5. Enhancing Retail Sales

Bringing in revenue from retail operations is crucial to most hospitals' financial success today. The trend is to provide multiple stations featuring restaurant-quality cuisine. At Elmhurst Hospital in suburban Chicago, for example, the Wildflower Café offers Asian fare prepared on an authentic Chinese wok, pizza made in a gas-fired brick oven, grilled burgers and chicken, a carving station serving cedar-plank salmon, pasta bars and a lot of take-out options. (For examples of how retail is succeeding in healthcare foodservice check out the Q&A with UNC Health Care's Angelo Mojica and Café 601.)

6. Hiring Trained Chefs

As healthcare establishments look to improve room service and retail sales, they're hiring trained culinarians who bring professional expertise to food preparation. Their expertise is reflected in high-quality menus featuring flavors and ingredients that belie hospital foodservice stereotypes of old. For patient foodservice, culinarians are discovering their teams can produce, plate, hold and eventually transport dishes to patient rooms without compromising quality, which leads to greater customer acceptance. Chefs visit patients and converse with them about preferences and food in general. Teaming up with dietitians, chefs find new ways to create tasty menu items for patients with special diet concerns due to high blood pressure, diabetes and celiac disease. Culinarians also show their talent in retail operations through menu development and visible, exhibition-style cooking.

Catering services also welcome culinary talent. At Providence Hospital in Washington, D.C., for example, a dedicated website promotes the facility's chefs, who provide "healthy, delicious food with great flexibility" for a variety of occasions. The menu includes fresh grilled shrimp, pan-roasted scallops, London broil, filet mignon and barbecue spare ribs, along with popular sides, salads and desserts.

7. Emphasis on Health and Wellness

Never before have healthcare institutions placed so much emphasis on health and wellness for their employees and foodservice customers. Many hospitals are taking a leadership role in providing education about and support for everything from weight loss to managing allergies and living a well-balanced life through diet and exercise.

Nutrition is a primary focus in the retail operations at Sanford Medical Center, according to Lisa Gibson, director at the Fargo, N.D.-based facility. As at many other hospitals, the staff at Sanford removed all fryers, replacing them with high-speed ovens. "We've completed an 18-month review of recipes to reduce sodium by 30 percent," she says. Flattop grills, combi ovens and sauté ranges also support staff as they discover healthier dining options for patients and retail customers.

At G.M. Wilcox Memorial Hospital in Lihu'e, on the Hawaiian island of Kauai, the café instituted "Fryless Friday" and began offering more healthful food choices to encourage staff and patients to become more conscious about healthy eating. Placing nutritious snacks in a more prominent position near the salad bar, introducing healthier versions of favorite comfort foods and posting nutrition information about menu items have also encouraged more healthful eating.

UW Health Partners Watertown Regional Medical Center in Watertown, Wis., hired an executive chef, Justin Johnson, and renamed its foodservice department "Nourishment." Johnson sources food locally as much as he can, including tomatoes, peppers and vegetables grown in an 11,000-square-foot garden beyond the parking lot.

8. Commitment to Sustainability, Green Initiatives and Social Responsibility

Yesford says sustainability is perhaps the most prevalent trend in healthcare foodservice right now. Thanks to a number of important initiatives, more and more hospitals use their purchasing power and expertise in the healthcare sector to advance the development of a sustainable food system. To help combat diet-related diseases such as obesity, diabetes and chemical-related illnesses, healthcare foodservice departments employ a variety of practices, including buying local produce, planting hospital gardens, participating in farmer's markets and creating less waste through recycling, composting and reusing.

At Fletcher Allen Health Care of Vermont, director of nutrition services Diane Imrie, MBA, RD, believes that food and good nutrition are essential to healing and the prevention of illness. Under her guidance, the hospital was among the first to sign the Healthy Food and Healthcare Pledge in 2006. Since then, nutrition services has established a bellwether program offering locally grown, healthy, sustainable food that is competitively priced and profitable. In July 2012, the dining operation, Main Street Café, was rebranded as Food Matters. Today, the operation generates approximately $5 million in business annually, serving 2 million meals. A room service program offers a menu with strong seasonal components. Since its inception, room service has seen a 20 percent reduction in waste, sharply cutting the amount going to the landfill.

9. Incorporating Technology

UCSF's Henroid concentrates on data integration and technology. In January he partnered with two companies to launch Smart Choice Smart U. This program combines food tracking with physical activity to help give participants real-time feedback about their progress toward meeting personal wellness goals. Participants can access data easily through an app.

"This even allows people to scan commercial barcodes and get nutritionals out of databases so you can populate your own food diary," Henroid says. "The Fitbit component tracks all one's movements and produces an eye-opening chart that shows one is 80 percent sedentary and rest-active."

At UNC Health Care, Mojica incorporates sous vide equipment into his operation to make salmon, burgers and other foods. Though the technology isn't prevalent in healthcare, more operators are expressing an interest using these techniques to increase menu variety and improve menu quality.