‘Room service’ food delivery brings big savings

Small hospital pleases patients, cuts costs

Other food service administrators still say it can’t be done. But the food service staff at St. Charles Medical Center in Bend, OR, have been proving them wrong for four years.

They have slashed up to $35,000 off annual food costs while pleasing patients with a 24-hour-a-day room service program.

Modeled after hotel room service programs, food service staff typically deliver freshly prepared food to patients any time of the day or night within 10 minutes. Some cooked foods may take longer.

"Other hospitals will call up and ask us about it and they don’t believe it can work and cost less, but it does," says Molly Slough, RD, assistant food service director at St. Charles.

The program has saved the hospital money primarily by reducing food waste. A comparison of patient orders to previous stocking demands shows that much of the food was either discarded or eaten by staff.

For example, the dietary staff used to stock the units with 40 sandwiches a day, but the room service demand is only an average of 15.

Also, the staff used to stock bags of popsicles on the floor weekly, and they would disappear. But room service records show an order of one or two now would be a heavy demand in a day.

While the hospital saves money, patients also benefit by dining on fresher fare. Room service requests show the demand is heaviest between 7 p.m. and 10 p.m., which means prior to room service, patients who were hungry during this period were eating sandwiches that had been stocked on the unit since first thing in the morning. Also, these sandwiches were barren of condiments and garnishes because they had to meet a variety of dietary guidelines. Now, a new mother who just spent 12 hours in labor no longer has to choke down a turkey sandwich with no mayonnaise that was meant for a cardiac patient.

Meeting needs, solving complaints

St. Charles launched the program about four years ago as part of an overall patient-focused care redesign. The dietary staff wanted to address patient complaints about food quality and service. At the time, the food service staff would serve the three basic meals on the floors. To feed those who were hungry in between meals, the staff stocked each unit in the morning with sandwiches, drinks, custards, and other items.

Food service revamped the system so patients place an order with the nurses. Patients can either order off the menu or request something special, such as a grilled cheese sandwich.

To make sure the meal meets the patient’s dietary restrictions, the staff consult the computer record.

At St. Charles, a small hospital where the average patient census hovers around 100, food service staff deliver an average of 170 meals a day, 100 of those in the evening. The department added a volunteer to help deliver meals during this peak period.

The kitchen prepares all its food from scratch and employs its own bakers.

Meals are served on china with silverware and cloth napkins to make them more appealing, particularly to patients who have not felt like eating following surgery.

To run the program, the department added one FTE to its staff of about 40. The rest of the work was easily redistributed because staff now spend less time preparing and stocking food on the units.

The staff continues to stock units with soda crackers, orange juice, and milk for immediate nourishment needs. Juice and soda are now dispensed from a machine rather than distributed in cans, further reducing costs.

The program has had its glitches. The daytime nursing staff have resisted the program for its perceived inefficiency for delivery of medications in food, among other reasons. Slough says this perception should be rectified soon with a new system in which nurses will explain that a given item is for passing medication, and food staff will drop everything to deliver the item immediately.

Food service continues to provide the three basic meals every day, but eventually Slough says she would like to convert to 100% room service. She says she would like to see patients place orders on a touch-screen television that features menus catering to their dietary needs and restrictions.

"The patients are really thrilled by this," Slough says. "Food is a priority to them and it’s a priority for us."

[Editor’s note: For more information about the room service program, contact Molly Slough, assistant food service director, St. Charles Medical Center, 2500 NE Neff, Bend, OR 97701. Telephone: (541) 382-4321.]