Tony Almeida is one serious guy—and he’s most serious in his determination to create fun on the job for the approximately 132 full-time equivalents (FTEs) in the food and nutrition department at 567-bed Robert Wood Johnson University Hospital in New Brunswick, NJ. He knows that if they’re involved in the process—whether it be a shift to room service for all patients, the opening of a new dining room with a substantially expanded menu, or planning a pull-out-all-the-stops gala theme day—they’ll come through like champs.
And they have. Thanks to their enthusiasm, turnover of full-timers is minimal, dining room sales are projected to reach $3.5 million this year (vs. $2 million for the old Woody’s Café), and
patient satisfaction scores are nearing the top of the chart.
Almeida wound up in foodservice seemingly by chance; the part-time job he landed, at the age of 16 in 1974, was as a pot washer at Elizabeth (NJ) General Medical Center, just a short walk from his home. Rapidly promoted to sanitation supervisor, then tray line supervisor, he graduated from high school with the conclusion that healthcare foodservice was the career for him. Soon after, he enrolled in the foodservice program at Middlesex County College (MCC) in Edison, NJ; then, in 1988, he joined the department of food and nutrition services at Robert Wood Johnson as assistant director and was named director three years later.
Today, his multi-department responsibilities include environmental and host services. Last month, 23 years after graduating from the MCC program, he received the school’s 2005 Alumnus of the Year Award.
Many hats: “I just love what I do—from 6:30 a.m. to 6:30 p.m.,” Almeida says. “People outside the industry generally don’t realize that as foodservice directors in healthcare we have to be experts in patient feeding, running retail operations and in special events planning. Here, we’re doing 1,350 patient trays a day, running about $3.5 million in annual retail sales, as well as approx. $800,000 in special event sales.
“And, we have to be able to do them all well in order to be successful. Feeding patients is only 30% of what I do; seventy percent is retail and special events. Of course, the revenue you generate is what brings your patient costs down.”
Today, the dining room check average at Robert Wood Johnson is $3.20 with approximately $11,500 in total daily sales and about $5,000 a day on weekends. Retail and special event sales have helped to bring net cost per patient day down to $11.18.
In recent years, Almeida and his staff have faced two of their greatest challenges: opening a new dining room and implementing room service. In both instances, the foodservice staff remained enthusiastic and unfazed, he reports.
Sales in the Woody Café (now closed) were about $2 million prior to opening the new dining room. Sales increased by $1 million during the first year in the new location with the addition of a broader range of selections including a 24-foot-long salad bar. Almeida added only eight FTEs to help provide for the expanded service, so he had to “push people to be more productive,” he recalls.
“You develop a positive working relationship by being there with them, by rolling up your sleeves,” he says. “This was a contract account when I arrived in 1988, but the next year the contract was broken and we were all asked to stay on, with a bonus. We really turned [the attitude of] the staff around by creating a positive work environment.”
The dining room, i.e., the main cafeteria serving visitors as well as 3,500 employees who work in the seven inter-connected buildings on campus, is open from 6:30 a.m. to 8 p.m., Monday through Friday, and until 6:30 p.m. on weekends. The new scatter-style serving line offers a gourmet pizza station and a recently installed hot panini station that serves about 250 customers each day.
Competing with the street: “Many healthcare operations give their food away, but our price structure is based on the competition outside,” Almeida explains. “If paninis are $5.50 outside, we charge our staff $3.95, $4.95 for visitors—40% higher than the staff price. Now, the dining room food cost average is 35% to 40%, down from 45% to 50% a while ago. Every January, we review each menu item and adjust our prices.” He’s aiming to increase daily sales by 10% to $13,000 by the end of the year.
October 14, 2003—the day room service was implemented facility-wide—is a date etched in Almeida’s memory. To develop the program from the outset, Sodexho was hired as consultant. “They’ll tell you it’s a hard transition for employees since you’re turning foodservice upside down,” Almeida says. “They warned us that some employees wouldn’t make the transition since you’re turning [many of] them into short order cooks. But they all adapted and we didn’t lose any employees.”
Room service is available from 7 a.m. to 7 p.m. seven days a week. About 1,350 trays are delivered each day to all 567 patients in 49 different locations within the seven-building complex. “Prior to [the implementation of] room service, we were in the 50th percentile in Press Ganey,” he says. “Now we’re in the 98th percentile regarding ‘quality of food’ and we’re in the 96th percentile in ‘overall meals.’”
Satisfaction guaranteed: From day one of the room service planning process, Almeida and his management team kept the foodservice staff involved and informed. Once a week a rotation of four staff members visited a smaller hospital nearby doing room service. “When they came back, they said, ‘Yes, we could do that here,’” Almeida explains.
“Overall, there’s been a 3% to 5% decrease in food cost, but there’s been a 15% to 20% increase in labor costs since we had to add 20 FTEs. The whole hospital’s [Press Ganey] score is now in the 96th percentile. We’re proud [of that increase] since we were the first ‘patient satisfaction initiative’ undertaken in the hospital to go live.”
Catering special events provides ongoing opportunities for Almeida, who prides himself and his catering chef and staff of three in being unique and in never doing the same thing twice, to raise the bar for each event. Special events are run as revenue-generators with two-tier pricing—one for the internal customer and the other for the outside customer such as the Chamber of Commerce or the Knights of Columbus.
All events are catered on campus and the Arline and Henry Schwartzman Courtyard—an atrium that seats 750 people for a full sit-down dinner—is “ideal,” he says. “We do a major event about every other month and our employees really get involved—and we get to shine.”
Expensive but worth it: Menus are custom-designed around the function in consultation with each customer, but Almeida makes sure they understand his motto: “We’re good, but we’re not cheap.” Overall, he aims to turn at least a 25% profit per event.
The creation of theme days is not part of the special events staff responsibility, but is willingly handled by the dining room and back-of-the-house employees. Special themes, such as Spanish, Hawaiian or Caribbean Day, feature recipes and costumes provided by the staff—and a live band is frequently hired. Often the event—typically there’s one every four months—becomes a point of pride and good-
natured competition to see whose ethnic theme day generates more revenue for the department.
Competitive edge: “For our Spanish Day, two employees from Puerto Rico came in to prepare special desserts—one at 11 p.m. the night before, the other at 3 a.m. to dish them out and add the garnish,” Almeida notes. “We send thank you letters after each event to those who have made special contributions plus a copy to the hospital’s vice president of operations. We know customer satisfaction increases, our foodservice employees’ satisfaction increases and we see a 15% to 20% sales increase for each major theme day.”
In the months to come, Almeida, an avid golfer with a 15 handicap, will be taking a swing for his department to achieve a national Press Ganey ranking in the 99th percentile. “To do that is a lot of work,” he asserts, “but we know we’re only as good as our last meal. We also know that our ceo’s philosophy is: ‘At Robert Wood Johnson, failure is not an option.’”