Cleveland's University Hospitals is one of the country's leading healthcare systems. An affiliate of Case Western Reserve University, UH's main Case Medical Center complex encompasses a set of specialty hospitals: Rainbow Babies & Children's Hospital, the Ireland Cancer Center and MacDonald Women's Hospital, each among the national leaders in its field. UH also operates five regional hospitals (plus a sixth affiliated hospital) in Northeast Ohio along with an extended care facility, a management services center and almost two dozen health centers.

Charged with providing dining, catering and vending services to patients, residents, staff and visitors at these disparate sites is Sodexo Health Care.

The contractor and the client have forged a strong relationship, says Tom Schwendeman, Sodexo's district manager for the UH contract. “We have a very nice partnership with UH that makes everything we've done work really well. As a contract company, you need the foundation of a strong relationship for the partnership to be successful.” He cites the recent remodel of a branded Einstein's Bagels kiosk. the introduction of new POS, digital signage and order entry technology and a partnership with a local nonprofit on a composting program as examples of successes derived from such a mutually constructive relationship.

UH's main complex, with its various hospitals, large staff and sprawling real estate require volume dining service with a personal touch. The regional hospitals — ranging from less than 20 beds to more than a hundred — need to be efficient with their small volumes, and yet offer the same level of service as the big main campus.

And then there is the extended care center, a triple-level residential complex with various dining needs ranging from retail dining for a small staff and restaurant-style dining for assisted living residents to traylines for the confined hospital patients. The management services center, on the other hand, is essentially a B&I location.

To deliver the kind of foodservice UH expects at such a variety of service points, Sodexo has designed a semi-custom program that combines the larger organization's broad capabilities in menu development, facility design and service modules with unit-level adaptations to individual circumstances.

All Kitchens Are Not Created Equal

The primary driver for Sodexo's initial relationship with UH, which began in 2002, was the contract management company's capabilities in implementing room service dining. Sodexo (then known as Sodexho Marriott Services) was one of the first in the industry to develop a room service module, At Your Request, and UH wanted to be among the early adopters of what was at the time a fairly unusual service.

However, UH's main kitchen — designed around a volume production cook-chill operation and traditional trayline — made effective individual tray service difficult, forcing employees who filled room service orders to negotiate the physical limitations of the space while completing their assignments.

About a year later, Sodexo got a second kitchen in a new building that it was able to design specifically to accommodate room service. Today, this kitchen supplies room service meals for about three quarters of the Case complex. (The rest must still be supplied from the old kitchen because the distance to some of the patient areas is prohibitive from the new one.)

The situation may improve in 2011, when UH plans to open its new cancer hospital, which will include another production kitchen designed with a series of built-in enhancements from lessons learned over the past five years.

One change will be a new layout for the cart delivery/return area. Currently, returning and deploying carts go through the same constricted doorway. The new system's circular design will allow returning carts to enter at one door, get sanitized and then exit through another door to the production area where they can be reloaded.

Retail Revival

Retail dining was the next major upgrade target for Sodexo after implementing room service at the main campus in 2003. The complex is primarily served by a single cafeteria in the Lakeside Hospital building.

AT A GLANCE Name: University Hospitals Dining Management: Sodexo Health Care Beds (main campus): 947 Beds (regional hospitals excl. extended care campus): 511 Patient meals (main campus): 696,000/yr. Retail transactions (main campus): 4,000-4,500/day Annual retail revenues: $6.9 million

By the early 2000s it was not only dingy but hopelessly behind the times — it was known for its “mashed potatoes with orange gravy,” jokes Ronald Dziedzicki, UH's senior VP and general manager of operations since 2006 who is also a colonel in a local Army Reserve Medical Group.

In 2004, capital dollars were allocated for a major renovation that took the cafeteria off line for about eight months. The project was unusual among capital investment commitments in that it was not expected to boost sales much in a space that, whatever its shortcomings, regularly drew thousands of customers each day.

“To make a change that would not impact revenue is not typical for us,” says Dziedzicki. “We did it for the employees and to some degree the patients.” Dziedzicki says his military experience has taught him the positive impact foodservices can have on morale as one of the reasons for this deviation from strict bottom-line thinking.

“We want to be an employer of choice and the quality of the dining onsite is part of that.” Significantly, in his former role as UH's chief nursing officer, Dziedzicki was credited for reducing annual turnover among the hospital's nearly 500 employee nursing staff to below two percent. He also speaks proudly of the time his combat support unit was a finalist in the Army's Philip A. Connelly competition, the service's most prestigious foodservice awards program.

The new cafe, unveiled in December 2004, brought UH retail dining into the modern onsite dining world with a series of stations offering an array of dishes, many prepared in front of customers. The mix includes pizza, grill and deli, a Freshens branded smoothie station and Innovations, an entrée station with revolving choices from a 35-day menu cycle.