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Still, DM&A President Bill Klein notes that "the infrastructure at every hospital is different. When room service programs are designed, you have to take these differences into account: whether the facilities are largely vertical or largely horizontal; how many beds and zones exist; elevator availability" and other meal transport and service factors.

"You have to get the metrics right," Klein adds. "The number of calls a center operator can take in an hour, the number of trays an ambassador can pass in an hour, and so on, are still limited. You have to allow for the right amount of interactive time per patient and with nursing. If an administration tries to pump those ratios up because of a fixation on FTE numbers, it has a negative impact.

"You also have to staff these positions carefully. Ambassadors need to have the right speaking, demeanor and other skills to be relationship builders, and often have to be coached to help them fine-tune these skills."

Antoinette (Toni) Watkins, MS, RD, LD, is the FSD at Texas Health Presbyterian Hospital Dallas, another DM&A client. When she accepted the position as director of food, nutrition and conference services there two years ago, a retherm system was in place at the  898-bed facility (the average census runs 400 to 500). She says her evaluation showed it just “wasn’t going to take us where we needed to go.” 

In evaluating other options, she brought in DM&A to conduct a  cost analysis. Room Service with conventional call center eventually debuted in July  of 2012. So far, Watkins sees that food costs have decreased “because we’re not putting additional items on the tray that the patient doesn’t eat because they didn’t want or request them. Plus, we knew the demand for Floor Stocks would decrease since patients can order whatever they want from the menu. We saw that impact immediately.” 

Watkins reports that the hospital's overall patient satisfaction scores have increased 18% and that, so far, original forecasts have proven out. The decrease in food cost has more than made up for the increased labor cost associated with hiring nine additional FTEs in the call center.

She struggles with the idea of eliminating the call center function since “it’s the first interaction our patients have with the process. Operators can help guide a patient in terms of procedures and, if a concern is mentioned, can determine if a member of the clinical staff or a diet tech needs to check in with the patient.”

Watkins says there are other advantages as well. She points as an example to the center's ready access to an outside vendor’s Translation Line. This, she says, is especially helpful in serving the facility’s large number of Spanish, Burmese and Nepali-speaking patients. “The call center operators conferences with a translator and the patient simultaneously." Nurses and the department's room service ambassadors can also have access to the service if it is needed."