news, strategies, & insights about hospital food service and technology

Patient room service is a major driver for food and nutrition automation in the global healthcare industry today. Precision coordination of menus, patient diet orders, allergies, food production counts, patient locations, rapid-fire communications, and high-level responsiveness could not happen without computer technology. Patient room service puts “hospitality” into hospitals and happiness into hospital food.

In hospitals, room service leverages these key advantages:

• A major uptick in patient satisfaction ratings for hospital food service. Patients who are in control of their menu choices and meal times are measurably more satisfied.
• Food cost savings. Extra meal trays and unwanted food items (that the patient didn’t order) are now automatically eliminated.
• Improved meal accuracy, as each tray is prepared to personalized specifications using the most current diet order.
• Reduced staffing load for nursing.
• The opportunity for increased revenue through guest trays for family and visitors.
• A boost in employee morale for food service workers, who may dress the part, enjoy more patient contact, and receive the praise of patients.
• An improvement in the patient experience, which reflects upon image and marketing value for the institution.

While hospital room service may take on many forms, a typical room service system:

• Allows patients to order meals when they are ready to eat, much like a hotel room service model.
• Operates within a prescribed time frame, e.g., 6 AM to 7 PM.
• Provides rapid turnaround and in-room delivery of individual patient meal orders.
• Serves fresher food with better quality and temperature control.
• Allows patients to select all meal items that will be served, including entrees, sides, beverages, and desserts—within the constraints of the diet order and limitations related to food allergy or medication regimens.
• Features a perpetual room service menu with a variety of selections suitable for personal tastes and health-related dining needs

The Vision Software Patient Room Service system provides comprehensive solutions for room service implementation and service level enhancements.

Room Service is an outstanding way to provide meals to patients.  I am a huge fan!  It’s a win-win situation.  Patients enjoy and appreciate the flexibility and control they have to order what they eat and when.  Hospital food and nutrition departments enjoy seeing significant patient satisfaction improvements while improving operational issues such as excessive late trays and better control of waste and costs.

I have noticed, however, that organizations are challenged to determine how to coordinate meal delivery with bedside blood glucose monitoring and insulin administration.  Although intensive blood glucose management is important patient care, it should not derail or deter an organization from implementing Room Service or excluding patients with diabetes from having the Room Service experience.

The first issue centers around how to communicate the carbohydrate content of the patient’s meal to the patient care staff.  The second issue is how to inform patient care staff that a patient’s meal has arrived so blood glucose monitoring can be completed.  In addition, finally, organizations struggle with what their policy should be regarding missed meals.

Tackle these issues:

1. Organizations are looking to their food and nutrition software system to assist with getting carbohydrate information to the bedside and software systems are making this happen.
2. Work with your technology vendor to determine how software can easily assist you in accuracy, efficiency, and seamless operational procedures. A strategic and knowledgeable technology partner will work with you to make this seamless and painless.
3. Be sure to proactively engage an interdisciplinary team. Engage your nursing staff and dietitians upfront. Be proactive to come up with a process you can all agree on and KEEP IT SIMPLE.
4. Check and adjust medication administration schedules in the EMR.  Insulin given off schedule because of the flexible nature of Room Service may be recorded as a “ding” on patient care staff performance.
5. Rename food items or portion sizes to include the carbohydrate grams
6. Don’t be limited by a diet order but use it to educate the patient and staff.
7. Communicate a consistent and accurate way to inform the patient care staff that a meal is on the way or has arrived from the kitchen.  Methods organizations use include:
   1. call center staff paging patient care staff
   2. call center staff calling the nursing unit
   3. including a note on the tray ticket or some door/room signage to trigger the delivery staff to call the nurse
   4. deliver the tray to the nurse’s station and have patient care staff deliver the tray and complete blood glucose monitoring at that time
   5. script the call center to tell the patient to call patient care staff

There tends to be questions about whether or not to allow the diabetic patient to skip meals.  Some organizations do not allow diabetic patients to skip meals, some allow one or two meals to be missed and then they call the patient.  Being a Room Service “purist”, I have to say I prefer to let patients order at will – and, yes, I understand all the arguments to send all meals.  However, I also think this goes back to some of the reasons you do Room Service – to allow patients the choice.  Sending a patient an occasional meal they do not want seems counterintuitive.

