Changing Perceptions

Little changes, such as a new department name and uniforms, are increasing employee and customer satisfaction at St. Mary's Hospital.

At A Glance: St. Mary's Hospital

•91 employees; 4,500 meals served each day

•The department changed its name from Dietary to Nutrition and Dining to better reflect the department's two customer bases-patient and retail.

•Professionalism has increased with new uniforms and training.

•Room service and a new season-based menu will begin in September. 


FoodService Director - trendsetter - St. May's HospitalKeith DeMars, director of nutrition and dining services at 391-bed St. Mary’s Hospital, in Richmond, Va., knows how often hospital food gets a bad rap. Twenty years ago, DeMars’ wife spent the better part of four years in a hospital before passing away. Both DeMars and his wife are graduates of the Culinary Institute of America, and DeMars says, “It was disheartening to see what was going on in the hospitals with food. After my wife passed away, I made it my life’s mission to get a job in hospitals and see what little change I could do in my corner of the world.” Since then, DeMars has worked in healthcare trying to improve the dining experience.

Staff professionalism: DeMars has been at St. Mary’s for less than two years, but he has already made some significant changes in the department. “We were looking to improve patient satisfaction, employee engagement and the overall professionalism of the department,” he says. “One of the first things we did was change our name from Dietary to Nutrition and Dining Services, so we could have a delineation from the nutrition and clinical department and the dining services piece of it. We are able to better define ourselves rather than being a dietary department because that sort of gets you stuck in the mud.” Since the name change, DeMars says, people are more aware that the department deals not only with patient services but also retail foodservice as well.

After the name change, DeMars addressed the foodservice department’s appearance. DeMars ordered new uniforms to increase professionalism and department continuity. “In the beginning, everyone wore scrubs, so they blended in with everybody else,” DeMars says. “Instead, we went with a collared shirt and a black apron in the café area. We also put our cooks and servers on the hot lines in chef uniforms, but we made them a little bit more upscale with a chef’s coat that has a more front-of-the-house look. We also put them in black pants instead of the standard checked pants, so that we could be uniform and recognized as a team. It’s nice to have individuality, but it’s better to come together as a team in this atmosphere.”

The next step was making sure that every foodservice employee was trained in ServSafe. “We wanted everybody to have the same foundational knowledge of food and environmental safety,” DeMars says. “We wanted to make sure that in an instance where someone may have missed something, someone else would have the knowledge to assist. We define teamwork as helping the other person achieve success, so it becomes an unselfish act. We’re really looking out for the other guy and being humble in the process.”

The department is also becoming more involved in hospital activities. For the first time, the department hosted the annual company picnic. In the past, food for the picnic was catered from an outside company. “Originally the picnic came in at $50,000,” DeMars says. “We were able to bring the cost down to $20,000. The $30,000 reduction in cost was from us doing food in house and also us planning the event and not having a middleman go out and get the tents and all the other items needed.” DeMars also increased the picnic’s food options to include not only hot dogs and hamburgers, but also ribs, barbecued shrimp and a wide selection of desserts.

FoodService Director - trendsetter - St. May's HospitalDeMars says the hospital’s administrators were hesitant to have the foodservice department take on the event because they feared the foodservice staff wouldn’t be able to enjoy the picnic. DeMars, however, says the staff not only appreciated the event, but also considered it to be a good team-building exercise. “The staff was getting accolades right at the point of service. For an individual who has been cooped up in a kitchen where they don’t receive accolades firsthand, this was a real treat for them.”

All of these changes have been made without touching the food component, and DeMars says he has already seen a difference. “All these changes are engaging the employees,” he says. “We know we have been stigmatized with the idea of institutional foodservice. So here the little changes are becoming apparent to individuals in the department who have seen the outcome from our customers’ reactions, which in turn excites the employees and engages them to take further steps to assist us in making these changes.”

Patient service: Another area in which DeMars wanted to improve staff professionalism and the customer experience was patient service. DeMars is in the process of changing the department from traditional tray line service to room service, which he hopes to have implemented in September.

In preparation for the switch to room service, the department is making several changes. New patient trays, which DeMars says are more upscale, were purchased. The department is also developing a new menu that will better reflect seasonal and ethnic items. DeMars says that they are working to create a foundational menu from which specials can be added. “I don’t embrace cycle menus, because every four weeks it repeats itself in the café, and on the patient side it could be every week,” he says. “So you aren’t capturing any of the seasonality or the freshness of the foods or the cultural expectations based on the seasons. That’s where we will have the foundational menus, where those seasonal items will be able to change.”

He adds that the new menus will also focus on healthier items and partnerships with local farms to increase the department’s sustainability efforts. Once room service is running, patients will have one menu for breakfast and one for lunch and dinner.

In advance of the switch to room service, the department has already changed the way it serves patients. Patient meal coordinators are visiting rooms to take orders using a select menu. Coordinators then take those orders back to the kitchen for preparation. Once the trays are assembled, the coordinators deliver them to the patients. Coordinators stay on the floor to help assist with any patient or family needs. DeMars says having coordinators on the floor during mealtimes helps the nursing department because nurses no longer have to worry about food issues. “It’s the idea of teamwork and helping the other guy achieve success. Nursing doesn’t feel bogged down at mealtimes with having to distribute and then follow up on meals.”

Once room service goes live, the coordinators will continue taking patient orders, or patients can order meals through a call center.