Margie Richardson, RD, retail F&B manager at Asbury Court, the main café at the EUH campus.

Arlene Bennett, RD, associate director Wesley Woods geriatric hospital.

Ronnie Gee, assistant director, retail food services, EUH.

“In making the transition to a retail model, one of our biggest challenges was developing the new staff,” says Moore, a former management company employee. The old facility had not been geared to the retail merchandising, grab-and-go and made to order services available in the new one and completely new employee skill sets were required. Some existing employees were re-trained for retail operations and others were hired to fill new positions.

“We were moving into a completely new and much smaller kitchen as well as a much larger new servery,” she says. “Every system we had or knew had to change in a matter of 24 hours. When it happened, it was like being thrown into a cold water bath. We weren't even able to train staff until the new building opened.”

To ease the transition, existing menus were used for the first few weeks and service was limited to the grill and main serving line areas. As additional stations were opened, menus and prep procedures were modified to introduce items that had visual appeal, grab-and-go packaging and the kind of retail presentation value Seasonings had been designed for. The impact of the new style of service was quick and dramatic: existing sales more than doubled within a few months.

A move to advanced production

Meanwhile, equally dramatic changes were taking place at the EUH campus, where the kitchen was undergoing a complete re-configuration.

“Advanced production promised to provide us with many efficiencies, but also a steep learning curve,” says Ometer. The tray delivery system was also going to change dramatically as both hospitals moved from the existing cook-serve approach to a re-therm model.

David Horning, EUH associate director, production and purchasing, headed up the team for that transition. A 20-year veteran at EUH, he had watched the implementation of a less than successful cook-chill conversion at another hospital early in his career and was intent on making sure Emory's went smoothly.

“When we joined the two hospital production teams we had two complete kitchens based on cook-to-serve production and were duplicating a lot of effort,” he observes. On the other hand, “the conversion required us to remain operational here at EUH even as the kitchen was completely re-engineered. We did it in 10 successive phases during which a different area was sealed off, gutted and re-built.”

That process took nearly two years to complete. It included the installation of four new steam kettles, two pump/fill stations, two tumble chillers/cook tanks, two blast chillers and additional refrigerated storage space for advanced production. The operation kept two tilt-skillets but replaced its fryers and ranges. In the end, an entirely new kitchen had been installed in almost the same footprint that had existed previously.

Developing new service models

Patient services were also undergoing a transition. That job fell to Associate Director Barbara Fussell, RD, another ECLH veteran who now has responsibility for patient dining services at both facilities. Ometer describes her as a “change agent.”

It's a characterization with which Fussell agrees. “If we're doing things the same way two weeks in a row, we are not doing our job,” she says. “Constant change is the job in this business!”

As the department prepared for a transition to advanced production, Fussell's team began meeting with nursing staff to develop common standards that would address issues that both groups faced.

Among them: procedures for receiving diet orders; a system for determining that patients were “meal ready;” and ways nursing and foodservice could more effectively ensure that the patient meal experience would contribute to raising hospital Press-Ganey scores. Foodservice undertook a complete review of its host/hostess program with a special emphasis on training staff to help them continually assess the level of patient satisfaction and to teach them proactive techniques for service recovery.

Last year, the opening of a new intensive care unit at EUH gave Fussell an opportunity to experiment with another new service model. Among other changes, the ICU model moved away from the traditional practice of delivering all unit meals at a designated time. While that remains an option, the floor clerks also can call for partial service, with trays delivered on an as-needed basis.

As finally refined, that dining services model now operates at all three Emory acute care hospitals. It combines a spoken, advance-select menu with host/hostess delivery and is fully scripted, says Fussell.

“Our goal was an inter-disciplinary approach,” says Ometer. “We wanted to create teams at the unit level that would permit service customization.”

In practice, “we tell our host/hostesses they are actually members of two separate teams,” she adds. “On one hand, they operate as our liaison to the unit, keeping us in touch with what is happening there. On the other, they are part of a unit-level team focused on the overall patient experience, of which foodservice is just one part.”

Extending the Brand

As the integration of operations at EUH and ECLH moved forward, the hospitals have continued to expand, providing additional challenges for Ometer's department. Foodservice at Wesley Woods Geriatric Hospital was brought under its umbrella in 2001 (foodservices at Wesley Woods' independent living and skilled nursing facilities remain separately managed).

Gwen Mays, manager of patient services, EUH (r.), and Brenda Lindsey, an EUH patient services team leader.

Donnell Jones-Craven (l.), F&B manager for Seasonings, with staff from the ECLH retail operation.

“Again, there was a need to establish commonalities that would help the facility work more effectively within the system,” Ometer says. The associate director of food and nutrition at Wesley Woods geriatric hospital — Arlene Bennett, MA, RD — runs a customized operation there but takes advantage of Emory's advanced production where it is appropriate. She also gets assistance with catering and other needs as part of the larger department.

In the spring of 2005, Ometer's department was asked under short notice to design and open a new physicians' dining room at EUH. Ronnie Gee, EUH's assistant director of retail food services, and Margie Richardson, RD, EUH's retail F&B manager, worked with facilities management to pull that off in 60 days, a fast track time frame required by physical re-construction activities at the Emory Clinic. The new dining room is now located behind the main EUH café, allowing for efficient staffing and production.

Other initiatives are organic to the department. For example, as the Seasonings café has become a highly successful brand for the nutrition department, Ometer has looked for ways to extend that brand to other services. The department's current master plan calls for it to be applied to Emory's proposed room service program as well as to selected menu items, packaging and catering services across the system.

Today, the Emory Health System produces about twice the number of meals it did ten years ago with seven percent fewer staff. Seasonings has become a prominent Emory brand that will be extended across the system in future years; and the department's central production capacity is helping undergird a variety of patient and staff services that have been added or are now on the drawing board.

Among other longer term goals, Ometer plans to add a financial analyst to the staff to use POS and other financial data to better guide retail and operational strategy. A new cashless payment system,has the potential to bring greater retail efficiencies and volume. And the department is evaluating ways to incorporate more sustainable food choices into its retail program in the coming year.

New integration challenges also lie ahead. Last year, Emory acquired Northlake hospital, which is undergoing reconstruction and will re-open this fall. Her staff will again be flexing to support the new retail and patient services to be offered there.

“We've slaughtered a lot of sacred cows over the last decade, one at a time,” says Ometer, looking back. “Every now and then, the team still finds a few hiding in the fringes. The difference is that now, we go after them together.”

At a Glance

Emory Hospitals: Four primary facilities, including Emory University Hospital (EUH) and its Center for Rehab Medicine, Emory Crawford Long Hospital (ECLH), Wesley Woods Geriatric Hospital (WWGH), and Emory University Hospital Northlake (EUHN).

No. of Licensed Beds*: 1304

No. of Budgeted FTE*: 254.9 (includes clinical nutrition staff)

Annual Catering Revenue*: $917,226

Annual Retail Sales*: $5,756,948 (cash and non-cash)

Total Annual Meals*: 4,112,600

* FY 2007; does not include EUHN