LISETTE COSTON has broadened the foodservice department's reach at Saint Francis Health System by:
• TAKING over and/or opening new operations as the health system expands
• SWITCHING from cook-chill to room service for the majority of the system's patients and enhancing meal service for patients at the psych hospital
• STARTING services to enhance patient and customer satisfaction, like Panda Meals to provide free meals to parents at the children's hospital
For some people, an expansion project can be a daunting task. But for Lisette Coston, director of nutrition and food service at the 912-bed Saint Francis Health System in Tulsa, Okla., it’s like a thrill ride. Coston has been with the system for 24 years, the last 13 as director, and during her time the system—and the foodservice department—have expanded tremendously. Hospitals, patient beds and a professional office tower were added, and Coston was responsible for providing services to all.
“The most rewarding aspect of my job has been that we have grown tremendously as a department during the last 10 years and we’ve been able to start new projects,” Coston says.
“I took over this operation in 1998. Since then I have made a number of changes; I’ve just about hit every element of the department, as well as acquired new facilities.”
Growing strong: David Wagner, vice president of support services and facilities management for the system, says tenacity is Coston’s greatest attribute. “She doesn’t give up easily,” Wagner says. “If she runs into a challenge she will stay hold of what the original concept was and she finds a way to make things work. She works in a very positive way. I’ve always appreciated that she doesn’t come up to the first no or roadblock and say, ‘I can’t do that.’ ”
At the system’s main location, 603-bed Saint Francis Hospital, Coston is responsible for the Food Court, the main cafeteria, which serves an average of 2,500 meals each day; the physicians’ lounge, which serves around 150 doctors daily; and Café Francisco, a coffee kiosk that had $133,000 in sales last year. There is another coffee kiosk at The Heart Hospital, which had more than $131,000 in sales last year. At 162-bed The Children’s Hospital at Saint Francis, in addition to patient feeding, Coston operates PJ’s Snax, a grab-and-go concept that offers coffee, smoothies and sandwiches. In 2007, the system added the 56-bed Saint Francis South, which has a physicians’ lounge and Redbud Café. Coston also offers patient feeding at the 91-bed Laureate Psychiatric Clinic and Hospital. The system also has a full retail operation at the Warren Tower, a professional building for the financial, accounting and human resources departments. Lastly, Coston operates Zone Appetit, a grab-and-go retail location in the system’s Health Zone, a 70,000-square-foot fitness facility.
With so much on her plate, it would be easy for Coston to get bogged down with keeping the operations up and running, much less adding and improving services. But that’s not the way Coston operates.
Patient services: In June 2007, the system acquired Saint Francis South. In a two-week period, Coston’s team switched the department from contract managed to self-op, gutted and rebuilt the kitchen, expanded the dining area, built a physicians’ lounge and started room service for patients.
“The kitchen was really tiny,” Coston says. “My administrator came to me and said, ‘we are going to close down the hospital for two weeks and we are going to give you the space adjacent to the kitchen. We want you to come up with a plan to make it bigger and more functional.’ Everything was new and we had to take over from a contractor, so that was a challenge.”
Coston and her team also created a physicians’ lounge at Saint Francis South. The team used the blueprint from a renovated physicians’ lounge at the main hospital, which was redone in 2005. The renovation took what Coston called a “grim” location and turned it into a county club-type atmosphere. Round tables and large club chairs were brought it. “The kitchen looks like a home kitchen, but it’s not,” Coston says. “We have a sub-zero refrigerator with a cabinet front and we put in hot and cold wells sunken into the counter. From far away, it looks like cabinetry, but it has the functionality to be able to serve meals in bulk. We worked with the South location to do the same thing there because it was so successful at the main campus. We also wanted physicians who were going from one hospital to the other to experience the same thing.”
In June 2008, Coston implemented room service at the main hospital, where a cook-chill system had been in place. Since the switch, patient satisfaction scores have increased from 56% to 87%. The switch to room service was done “basically with one room service line, so it’s very hopping,” Coston says, adding that the kitchen will get some relief soon. “We are building an additional 150-bed tower. We realized we are at max with our room service line, so we are remodeling to add a second line.”
Around the same time, the 162-bed The Children’s Hospital at Saint Francis was built. The children’s hospital was built with a room service kitchen and program.
Because of the nature of a children’s hospital, feeding parents of patients is a large component of the program. In 2008 Panda Meals started. In this program, one caregiver for each patient is given one free lunch each day, Monday through Friday. The program, which offers several sandwich and salad options, is funded through a grant. In September 2010, the Panda Meals program was broadened. Through a $300,000 private donation, both parents of patients from lower socioeconomic backgrounds are given an $8 voucher, which they can use to purchase a meal from any of the retail locations, or they can order a guest tray.
Patient feeding also changed at the 91-bed Laureate Psychiatric Clinic and Hospital in July 2010. The hospital feeds three types of patients: geriatric, adults with a chemical dependency and women with eating disorders. Service was changed from cook-chill to bulk congregate feeding for the geriatric and adults with chemical dependency populations. Food for these patients is prepared in bulk at Saint Francis Hospital and transported to the psych hospital.
Service for the eating disorder unit was changed from cook-chill to chef-prepared meals. “From what I understand we have one of the only eating disorder programs within a hospital setting, whereas a lot of these programs are freestanding,” Coston says. “This is such a fragile group of patients because food is definitely their enemy. We put a tremendous effort into making sure those meals are fabulous and appetizing. We hired a chef, and now all of those meals are prepared on site.”
There are three levels of service for the eating disorders program. The non-select level is for incoming patients to the program. A dietitian dictates what patients eat at this level. The second level is menu-select, where patients select items from a restaurant-style menu. For the third level, self-select, patients are served in a congregate setting. A buffet is set up for the patients to serve themselves.
Retail ops: While Coston is very focused on patient service, she has not neglected retail operations. Since 2008, Coston has opened three retail operations: Café Francisco and a Heart Center lobby kiosk, both are coffee and grab-and-go locations, and PJ’s Snax, a grab-and-go outlet in the children’s hospital. The kiosks were added as a way to increase revenue and as a way to reach employees and guests as the system has expanded.
Coston also is working on a partial renovation of the Food Court, the main retail outlet at Saint Francis Hospital. The Food Court was renovated in late 2001 to include branded concepts, such as Hot Stuff Foods’ SmashHits Deli, Tyson’s Sunset Strips and Hormel’s Austin Blues Barbeque. The Food Court also has self-branded concepts, such as 61st Street Grill, which offers traditional grill items, House Favorites and the Daily Special, which is a self-service rotating bar. Coston is working to renovate the seating and cashier areas.
Wagner says Coston’s dedication to patient service also helps with the retail side. “At the root of Lisette’s activities is trying to provide the very best for our patients,” Wagner says. “It’s nice to have the revenue side with the retail spaces, but she is very concerned with making sure the patient food is presented in a very positive manor. We reap the benefits from the families and employees because she does a really good job with our patients.”
Wagner adds that Coston is always looking for the “next thing.” “I have found that she is interested in being innovative in the service to our patients first of all, and then to our other customers,” he says. “I have to be a little guarded sometimes when I’m brainstorming with her because the next thing I knew I’ll get communication back saying we are implementing this in a pilot form. She really enjoys challenges and bringing new and unique aspects to foodservice.”