For Julie Jones on Decentralizing Hospital Kitchens

Ohio State's Julie Jones speaks about using finishing kitchens.

At the 1,000-plus bed Ohio State University Medical Center in Columbus, remote hospitality centers are being built to decentralize patient foodservice. Two are operating currently; five or six more are planned. According to Julie Jones, director of nutrition services, the remote hospitality centers will provide better patient service.

Q. Why did you start the remote hospitality centers?

In 2006 we started developing what we call a dining on demand concept. It was room service style. At our main campus we would have to struggle with having one central kitchen being able to provide room service for the multitude of beds. We’re pretty spread out. We worked with a couple of consulting groups. They conceptualized this model using finishing kitchens. The hospitality centers are close to patient floors. One hospitality center may serve several floors. Some of them are tiny. The one in our heart hospital is 140 square feet. All patient meals will be served from the remote hospitality centers. Our main cook-chill kitchen will remain. We are doing an overhaul of that. The area that was our trayline will be a dishroom enlargement.

We will certainly increase costs, but we are a very lean organization. As with most people who go to room service, we anticipate that our food costs will be neutral or go down as we won’t release as many trays. Our greatest addition is providing more nutrition aides at the bedside. There will be something like one nutrition aide to every 25 to 45 beds.

Q. What is the process of ordering, preparing and delivering a patient meal?

We will have our nutrition aide, so it’s a host/hostess function, at the bedside to support menu selection with the patient. We are also developing a product to allow patients to select at the bedside from a number of options, whether that is TV or computer based. Our goal is to have that selection electronically transmitted to a remote hospitality center. We will have sous chefs and food production staff creating the trays to order. The trays will be delivered to the room by the nutrition aide.

Our hospitality centers will be supported by the central kitchen. We will be producing things that can be used in a common perspective in all places. Most of the food is prepared in the main production kitchen and finished in the hospitality centers. We are a cook-chill facility. We do have some induction cooktops in the centers, but the lion’s share we can hold cold. At our main production site, we have robotic transport, so we can transport from our main cold food bank up to the hospitality centers.

Q. How will the menu change with the hospitality centers?

One of the things that we struggled with on our main campus was that we had one menu that we were using to support the needs of all of these beds. It just didn’t work very well. We have a cancer hospital, a heart hospital, women’s and rehab. It became very difficult to meet individual patient needs. Our model is one that is predicated on customization around the needs of the patient and in the use of these remote hospitality centers.

At Dodd Hall we have a number of dysphagia diets or texture-modified diets. With cook-chill retherm we couldn’t do a lot of customization because things just might not have heated well. Now virtually any item we have on a patient menu we will customize to the diet that the patient needs. We will do it to order at the time of service. It will also allow us to take the same base chicken breast and do four different things with it, depending upon which patient it is for. We’re hoping to use some of the same core ingredients, but they may not look the same from the menu process.

Q. What equipment is at the hospitality centers?

There is the Aerospeed oven, a water bath retherm system, cold tables for building cold foods to order, refrigeration, full beverage station, support equipment to hold trays and induction cooktops. Because we are on patient floors, we had to get equipment that didn’t require full ventilation systems.

Q. What was the biggest challenge?

Getting space has been the biggest challenge. Some of the space came from existing areas on patient care floors. Some are galleys that were our space already. Three are new spaces to us.