Walk through the marquéed entrance of Crawford-Long Hospital's Seasonings café and you will see a retail operation equal in every way to that of the most successful casual dining commercial chains. From the larger-than-life environmental graphics at the entrance to the ambience inside, the Seasonings experience is attractive, comforting and immediately inviting. A half-dozen points of service are apparent at first sight; others appear on both sides as you walk along the café's wide and flowing traffic pattern around a central service and display core.

High daily volume supports a broad variety of offerings, and a customer's attention is directed with lighting and displays, even as the sense is one of self direction and choice. Grab-and-go, made-to-order and self-service options blend together in an ongoing experience of abundance, selection and place.

Behind the scenes, the highly merchandised polish and sense of casual abundance that characterizes Seasonings' front of the house belies its tiny kitchen and systemic efficiencies. Many station counters double as prep tables during morning hours and setup times, and the café takes full advantage of the central, advanced production facilities (cook-chill) at the main Emory University Hospital a few miles away.

In many ways, Seasonings is not only highly effective on the retail front, but also metaphorical. It is a testament to the many foodservice goals that Emory was able to reach over the past decade, as well as to others that are less visible or still being sought.

Looking beneath the surface

Like that of many healthcare systems today, Emory's foodservice story is one of mergers, integration, a continuing search for greater efficiency and the kinds of retail and patient services that would drive revenue and benchmarking scores. With each merger, administration change and advance in Emory Healthcare's overall evolution, food and nutrition services and its staff had to flex and find new ways to manage day-to-day processes.

If you wanted a single phrase to describe that process, you couldn't do much better than to say the department operates with a sense of continuing and managed transition. That is, with continuing change, but also with a view of what it is trying to accomplish in the medium and longer term.

Lynne Moore, associate director, retail and production, ECLH.

Barbara Fussell, associate director, patient dining services, EUH and ECLH.

David Horning, associate director, central production and purchasing, EUH.

And while she will take pains to remind you her role is primarily that of a coach, much of the credit for the team's results lie with Lynne Ometer, RD, who joined Emory in 1997 after an earlier career at Geisinger Medical Center in Danville, PA. That was shortly after Emory University Hospital (EUH) and Emory Crawford Long Hospital (ECLH) had merged after a long alliance, and when both facilities had operated for almost a year with only acting foodservice directors.

“To me, the story here has always been how we came together from different facilities to become a true system,” she says. “Foodservice was one of the last departments to undergo that integration — as you would guess, there were initially two extremely distinct cultures.

“The culture at EUH was very structured and formal. It had developed more of the layered, organizational complexity typical of academic medical centers. ECLH was less formal and more team-based; it had focused more on managing costs.”

Very little communication or sharing between the two took place on a regular basis at the time she arrived, Ometer recalls. “The foodservices operated completely separately. It actually took quite a while to figure out the dynamic of what was really going on underneath the surface at each location.”

Initially, she was stymied. As an outsider at Emory, “you had the sense that if you didn't ask the right question, you wouldn't get the right answer. There was a lot of underlying uncertainty.”

Although ECLH had a lower cost structure, “equalizing the financials of the two operations was not the primary task at first. The main objective was to bring the two groups together so they shared common practices, procedures and systems.”

Turning a human face to visitors

Ometer began that process by establishing small management teams that included members from both facilities, charged with working together to develop common processes in areas like purchasing and production. The two hospitals had different prime vendors and different purchasing contract terms; both would be reconciled over time. On the production side, both used a cook-to-serve model and the same menu management software, but had much different menus and employed different clinical nutrition practices.

As the combined operations represented a much larger combined production volume, Ometer saw a chance to create efficiencies by centralizing production. When ECLH announced in 1999 that it would build a major facility addition to the downtown campus, she took that opportunity to propose a dramatically different approach to foodservice there.

Ometer offered a combined proposal that involved converting the EUH kitchen to an advanced production system to serve both hospitals. Shifting some ECLH production to EUH would permit ECLH to build an expanded, truly contemporary, retail servery.

“Our idea was to design and locate the servery to give it a great deal more visibility than it had before. We thought the new café could help the hospital turn a much more human face to its patients and visitors,” says Ometer.

“We also knew we could do a lot more with a retail operation if it had that visibility. Obviously, this was not a decision that could be driven only by the food and nutrition department. But our administration was receptive to these ideas and saw that they could really support its larger goals.

“The hospital wanted Emory Crawford Long, which has a 100-year history in downtown Atlanta, to have a greater presence,” she says. “It also wanted to address the perception some had that there was an inequality between the downtown facility and the EUH campus. There were many forces at work, and in the end dining benefited from them.”

Just getting support for the idea was only the beginning. Ometer turned to Lynn Moore, RD, associate director, retail and purchasing/production at ECLH, to lead the team that would bring the new ECLH facilities on line.