You’d be hard pressed to find someone more involved in healthcare foodservice than Tim Bauman, director of food and nutrition services at 167-bed Wood County Hospital in Bowling Green, Ohio. He is a 35-year veteran of the foodservice industry, 18 of which has been as director at Wood County. He was on the national board for the American Society of Healthcare Food Service Administrators (ASHFSA) for four and a half years; he is Ohio’s state president for the Dietary Managers Association; he is on several other regional and national advisory boards; he teaches a class for dietetics majors at Bowling Green State University; and he recently published his first book, The Food Service Managers Tune-Up Book. Bauman admits he has a hard time saying no, which helps explain the many changes that have taken place the past couple of years.
With so much experience, it is no wonder that Bauman has been able to create an innovative and well-managed foodservice department at Wood County Hospital, where he manages a foodservice program that has 30 FTEs and serves an average of 1,200 meals each day. He oversees the retail cafeteria, vending, an on-site catering program that averages between 50 and 70 events each week, a Meals on Wheels program and a student intern program for Bowling Green State University’s dietetics program.
Cafeteria culture: “I am big on fighting boredom with people who are repeat customers, and in an employee operation, there is a lot of repeat,” Bauman says. “I hand-write a cafeteria menu that is totally different every week. I typically start with the entrée and I base the rest of the meal around that so that the vegetables and starch are appropriate for whatever entrée I pick.”
For example, a typical cafeteria menu for a day will have three entrées. Bauman will pull two of those entrées from the one-week patient cycle menu. The last item will be a completely different entrée than those offered on the patient menu or one that has been offered in the cafeteria previously. Bauman says he rarely repeats the non-patient menu items in the cafeteria. Even with a popular item, such as beef brisket, Bauman says he may only menu the item three to five times a year.
Another way Bauman prevents customer fatigue is by staging promotions in the cafeteria. One recent promotion was designed to help customers select foods that are high in fiber. The promotion, developed by an intern from Bowling Green, provided cafeteria patrons with information about which foods contained a high fiber content, such as the café’s ziti bake, roasted vegetable lasagna and red pepper crab bisque, which were on the menu that week. Display cooking also helps create “a bit of theater” in the café.
Bauman says a major reason he can create this type of menu is because of the culinary expertise of his staff. “The staff here really can turn on a dime. I have four people who are schooled chefs. It’s a staff that you can hand anything to and they just make it, as opposed to a lot of places where it’s roast beef every Tuesday whether you like it or not.”
Ray Hohman, kitchen manager/chef supervisor, has spent the last 16 years working under Bauman. For his part, Hohman says the stigma of bad hospital food has been erased at Wood County because of the administration and Bauman’s commitment. “The administration has chosen to allow Tim to put together a strong kitchen and I think it’s showing,” Hohman says. “Tim’s biggest asset is he realizes people’s strengths and weaknesses and allows people to excel. If someone is not successful in one position, Tim has the foresight to find him another job where he can succeed. So you have a success story rather than a rehire situation.”
Bauman says the most rewarding part of his job is teaching and managing people, which has helped to create an environment where apprenticeship is valued. The average tenure for foodservice employees at the hospital is 12 years. That number used to be higher, but many people who had been with the hospital for more than 30 years retired recently. “There are so many things that you can only learn on the job,” Bauman says. “I started top-down with high quality chefs. There is a heavy emphasis on technique, procedure and outcomes. I want people to have pride in their knife skills. When people have a lot of pride in the work they do, it makes them want to stay and build on each other.”
Mapping the menu: In 2008, Bauman and his staff decided to tackle employee dining habits head-on with a program called Meal Maps and Menu Markers. In the program, a registered dietitian analyzes every item sold in the cafeteria for nutrition information such as calories, fat, sodium, cholesterol and carbohydrates. That information is then printed on stickers and placed on the menu items.
“This is an offshoot of what some states and cities are doing with requiring restaurant chains to supply nutrition information to customers,” Bauman says. “I see this as a trend that will increasingly take hold in the United States.” He admits there is a lot of up-front work—eight labor hours a week were added to get the program running—but he says once the program has been fully implemented, it will take little work to maintain it.
Bauman hopes this information will sway customers to make healthier purchases. While he acknowledges changing people’s dining habits is difficult, Bauman says when customers are supplied with educational materials they are more likely to make healthier food decisions. Part of that education is helping customers make a balanced plate. “What we are doing is preaching the total meal concept,” Bauman says. “Say you decide to splurge on a dessert and it’s got 50% of the calories from fat. You might then pick a salad with a low-fat dressing to go along with that. If you put the salad together with your dessert, the total calories from fat might fall down to 28%. So it will show you where you are allowed to splurge or where you can cut. We try to create interesting menus and then train people how to eat in a healthy way.” The goal is to have a plate with 30% of calories or less from fat.
Currently, the Meal Maps and Menu Markers program is 60% implemented; Bauman hopes to have the program completely in place this summer.
Meal Maps and Menu Markers is just one component to the hospital’s commitment to better employee health. All employees who are on the hospital’s insurance plan have been biometrically screened, and once that data is analyzed, Bauman will have aggregate data on things like employees’ cholesterol and blood sugar. He hopes to check those same levels after the Meal Maps and Menu Markers program has been in place for one year to see if the cafeteria program is making a difference in the employees’ health.
Meals on Wheels: The hospital’s Meals on Wheels (MOW) program is a rare example of a completely volunteer-run MOW program, Bauman says. As such, it was having problems finding people to fill vacant leadership spots. “Some of the chairmen were taking on too many duties and then when they would leave the job seemed too overwhelming for a new person,” he says. “That makes it hard to get volunteers when they don’t feel they will be able to fill all the expectations.” So last year Bauman decided to implement a volunteer succession plan to help fix the problem.
Along with the program’s new chairman, Bauman rewrote job descriptions for the program and provided proper training for the volunteers so they felt comfortable in their roles. Since making the changes, Bauman says the MOW program is fully staffed and commitment is once again strong. In August 2008, Bauman was inducted as a fellow of nutrition to the National Center for Nutrition Leadership, a Meals on Wheels Association of America educational and development group. Following the induction, the volunteer succession plan was made available to all MOW programs.
Even with all the projects Bauman already has on his plate, he is about to add yet another. In the next couple of years, the hospital, and foodservice department, will undergo a much needed expansion project. A new 50-bed tower is being built and Bauman says work on a redesigned kitchen and servery will break ground in late 2010. “The cafeteria was built when we didn’t think we would have more than 250 people on campus,” Bauman says. “Now, we have more than 1,000 people on campus. Seventy percent of the food produced in the kitchen is not eaten in the cafeteria, whereas in most hospitals that number is around 50%. So I need a big cafeteria built to accommodate all the people on campus.”