Your patients have very little say so on any part of their visit to your facility.  It is an environment that’s foreign and often scary to their senses.  Food, the major service you provide, is the one experience during a patient’s stay that can actually satisfy and warm their senses.   Room Service allows the patient to control a very critical measuring stick of their stay that affects the facilities overall satisfaction scores. It caters your menu fare to their individual tastes and allows them to decide the most appropriate time to enjoy their meal.    Selections can range from comfort food favorites to “Build Your Own” Sandwiches from the grille or deli.  Based on diagnosis, the Physicians will decide the patient’s diet order, which could include significant food restrictions.  Room service allows the patient to make selections that sound good to them based on these restrictions.  Restricted diets will be better accepted and the patient will appreciate you for catering to their needs.

Room Service Can Stimulate Growth for your Operation.

Do your employees need a morale boost?   Room service involves your staff in the design process of the system.  It will focus their talents in new ways, from cooking skills to serving styles… it all changes.  Like any change there will be challenges.  Your long-practiced system of meal service will be completely revised.  A well-built strategy, constant communication, and consistent feedback will calm your associate’s anxieties.

Don’t forget to include nursing in the build process as they are your biggest bedside cheerleaders.  These new dynamics in patient and nursing interaction with your staff will produce amazing relationships and stimulate quality and efficiency.

How does Room Service Software play a role in overall satisfaction?

A comprehensive software system is critical in your decision to implement a successful room service program.  The software you choose should:

• benefit your diet office by increasing productivity
• provide support for patient safety
• enhance your meal selection process
• simplify and control your  production inventory, and recipes
• provide for clinically mandated pathways
• allow you to maintain your budget
• not require a capital investment at the start
• report on all of your cost accounting needs

What is your ROI with Room Service?

Cost reduction seems to be the focus these days, while still maintaining quality. As a result of the patients ordering exactly what they want, when they want it, room service will improve your cost savings from less waste and a reduction of replacement trays.  Decreased costs will occur as the effect of a good patient focused foodservice.

It is a big challenge meeting the needs of the most important aspect of your service – your patients.  Room Service reduces that challenge by creating instant Patient Satisfaction that pays it forward to not only the patients and family you serve, but to your associates and administrators as well.

How many times are you going to present your Healthcare Administration with a capital expense for foodservice automation just to have them tell you “NO”!  Why not find a solution that will benefit both the foodservice department and Administrative needs?  Why not present a NO CAPITAL EXPENSE SOLUTION?  The SaaS solution!

Get your head in the cloud; SaaS (not ASP) environments are the way of now and the future.

Big advantage is in the dollars!!

• NO UPFRONT COST FOR SERVER HARDWARE AND LICENSING!!!
• Since pricing is set as a subscription fee, the cost is the same month to month.
• You only pay for what you use!  You are not paying for modules you don’t need!!
• The SaaS environment eliminates backend cost of maintenance, end user support, and administration cost of the software!
• Start-up cost for implementation and updates with SaaS is eliminated as well!

Other advantages to think about!

• The vendor is responsible for managing and maintaining the software and hardware of the applications.  What this means is, the hospitals IT department does not have to allocate resources with managing the locally installed foodservice system.  I’m sure that group would be happy to not have something else added to their busy plate!
• Data redundancy, back-up, and recovery is planned and managed by the vendor.
• Upgrades are done on a regular basis,  and in the background with minimal impact on your daily operation resulting in reduction of down-time.

What does all this mean to your health care organization, Lower total cost of ownership (TCO) and greater flexibility!

Stop getting “NO” and get a “YES” from your Administration.  Your associates, patients and the hospital budget will thank you!

Beware of imitators,…SaaS vs. ASP, here is a good comparison provided by the AMA.

“IT’S BEEN TWO HOURS SINCE I ORDERED, WHERE IS MY FOOD”!!!!!!!!!

How often does that statement impact a facilities satisfaction scores?  More often than we care to admit.

As a patient, the only control you have is the ability to decide what you want to eat.  With healthcare moving towards a “5 star hospitality experience”,   hospitals all over the United States have moved to a Room Service style of meal selection.  This approach to service, when executed properly, will increase patient satisfaction scores and give patients more control over one aspect of their hospital stay.

