By H. Rae Gibbons

Unlike a restaurant, the foodservice department in a hospital has to feed all their patients, which could range from newborns to the elderly, all their meals — all the while meeting the patient's dietary needs. For a hospital with 800 beds, that can prove a daunting task, and if done manually, a confusing and time-consuming one. The OSF Saint Francis Medical Center in Peoria, Ill., is using both Computrition's nutrition care management and its foodservice management system to increase efficiency and to document the process of providing patients with cost effective, high-quality food, based on specific nutritional requirements and the patient's personal needs.

Previously, the hospital was under contract with Aramark, which managed the foodservice department until 1994, using an automated system. When the contract ended, Greg Wolf, production manager for OSF Saint Francis Medical Center for the past 15 years, and another manager at the hospital put in a proposal for self-operation because they believed that they could manage the department in-house. Their proposal was accepted, and they began tackling the task at hand. Unfortunately, when the contract with Aramark ended, so did the hospital's use of their recipes, menus and automated systems, so right away, according to Wolf, they began to search for a new system to replace the old.

Utilizing their in-house information systems services department, Wolf says they contacted the two major vendors in foodservice software at the time, Computrition being one of them. Computrition then set up meetings at different hospitals for them to visit and see first-hand how the system worked. What they found was a system that combined the nutrition care management and the food cost management that they were looking for. Wolf says, "We wanted to integrate diet office with food cost management in order to get the best food cost benefit out of our purchase." The system the hospital is using is UNIX-based, but it is also available through Computrition in a Windows-based platform.

Putting in the time

The system was purchased from Computrition in 1996, and it took two years before the OSF Saint Francis Medical Center had full use of the system due to the time that went into entering all the data. With 1,900 ingredients used to build 1,200 recipes, data entry was a full-time job in itself. Wolf and the diet office supervisor, Colleen Crowley, were removed from their operational responsibilities for one full year in order to concentrate full-time

on getting the system up and running. Wolf believes that "the problem with a lot of facilities that implement an automated system is that they don't put the resources into getting it fully functional, or they have to do it as part of their regular job. It's impossible to do this kind of work and function in an operational capacity. Our director had enough foresight to see that if we were going to get the system working we were going to have to put the time and resources into it."

Worth the wait

Wolf says that the cost savings they've seen since using the system have contributed to the system's worth. "We saw a significant drop [in costs] initially, and we've been able to remain relatively consistent. We've been able to reduce our standing inventory from $40,000 to approximately $20,000 due to the reduction in over-ordering."

Crowley adds that they have also experienced savings in time spent analyzing recipes because the system automates so much of what was previously done manually. During the transitional period between systems, the hospital staff had the difficult task of manually running a department that produced 4,000-5,000 meals per day. Wolf says they ran into a lot of product inconsistencies with the manual system that have been eliminated since using the automated one.

Report assistance abounds

According to Crowley, the system gives the diet office the ability to do the following:

  • Prioritize — "The diet office can choose to run a census for their unit and that will help them with menu collection. We can run a list of everyone that is on a nutrient intake, which allows us to separate and print out all patients that have nutritional risk factors."
  • Adapt the system — Crowley says they are able to adapt the system to assist their peration with functions it wasn't originally intended to do. For example, they can "create a recipe call. If we're having brunch for a special occasion, we can enter a recipe called 'brunch' and multiply it by the number of people attending and give production a count of how many people have made reservations."
  • Test new recipes — "If we're trying a new recipe, we'll run it as a special, offer it to patients and then run a report to tell us every patient in the hospital that selected that recipe. We then follow up by visiting those patients and getting their opinion on the new menu item."
  • Monitor food safety — If an operation received reports of a food-borne illness, this system would offer a means to go back and find out exactly who ate a particular menu item to discover the cause.

On the production side, the system's reporting capabilities aid in the financial tasks associated with running the medical center. Those reports include:

  • Account history report — Gives a count by day and total for the month of actual patient trays that are served. Wolf says, "From a foodservice financial standpoint, we want to make sure that every single meal we serve is counted. All of our budget accountability, everything administration holds us responsible for is based on meals served."
  • Patient history report — Counts the number of caregiver meals, which is a complimentary meal for caregivers of pediatric patients.
  • Food cost report — Totals all purchases and breaks them down by vendor and by category. This report enables Wolf to check for consistency in purchasing dollars.
  • Inventory evaluation — Wolf says a fiscal count is done every month and this report gives him the exact dollar value of the standing inventory.
Hospital of the future

Wolf and Crowley both have ambitious plans for the foodservice department's future technology installations. Crowley says that although Wolf may tease her about imagining a hospital from the cartoon "The Jetson's," she would like to see a touchscreen ordering system installed in every room at the hospital for patients to order for themselves. And despite his teasing, Wolf's hopes for the department's future technology aren't too far behind Crowley's. Wolf says a lot of hospitals are moving toward room service models because they increase patient satisfaction, but he recognizes that it is a difficult proposition for a hospital of this size.

Another future technology of interest to Wolf is a form of bedside menu entry with a phone system designed for patients to call down for room service. Ideally, Wolf says he would like to have "a nutrition technician sitting at a desk taking patient orders via the telephone. The technician would then pull up the patient's menu on a restaurant-style touchscreen, select the menu and print it out in production." George Jetson would probably approve.