Staff Comes to St. Bernard’s Rescue

Raising patient satisfaction scores isn’t complicated. Keeping them up is.

It has been a decade since Carolyn Hackworth, RD, LD, arrived at 375-bed St. Bernards Medical Center in Jonesboro, AR, to become  director of nutrition services. Back then, Press Ganey scores had consistently hovered around the 70th percentile for nutrition services. Within six months of Hackworth’s arrival, she implemented innumerable changes and scores for the department soared to the 90th percentile; they’ve been circling round the 98th percentile ever since and patient services are a top priority.

FoodService Director - St. Bernards Medical CenterHackworth credits this consistent striving for excellence to a staff that was then—and is now—determined to succeed. In no small measure it’s also attributable to the more than 100 changes—including taking over tray delivery from nursing—the team effected a decade ago that are still in place. To ensure that service is truly customer-friendly, the scripting of roles for each member of the team who interfaces with patients is absolutely central to success.

Knowing what to say: “I believe in scripts and I tell [staff] exactly what to say from the moment they walk into the patient’s room with a smile on their face,” she asserts. “They walk in the door and say, ‘Lunch! Will you be needing help eating, Mr. Jones? Can I call your nurse for you?’ And I tell my staff never to say ‘It’s not my job!’ The perception was that it was our job. You have to communicate with the patients, otherwise they don’t know what your job is.

“They’ll ask, ‘Honey, can you raise my bed?’ You say: ‘They don’t let me do that but I’ll be glad to get you help,’ and we ring the nurse’s bell. We lost no efficiency by being nice. Nurses like it, too, because this way they know who needs help.”

Leaving little to chance, Hackworth is a firm believer that you “inspect what you expect” and knows that her managers and team leaders are up on the patient floors, popping into rooms to make sure the script is being adhered to. Patients gain a clearer picture of the foodservice staffs’ role from this exercise, and servers are able to diplomatically avoid questions that slow them down so trays yet to be delivered don’t lose temperature.

Living room: St. Bernards offers room service but without the computerization or trained executive chefs in the spotlight as in other healthcare facilities. Here, it’s done simply by talking to the patients. “I always get kind of tickled when I see how many chefs other facilities have hired for room service,” she says. “In Arkansas, half our patients are elderly—do you think they want chicken cordon bleu? They want comfort food and when you’re sick it’s also not the time to make them eat healthy foods.”

Hackworth firmly believes there’s a time and place for nutrition education. “In our pediatric unit, the menu is a blank piece of paper with lines on it,” she says. “My staff wrote this ‘menu’ and the kids can choose [i.e., write in] vending items, sandwiches, plus anything from the whole cafeteria menu. Then, there’s the ‘Everything else available in the kitchen’ category. So you could see a tray going to a kid’s room with a chili dog, a Snickers bar, a bottle of Yoo-hoo and a banana because that’s what he wanted to eat! He’s sick, he’s alone and it’s not the time to teach him to eat broccoli.

“There has to be a better environment in which to teach nutrition. Instead, I get the calories [i.e., nourishment] into my kids.”

Clear and easy: Patients have a clear and easily accessible way to order whatever they want, even though the program isn’t labeled “room service.” A 5-by-7-inch card on the bulletin board in each room directs them to call the hotline for help with their menu selection. The card proclaims.“Have problems marking your menu? Other foods we need to provide? You can have anything your diet order will allow.”

In fact, few patients look for more than what’s on the patient menu, a very simple seven-day cycle that was rewritten 10 years ago as one of Hackworth’s many changes. Breakfast is the same daily menu with lots of choices including two hot cereals and five cold varieties. At lunchtime, the alternate choice is always fried chicken and for dinner it’s always roast beef. Since it’s the rare patient who wants something expensive, meal costs have actually decreased from $4 per patient meal a decade ago to $3.23 today.

Other gains: Productivity has also improved, Hackworth notes, to 5.4 minutes per meal; she compares that to the 25th percentile of HFM’s Benchmarking Express tool: 6.6 minutes per meal. “That wasn’t part of the original goal but it happened,” she notes. “None of the changes we made was expensive but some have incidentally saved time or money.”

Hackworth proudly admits that her employees care enough to make the changes work. They’re working smarter, complying with as well as suggesting improvements to the system. Tray assembly has been 100% accurate for the past four months (at presstime), with four trays completed per minute. “Even though my staff was skeptical at first, we accomplished this by slowing down the tray line,” Hackworth notes. “I say: Quality is more important than quantity.”

New mission: Prior to arriving at St. Bernards, Hackworth’s passion was cafeteria and retail operations—but there’s a different mission here at this 105-year-old Catholic hospital. It was founded by the Olivetan Benedictine sisters from Switzerland who established a convent and began to care for the victims of a malaria epidemic then gripping Arkansas.

Their patient-centered focus continues to this day. “I don’t get ‘fussed at’ for budget—there’s not the concentration on just the bottom line,” Hackworth says. “We raised the quality and the costs went down.”

Hackworth decided that getting the Press Ganey scores up—and keeping them up—would be her legacy. Fortunately, she’s had a team of 62 FTEs who have been just as determined. “They really bought into it,” she notes. “I may have started it, but they’ve kept the gas in the machine.”

More From FoodService Director

Sponsored Content
coffee senior living

From Keurig Green Mountain.

Healthcare foodservice represents the perfect environment for serving coffee. For the time-crunched staff, family and friends visiting patients, and seniors craving a treat, snack, or pick-me-up, coffee is considered a valuable amenity.

What’s more, purchasing beverages away from home is a popular habit. According to Technomic’s 2016 Beverage report, consumers average 3.6 drink purchases per week from foodservice outlets. And coffee is one of the most popular beverage options— Technomic’s 2016 Snacking Occasion report found 61% of consumers say...

Industry News & Opinion

South Valley Preparatory School in Albuquerque, N.M., has launched a range of healthy eating initiatives to combat obesity, the Albuquerque Journal reports.

The initiatives are in response to a State of Obesity report that stated that nearly a quarter of 10- to 17-year-olds in New Mexico were overweight or obese in 2016. The school banned junk food on campus during school hours for both students and staff, and offers healthy seasonal meals in its cafeteria. Students also take weekly trips to local farms to get an inside look at where their food comes from.

While the school...

Industry News & Opinion

Food delivery company Good Uncle is expanding to 15 college campuses this fall, The Daily Orange reports.

The company plans to grow along the East Coast and is looking at opening at schools such as George Washington University, Pennsylvania State University, Villanova University and American University. Good Uncle hopes to open at 50 to 100 campuses by 2019.

Starting as a delivery-only kitchen in 2016, Good Uncle partners with local restaurants to recreate their popular dishes and then deliver them to college students. The company offers free delivery, no delivery minimum...

Ideas and Innovation
wahoo tacos

School lunch is heating up. As expectations rise in the noncommercial sector, the old-fashioned cafeteria has become a hot topic. Political pressure on schools has seesawed over the past eight years, and nutritional regulations on items like sodium and whole grains have been overhauled (and back again). Meanwhile, students, parents, teachers, administrators and policymakers are demanding more healthfulness and better taste from school meals, often for the same cost.

Yet the industry’s best are dedicated to getting better, even while looking to the future with caution. “There’s not...

FSD Resources