While Room Service can be a great satisfier, it can also have the total opposite effect. Typically, Room Service programs promise the patient tray delivery within  45 minutes.   If you are not meeting the delivery target time, your department will lose creditability, not only with the patient but the staff and administration that are supporting the program.

It’s not feasible to have your managers and supervisors stationed on the patient units following the host/hostess to monitor delivery compliance.   So, what can management do to monitor their Room Service delivery time is being met?  Automate your delivery schedules with Real-Time Tray Tracking.

Only Real-Time Tray Tracking provides useful information to ensure delivery schedules are being met.  Monitoring all service processes in “Real Time” gives your team the opportunity to prevent service issues when they occur.

“Batch” tracking systems generate reports that reflect what happened “after the fact” and do very little to prevent processes from happening again.  When comparing systems/solutions, you need to determine if your focus is solving process issues when they occur or after, risking repeat issues and poor patient satisfaction?

When comparing Real-Time tracking systems to “batch” tracking systems, with meals leaving the kitchen on demand it is important, to know where that tray is, from assembly to delivery.  Real-Time Tray Tracking helps management understand obstacles/barriers to immediately, correct these issues regarding tray delivery to ensure patients are receiving their meals within 45 minute as promised.

Real – Time Tray Tracking complements your Room Service Automation to allow:

• Shorten delivery times
• Eliminate service errors and delays
• Ability to address patient calls for late meal deliveries
• Food Safety – Ensure hot foods are hot and cold foods are cold
• Access to reports so, managers can spend less time behind the desk

Eliminate the complaints and be the leader in your facilities patient satisfaction with Room Service and Real-Time Tray Tracking, you’ll be glad you did!

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?

My dad, who I sadly lost this year, had a saying about selecting a life profession: “Think of what you like to do, and decide if you’re going to either make it or sell it.” In its simplicity, the adage has proven itself true over and over again.

Consider the talents of artists, scientists, and engineers – all of whom can conceptualize an idea into masterpieces of beauty and/or function. How else would we have the benefits of a Renoir painting or a home designed by Frank Lloyd Wright? Who would have ever imagined we could reduce a computer’s size to that of a manila envelope? Wait – who could have ever imagined a computer in the first place? To help creative souls make an actual living, it is the sellers – teachers, marketers, salesmen – who find ways to promote artistic concepts into consumer needs. If done effectively, we become excited to be part of something new or beautiful, to embrace a better breadbox by improving circumstances to a higher standard than ever before.

Historically, the sales and marketing side of business has been seen in a negative light – tough to justify expense and return, annoying and persistent personalities, etc. Yet, even if we can’t take credit for a product’s design or creation, aren’t the rest of us actually sellers? Aren’t we selling a new entrée plate in the cafeteria, or a new menu delivery system to our patients and hospital staff? Aren’t we selling an efficiency method when we promote automation of our inventory? Or, would it be more accurate to state we are sharing excitement and fun instead? Doesn’t everyone want to be “in” on the latest idea or fashion? Perhaps not, but sharing happiness and excitement is definitely a fun way to manage change.

Over the holiday season, I kept wondering how one of my favorite movie characters – Buddy the Elf – would handle customer service and sales. His innocence, and genuinely happy approach to everything, is pretty significant when one also considers outcomes. Recipients of his antics do not realize what hit them: random acts of kindness, compliments, and silliness temper the doldrums of day-to-day life.

In a recent blog by Ron Dawson (12/10/10), he cites Buddy life-lessons we can all use every day – from greeting everyone with a hug to loving the unlovable. While we can’t hug everyone in our daily business, we can treat everyone with genuine welcome. And, perhaps the hardest challenges are the most rewarding (aka the “unlovable”)? In Stephanie Wonderlin’s blog about Buddy the Elf, she identified how his skill sets – always asking questions (“Buddy the Elf, what’s your favorite color?”) and positive outlook (“You did it! Congratulations! World’s best cup of coffee! Great job, everybody! It’s great to be here.”) – help us learn our customers’ needs, along with adapting sales strategies to accommodate the target market. She reminds us that technology does not replace human contact. Surely, we haven’t forgotten that?

In the end, I think we sometimes forget who our customer really is. It could be someone calling for software assistance, or a recipe’s allergy information, or just another human being seeking to expand their knowledge. We might also forget that the majority of us are the sellers, or better yet, the educators of a challenge yet unsolved. What an awesome privilege – sharing knowledge, promoting solutions, and bringing artistic concept to reality.

