Growth comes with the territory when you are the director of
foodservice for the nation’s No. 1 integrated health system—St. John’s
Health System in Springfield, Mo.—but for Donna Medlin, the growth has
come naturally. Medlin, a 31-year veteran of the foodservice industry,
isn’t reveling in her accomplishments at the 880-bed St. John’s Mercy
Health Center, nor is she content with the status quo. She is always
looking to the future.
Over the past 15 years, Medlin and her staff of 193, 134 full-time equivalents, have more than tripled the number of daily meals served, from 3,000 to 10,000. Most of that growth came in 1999, when St. John’s Mercy Health Center became part of an integrated health system, which incorporated five smaller rural hospitals and 460 physicians’ offices with the main hospital, for a total of 10,000 employees. With the integration, Medlin oversaw the opening of cafeterias in two office buildings that house several dozen physicians’ practices, as well as three other satellite cafeterias on the one-and-a-half-mile long campus. Even with so much expansion, 95% of all cooking is done at the main hospital and then shipped daily to the other locations.
Even though, for the most part, patient count has remained stable since the integration, Medlin says the increase in average daily meals can be attributed to a boost in hospital employees, as well as more staff members choosing to dine in the cafeterias, which has become a more convenient option since staff parking became limited with hospital renovations.
Another jump came in 2001, when St. John’s became the first non-contract hospital in Missouri to implement a room service component. Currently, 120 beds are on room service in the OB, Pediatric, Women’s Surgical Center, Oncology and Burn units, which Medlin says hold patients who typically don’t like to be constrained by set meal times. Room service is available from 5:30 a.m. to 8:30 p.m., with options ranging from short-order items such as chicken strips and cheeseburgers to roast beef and spaghetti.
“We tried [to offer room service to] the whole hospital and we just really weren’t set up for that,” she says. “Those were some of the most memorable and stressful days in my career that I don’t wish to repeat.” Limited staff and kitchen space, as well as the extensive menu she offered, were where Medlin says difficulties arose.
Internal operations: Growth has also occurred within the health system with the opening of five satellite cafeterias since 1999. One such operation is Heart Rock Café in the Cardiac Research and Rehabilitation Facility, where most menu items are heart healthy, such as lean meats with a low-calorie or fruit sauce. Medlin says the café has its own distinct menu. “We’ve tried to keep those entrées specifically for that facility to give them brand distinction,” she explains, adding that the café is often a social dining area for those with a family member in the facility. “We try to pick items that people aren’t going to say, ‘This isn’t so bad for healthy food.’ We want it to be good food and be able to stand on its own anywhere.”
In addition to the five satellite cafeterias and coffee bars, which bring in 10% of yearly sales, Medlin says the department sees about $1 million in internal catering each year. She says with the integration of the physicians’ offices, catering demand increased significantly because of the sheer number of people to serve, and staff meetings have become events commonly catered. She attributes this to “food being very much a part of our culture in the Ozarks. If two of us get together, we eat.” Internal catering sales have more than doubled since the integration with the health system, she says.
Outside business: Another area that has seen increased revenue for the department is a contract with a local adult daycare center, DayBreak. For the past five years, St. John’s has served between 40 and 45 daily hot lunches at the center, which provides a place for those adults who might need care during the workday. The menu is the same as the hospital’s cafeteria menu, with as-needed substitutions for special diets. Medlin says the partnership works well because both entities are affiliated with religious groups with similar missions. Revenue per week is around $750. “We aren’t trying to get rich off of them,” she adds.
Staff retention: Forty percent of Medlin’s current staff has been at the hospital for more than 15 years, with one worker who recently retired after a 45-year career. “The most rewarding part of my job is the people I work with, both my staff and the patients. I especially enjoy my staff,” she says. While Medlin attributes this longevity to St. John’s being a good employer, Karen Denny, the hospital’s operations manager, says Medlin’s management style and vast knowledge are key to retaining staff. “It is unusual for a foodservice director in a hospital to have so many years of experience and in such diverse fields,” Denny explains. That experience includes being a surveyor for the Missouri Department of Health, running her own catering business, and working in other healthcare and university operations. “I think a lot of times we try to force programs and progress,” she adds. “But with Donna it’s not forced. It flows.”
Another asset Medlin has is empathy for her staff. “Donna is very sensitive to the employees’ needs,” Denny says. “They know that if they are in a crisis and need help, Donna will direct them to resources.”
For her part, Medlin says she “hires to fit,” meaning she will look at past job performance as an indicator for future performance to gauge if a person is service oriented. “Generally, whenever there is a good fit between the department and the coworker, they stay around,” she adds.
Looking ahead: With so much growth in the last decade, it would be easy for Medlin to concentrate on her already full plate. Instead, she is working on new projects, including a kitchen renovation tentatively set for next year. Currently, the health system is in the process of implementing a new limited-paper information system. “We’re planning technology for the future,” she says. “That system is going to leverage all our information together, from patient charting to revenue streams to purchasing to payroll. So pretty much every workflow process has changed or is changing.” The last portion of the program, electronic patient charting, will go live in December. Medlin admits that the change was difficult in the beginning, but she says the benefits, such as patient safety and efficiency, are worth the hassle. “When you’re dealing with patients from about 26 counties in rural Missouri and northwest Arkansas, it’s a pretty big geographical area to cover,” she says, adding that the new system will help in the foodservice department, for example, by automatically updating the hospital’s information when a patient at one of the clinics is diagnosed with an allergy.
In addition, Medlin is looking outside the health system to develop a pilot program that would feed senior citizens who are not being reached by other groups. Along with Denny, Medlin is creating a carryout meal program in response to the hunger problem in the Ozarks. “We have a lot of staff who are taking care of their parents, and also in the community in general,” she explains. “So we are looking at some kind of take-home meal designed for the senior citizens.” Right now, Medlin is trying to determine how great the need is, but she says the county’s Meals on Wheels program is backlogged due to a lack of drivers.
Denny says this concern for the needy is not unusual for Medlin. “Donna has a very compassionate heart,” she says. “She is very active in her community, be that the hospital, her town or committees she is a member of. And we are hoping that this program will be an asset to this community.
“Neat things evolve when you work with Donna,” Denny adds about the development of the hunger take-home project. “She is very good about getting the right people at the table to talk about things,” she says, such as setting up initial meetings with a possible vendor for the project.
This isn’t the first take-home meal Medlin has provided for the hospital’s staff. In the Co-Worker Store, frozen pizzas are available, at $12 for a 16-inch pie. Medlin says the store sells an average of 15 to 20 pizzas each day.
Medlin says her “never say never” attitude is the biggest lesson she has learned in her 15 years at St. John’s. And that has translated into tripling the department’s growth and her mindset for looking ahead. “The future is always changing,” she adds. “And everything is possible.”