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

Menu Development
spilled coffee beans glasses

Following an initial test at the end of May, Starbucks announced that more than 500 of its stores will be pouring nitro coffee by the end of summer. Capitalizing on the cold-brew coffee trend—which reached $7.9 million in sales in 2015 on 115% growth from the previous year, according to researcher Mintel—select U.S. cafes will give up the counter space to serve the creamy, nitrogen-infused java made from the cold-brew base. But how did nitro become the hottest new thing in coffee?

Bringing the bar to coffeehouses

It was the chrome double tap, similar to a bar’s beer tap, and the...

Ideas and Innovation
star wars storm trooper

My favorite event—because I’m kind of dorky—is our “May the fourth be with you” (aka “Star Wars”) day on May 4. The whole dining team dresses up, and we offer things like Chewbaklava, Boba Fettuccine and BB-8 Buckeyes. We had a guest cry because they got to take a picture with Chewy.

Menu Development
recipe revamp chicken soup

As a continuous care retirement community, The Garlands of Barrington in Illinois provides daily foodservice to 270 independent living and skilled nursing care residents, with the majority of sodium restrictions coming from the latter, says Executive Chef Nicola Torres. Instead of cooking two versions of chicken noodle soup—a favorite offered at least twice a week—he reworked his recipe into a flavorful lower-sodium version that appeals to all. “Everybody eats soup, so I created a homemade stock that uses no salt at all, ramping up the flavor with fresh herbs and plenty of vegetables,...

Ideas and Innovation
tray number

We created lucky tray days to help create an experience surrounding our brand. The trays are numbered; we pick a number and the winner receives a free lunch. We’ve enlisted the help of one of our coaches, who calls out the random lucky winner, and it drums up a lot of excitement.

FSD Resources