Thanks for the reminders, Buddy… my favorite color is red.

I recognized an opportunity and became an advocate to use a food and nutrition system in the food and nutrition department within our hospital over 12 years ago. At that time, my vision was to have a software system do the repetitive clerical tasks of the diet office while our employees moved to the bedside to provide a personal touch to improve patient satisfaction.  From the first software training session, I was hooked on what is now considered “Nutrition Informatics”.

The American Dietetic Association defines Nutrition Informatics as “the retrieval, organization, storage, and optimum use of information, data, and knowledge for food and nutrition related problem-solving and decision making.  Informatics is supported by the use of information standards, processes, and technology”.

What food and nutrition professional doesn’t fill their day solving problems and making decisions?  Now, you may think, as I once did, that informatics is more about technology and having computer skills. Fortunately, (at least for me), technology is the tool in informatics meant to complement and support you.  This graphic simply defines informatics -

Friedman, 2009

Because of my informatics “addiction”, I was compelled to complete the AMIA-ADA-OHSU 10 x 10 Biomedical Informatics Course.  This course opened my eyes to the depth and variety of ways health information and technology are being used today and will be used in the future.  I believe now, more than ever, that food and nutrition professionals need to embrace informatics as a core competency.  Nutrition Informatics is poised to grow and will need your knowledge and support to be effective in your environments.  You may ask why? Consider this:

• You need to align with the strategic initiatives of your organization: Food and nutrition professionals need to use and interpret data and report information that supports regulatory compliance, patient satisfaction, performance improvement, and cost control. Food and nutrition systems, such as Vision Software Technologies, provide essential tools, solutions, and reporting to meet your organizations’ requirements in a timely and effective manner.
• Patient and public safety will continue to dominate the media headlines: Do you know what resources are available to you to monitor food safety and security?  How are you getting food ingredient and allergen updates?  How about food-medication interactions?  Creating efficient processes around safety will be a growing area of nutrition informatics.
• Health care is poised to take a more preventative focus: The public will be more participatory and engaged in their care.  As such, they will turn to Personal Health Records (PHR), telehealth, mobile apps, social media, and persuasive technologies for health information and to interact with health care providers.  Do you know how this will affect practice and what the potential ethical and privacy issues are? The new cool technology is patient-centric. Can you think of using it in dietary/foodservice?
• Electronic health records (EHR): If your organization has not moved to an EHR, they are probably taking steps to do so.  Food and Nutrition professionals need to be ready to evaluate their workflows and processes and interpret them for an electronic format with the goal of making performance and patient care better. Do have knowledge of food allergy standards, diet order syntax, HL7, or the International Dietetic and Nutrition Terminology (IDNT)? Do you know how information will flow to you and through the EHR?
• Web based Platforms will be more prolific within the healthcare setting: These allow the user to retrieve and exchange information with ease between people, hospitals, and departments. Understanding the essence of a dietary and food software that is web based and what goes into the configuration of the web will be integral in setting up systems in the future. The platform of this decade is not going to be built around controlling hardware resources and rich UI. Instead, it is going to be built around access to community, collaboration, and content for hospital-increased efficiencies, increasing safety and integration of the hospital disciplines.

There are probably many other reasons to improve your informatics skills.  What steps have you taken to improve your informatics knowledge?  What newsletters, blogs, websites, or resources do you find helpful?  How are you using informatics now?

To the today and beyond,
Donna

Reference:
AMIA – ADA – OHSU 10×10 Biomedical Informatics Course – Nutrition Informatics unit

Your team is in place and you are about to start your food and nutrition software system implementation.  However, before you start, have you thought through the “unknowns” in your project?  Every project has uncertainty and risk.  Identifying and planning for those risks now will ensure that you have a “rainy day” plan to keep your project progressing smoothly.

You might be thinking, “What could possibly go wrong?”  How about the unforeseen four-month medical leave of an important team member?  On the other hand, your primary food supplier, due to mergers and acquisitions, changes their technology and all their product order numbers – twice?  These two situations are risks and I am sorry to say I experienced them and their effect on system implementation first hand.

