent of the burger ingredients. But that small amount lowers the fat content by 38.4% to 9.3 grams. And the taste is really superior. My staff tested them first against the burgers we were currently serving and the new burgers were juicier and tastier and held up better on the line.
As the publicity continued unabated and burger sales continued to plummet, Wittrock sent out a letter to all foodservice managers informing them that the burgers currently being sold in the schools contained no prune puree and that the burgers containing the puree had been served only in the taste tests.
Delivery of the reformulated burgers was still months off. In the midst of the coverage, Wittrock served platters of “prune burgers” and current burgers to the seven school board members in a blind test. Six of the seven preferred the taste of the burgers containing puree.
The media deluge escalated. Television stations wanted to send crews into the cafeterias to follow up on the story. Print media wanted to interview students. And the radio hosts wanted on-air interviews. Wittrock called her school district public information office and asked for help.
“I was really concerned about the integrity of the program at this point,” says Wittrock. “My boss was concerned—naturally—about the damage that this publicity could cause the program. He suggested we call the California Prune Board for assistance handling the media. After all, they had issued the first release. That’s what we ended up doing. All calls that came into our offices were referred to them.
“As I look back I am not certain what I should have done differently. I know I’m serving a product that is lower in fat. I know kids like the taste. If kids wouldn’t have liked the burgers, we wouldn’t have chosen them. I suppose thinking about it now I should have thought through the subject and idea of prunes a little longer.
“I keep hoping it will go away, but as late as December there was a conversation on talk radio where one of the hosts was complaining about a visit he had made to a local restaurant where he said he had ‘the worst meal he had ever eaten.’ The other host said ‘it couldn’t be any worse than prune burgers in the schools.’ So it is still out there as a topic.”