Healthcare foodservice has come a long way in the past 20 years and it continues to progress. To get a better idea about how this segment is incorporating consumer-driven trends into its operations and what healthcare foodservice operators will need to do to be successful moving forward, FE&S chatted with Bruce Thomas, president of the National Association of Healthcare Foodservice Management. Thomas is also associate vice president of guest services for Geisinger Health System.

FE&S: What impact is the economic climate having on healthcare foodservice providers? Has it impeded the implementation of new projects? How has it affected existing operations?

BT: Our biggest impact was the rising cost of fuel, which is now coming down. But it drove up the cost of food and that has such a significant impact on our bottom line. This was the biggest single-year increase in food costs we had seen since the early '90s. The increase was beyond the rate of inflation.

In healthcare, foodservice struggles to compete for capital under normal times. And that capital will get tighter over the next 12 months or so. Non-profits rely on their investments a lot and we know what happened there. It is going to be a challenge and I have already seen a number of projects put on hold.

The knee-jerk reaction is to pass those price hikes along to our customers. But we also realize we need to find ways to cut waste and provide foodservice more economically than we have in the past. We are decreasing some menu offerings and looking at the number of SKUs we have to reduce our inventory and control costs. We are also looking at how much we are making from scratch vs. what we bring in to make sure we are getting the most from our labor resources.

FE&S: What steps are healthcare foodservice providers taking to make their operations more environmentally friendly?

BT: We are seeing more recycling programs. A lot of facilities are going to locally grown food programs. Some facilities are bringing farmers’ markets on-site. We also see an increased use of biodegradable products and reusable products such as coffee. Waste minimization is a big thing, too, and green cleaning items continue to gain popularity.

HFM is launching a survey to its membership specifically on sustainability and green initiatives in healthcare. We wanted to find out what members are doing and what’s hot there. It helps us with education and gives the chance to let our members know what other healthcare foodservice providers are doing.

FE&S: How has the sustainability movement manifested itself in the healthcare market?

BT: The company I work for is not doing a buy-local program yet. We are located in rural Pennsylvania and I am trying to define the program. For the people that are using buy-local programs, they are experiencing some challenges in the form of product availability, which impedes their ability to make certain menu items.

FE&S: Healthcare has become so much more transient, meaning patients visit a facility for a test or procedure but the amount of time they actually spend overnight has dwindled dramatically over the years. This means there’s way more churn among patients than what used to be the case. How has this affected the way foodservice goes about its business?

BT: Generally speaking, those patients that are in the hospital today are sicker and have a higher level of acuity. Years ago, someone would spend four days for a hernia operation. Today, it’s much shorter.

According to the HFM benchmarking study, on average 35 percent of the meals served in healthcare facilities are patient meals. In my company’s biggest operation, that number is down to 23 percent. With patients in and out faster, you don’t get to see them as long as you once did. So, how you create menus is way different. If your average stay is two or three days, you don’t have to have a two- or three-week menu cycle.

FE&S: This year HFM celebrated its 20th anniversary. What are some of the more significant ways healthcare foodservice has changed over the past 20 years?

BT: Healthcare business is more based on the retail trends today. That’s the biggest change that’s occurred over the past several years. There’s been more of an increase to on-demand services in healthcare, such as room service, and that drives the back of the house. The foodservice departments are seeing an increase in the demand for quality food and use of trained chefs. Food safety is a big issue for us, too. And the grab ‘n go market is a big trend. We are dealing with every type of customer from grandparents to little children so we need foods that meet all their needs. We are not serving fewer meals. It’s just that the mix has changed.

FE&S: How do you think your business will change in the next 20 years?

BT: One of the most significant trends we are watching centers on incorporating more of the services consumers see in that broader foodservice market on a day-to-day basis. Healthcare needs to offer services that make life easier for the time-pressed staff and have some creative retail concepts that drive customer satisfaction and sales.

Baby boomers have impacted our economy everywhere and healthcare foodservice is no different. Our patients will be much more knowledgeable and demanding moving forward. It won’t be enough for us to offer meatloaf and mashed potatoes. We will have to reflect the market. Plus, we will need to be the leaders in healthy eating.

FE&S: Foodservice operations in a healthcare facility seem to have pretty long life spans. By this, I mean once designed and constructed the hospital or care facility seems to work within that framework for a considerable amount of time. Knowing this, what are some of the more important considerations that go into planning for a new facility?

BT: I hope we are designing for the long term because the capital reality is that we are not going to be able to turn our design every couple of years. You have to look at cutting-edge today because in five or seven years that will be the norm. And if you are in a location for 15 or 20 years or longer, you have to be able to deal with that. We have to be able to support customer satisfaction initiatives and better manage our full-time employees. You have to partner with the hospital to see what its long-term goals are and make sure you plan for that.

FE&S: Your members tend to have to work within some specific budget constraints when it comes to food costs and the like. What are some ways equipment and supplies providers can be of assistance in this all-important area?

BT: Perhaps our suppliers can help us in some non-traditional ways. Good foodservice directors will know how to run their business and get a better food cost and minimize waste. Some of the things they might not be used to looking at are energy use or waste reduction.

Some foodservice directors may not be up on some current trends. They may not be aware about how much they are paying for energy in their kitchen. So, they could do some energy audits to introduce some savings into the kitchen. They need to show us how some of the technologies can change the way we do business.

A UV hood is an example of a newer product out there that could introduce savings. A compost machine and low-temp cooking are examples.

FE&S: How important is training on equipment for healthcare foodservice operators? And what are some ways your members go about training their associates on how to properly use and clean specific pieces of equipment?

BT: It’s extremely important. By regulatory standards we need to document that our people are trained properly on equipment. That’s a big challenge for us and anything equipment suppliers can do to help us would be beneficial. Traditionally, we buy a piece of equipment and the manufacturer trains the trainer. And that person has to educate everyone else. Perhaps they could help us train our people online. This will help us with documentation and ensure a consistent effort.