So do not let diabetes treatment goals dampen the Room Service experience for you or your patients.  Innovative solutions are out there to keep Room Service a winner for everyone.

What challenges have you faced with your diabetic population and Room Service?  What ideas can you share for overcoming these challenges?  If you could have your food & nutrition software do one task to improve this process, what would it be?

You have made the decision to introduce Information Technology (IT) into your food and nutrition operation.  Congratulations!  This is an exciting time – you are embarking on a project that will lead to years of success for your business.  However, the days, weeks, and months to your “go-live” date are critical.  Choosing your IT implementation team is critical as well.

It may seem straight-forward.  I need my inventory/procurement expert, my production manager/chef, my patient services manager, my clinical dietitian, my retail manager… the list could go on and on.  And, while all of your talented people have the expertise to contribute to your operations’ success, there are other skills and attributes that are essential for successful software implementation.  So, how should you choose your team?

To get started, you need to assemble a small, but focused, team of individuals who share your vision and commitment to introducing this technology into the organization.  Essential team members are:

Team Leader or Project Manager – This dedicated person manages the team operations.  They have an expert understanding of the project charter and scope.  They lead and motivate the implementation team.  They can manage the effects of change.  The Project Manager also provides the support and resources to help the team meet its goals.

IT Contact from your facility – Your facility’s IT department must partner with you to provide expert advice and support for hardware purchases and repairs, server support (if needed), and interfaces with your hospital’s information system.  Ask for a dedicated resource that will offer input into your project scope or schedule.  It has been my experience that once an IT team member realizes the impact that technology will have on patient satisfaction, patient safety, and workflow improvements they buy-in to the opportunity wholeheartedly.

Software Vendor – Your software vendor is your partner for success and should be considered a member of your implementation team.  They will look at your operation with fresh eyes and help your Project Manager build an implementation plan.  Your vendor brings a wealth of knowledge to you so you can get the most from your software system.  Ask questions about success stories they have witnessed and use that great information to your advantage.

Team Members – Team members are individuals that you and your Project Manager identify are, at a minimum computer-savvy with a good understanding of the food service department as well as knowledge about diet compliance.  This is a starting point.  You may also want to ask:

• Who will have an important role in making the needed changes to implement this software?
• Who can influence the success or failure of the software?
• Who has special skills that the implementation team may require?

Going a step further, I recommend considering two more important skills.

The first is to identify who excels in Systems Thinking.  No food and nutrition operation runs as small separate departments.  Procurement effects inventory levels which effects production and so on.  We have all experienced a situation where what seemed like a small “tweak” rippled through our operation – ever growing – and ended up as an avalanche of change with unintended consequences.  That’s why it is important to choose team members who understand and can identify how processes influence one another and work together.  They may demonstrate this by how they approach problem-solving.  Do they deconstruct a problem to understand all its parts and pieces?  Then, seek to understand how they connect, relate, and influence one another?  If so, this is someone you want on your team.

Second, it is said that the “Devil is in the Details”, well you should find someone who “Delights in the Details”.  All of your operations’ information needs to be in your database.  Imagine “go-live” day and you forgot to include alternative textures for dysphagia patients or the Turkey Tetrazzini recipe scaled beautifully except it was missing an ingredient – Turkey.  Implementation team members should have the drive and the stamina to continuously ask questions, collect information, process it, and test it to measure performance.  Your detail-oriented team member is someone you know pays attention and notices everything.  They truly care about every dotted “I” and crossed “T”.  They will insure that everything about your operation was included during your implementation.

Choosing your IT implementation team is an important step in driving this fun and exciting project to a successful “go-live”.  Your team embraces your vision for the department and will drive its success for year to come.  Team members need skills and attributes that may go beyond their job titles.  I have described what I think are important questions to ask and important skills to consider when building your team.  What has been your experience?  What do you believe is essential for your IT implementation team?