So, assemble your implementation team, stakeholders, and others close to your project and brainstorm to identify all the potential risks both within and external to your operation.  Nothing is too small!  Then evaluate your risks for the impact they could have on the project.  You might want to develop a ranking system.  Prioritize the risks your team has identified and finally develop strategies to control or lessen the risks.

Usually project risks fall into one of three categories.  Let’s look at each and some possible solutions.

1.  Resources – Your software implementation is a special project.  For most food and nutrition operations, this means your implementation team probably has other responsibilities while they take on tasks related to your system implementation.  It is extra work … or is it? It shouldn’t be, and this is a key problem why implementations get off track. It takes time that you, the food service director, really need to allocate otherwise. Everyone is stressed out!  It is easy to see how this can create time management challenges and conflicts in work-related priorities.  Other risks might be team attrition or team members who need to update their skill set.

Solutions:

• Review your resource allocation plan with  your software vendor project manager.
• Be sure that you have enough people in the right places at the right time.
• Have a kick-off event or workshop to build enthusiasm and buy-in from the team.
• Communicate with your implementation team the time and productivity expectations.  Do not overextend your staff.
• Ask for their commitment, then support and protect your resources.
• Have a business vendor who will be your partner and do an express implementation if and when necessary.

2.  Change is inevitable and may be for the better.  The project scope defines all the work to be done during the software implementation.  Multiple, uncontrolled, and unevaluated changes to the scope of the project cause the project to lose its focus, which leads to increased costs, schedule delays, and more risk!  Consider how redoing your cafeteria menu would change your inventory, production, and recipe database.  Or consider that technology has changed for the better and you want to take advantage.  Both would change the project work and resources needed.

Solutions:

• Implement a formal process to request, evaluate, and prioritize change requests to the project work.
• Use consistent criteria to evaluate all change requests.  A couple of questions to ask might be: Is the change good for business? Is it a change the implementation team is able to make?
• Thoroughly define and communicate the changes to  your implementation team.

3.  Schedule risks usually relate to not sequencing the project work correctly or incorrectly estimating the time it will take to complete implementation activities.  Both will lead to delays in the ability to start the next task or phase of the project.

Solutions:

• Use your software vendor’s project manager to assist with scheduling.  They can share best practices with you.
• Determine the sequence of work that will take the most amount of time.  Monitor this sequence closely, and intervene quickly if there are problems.
• Consider team member scheduled time off for vacation and holidays when estimating the schedule.
• Consider your operation’s priorities in your schedule.  For instance, the month of December may bring increased opportunities for revenue from catering.  Therefore, implementation work slows to meet catering demands.
• Update and communicate the schedule as needed

Implementing food and nutrition software is exciting and fun.  Planning for uncertainty and risk may seem like a “doom and gloom” process, but can really help control the inevitable “rainy days” during your implementation.  Take the time now to do risk planning and keep the sun shining!

How do you minimize the risks in your operation?

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?

The term “All Hands on Deck” was created by the Navy as a command signaling the entire crew to assemble on deck.  Direction was given to the sailors’ needing all hands to work on something of the utmost importance.

This is an interesting concept where the goals are obvious:  ensure an efficient implementation of a solution where activities are coordinated for transition to happen as smoothly and as quickly as possible with minimal disruption of service to adopt the new service model and set the mission for on-going success.

When food service contractors go onsite, they pool their resources, bringing in managers, supervisors, RD’s, and chefs to get their client on-line and moving toward their goals.   Why isn’t this more common in our market?

In the realm of F&NS automation implementation, many projects fall well short of expectations due to a loss of focus, resources or, most importantly, time.  Prolonged implementations are one of the biggest issues that I see as a consultant and advisor in this market.  An “All Hands on Deck” approach with regards to software implementation would be an ideal remedy for this condition.

I have found that Vision Software uses the all hands on deck approach for implementation.  Vision collaborates with you and your team, providing one-on-one attention and working side by side through every step of the process.  This results in rapid Implementation and deployment of automation solutions to provide the outcomes and ROI you expect. ROI with safe food, quality food production, increase revenue generation, enhanced patient safety, and increased patient satisfaction.

Does the software vendor you are considering provide this focus?  If not, you may want to consider the benefits to your department or, more importantly, the negative ramifications of not getting your system up and running in a few months.