When asked to identify his favorite pieces of equipment, Morin quickly chooses the combi ovens. "They are so versatile, he says. "We can proof and bake, use the grilled grate and mark chicken and steak, and then roast. And having multiple combis is great because we can prepare items for the whole operation, and especially banquets, very quickly."

Morin's also a proponent of gas cooking and charbroilers, which he says aren't often available in hospitals because the kitchen is often close to areas in the facility that use medical gas or sensitive equipment. At PRMC, the kitchen sits on the side of the kitchen that is away from such hospital units.

When transporting food from the retail production area to the point of service, staff use a designated elevator, and upon arrival in the café, they distribute the prepared and raw ingredients to various stations.

At Your Request for Patients

Preparation and assembly for the room service program, named At Your Request by Sodexo, takes place in a designated area of the kitchen. Patients phone in their meal orders to a call center, where a staff member dispatches their orders to the room service prep area. The call center also takes calls for the Randallia campus located in downtown Fort Wayne and for four community hospitals that are part of the Parkview system. Though the hospital does not have designated elevators for room service carts, "The average time from when the call is placed until delivery to the patient is 26 minutes," says Thorne.

"Because the hospital is so large, we designed two identical sides to the room service lines to expedite delivery to patients," Osatinski adds.

Each of the two mirrored lines contains a large flattop griddle for heating breakfast sandwiches, pancakes, French toast and hash browns and, at lunch and dinner, sandwiches such as grilled cheese. Two quick-speed ovens in the middle of the line cook fish sandwiches, fries, chicken tenders, small pizzas and more; ranges heat omelets, pasta and sauces; and bains-marie with small baskets, which employ water rather than oil, cook vegetables. A small combi oven steams or bakes small batches of vegetables.

Adjacent to the cooklines are assembly areas with everything else for the trays, including salads, cold sandwiches, wraps and desserts. While culinary staff prepare the hot food, a starter receives an order ticket and builds the tray with serviceware and condiments. This starter reaches through a window to take the hot and cold food and then places it onto the tray, puts the ticket on the tray and pushes the tray down the line. A second person puts beverages on the tray. A third person checks for order accuracy and places the tray on a corresponding cart. "Carts don't sit for more than seven minutes," Morin says. "We want carts to be as full as possible before they leave the kitchen for the floors, but we don't want to jeopardize quality."

Staff members, called hosts, are assigned to designated zones within the hospital and take the carts up to specific floors, present trays to patients and discuss their menu choices. When patients finish eating, the same host removes the tray and places it in a soiled utility room on the floor. When these carts are full, hosts take the soiled trays down to the kitchen for sanitation.

"The order/preparation/tray delivery system is designed to take no more than 26 minutes on average," Morin says. "Our software allows us to know when a call is made and the time the order is printed. When a tray is assembled and leaves the tray slide area, the order ticket is scanned. It is scanned again when it leaves the kitchen and again with a handheld scan when it is delivered to the patient. Scans allow us to analyze data to determine where breakdowns take place."

Simply to Go, Catering and Bakery

Another section of the kitchen is earmarked for Simply to Go, the grab-and-go area in the retail café. Here, staff make to-go items such as cheese and fruit cups, fruit parfaits, sandwiches, wraps and chef's salads, which they transport to the retail area and place in display cases. "Production for to-go items takes place 16 hours a day because of the volume," Thorne says.

Adjacent to the room service areas, staff use a prep area for catering and a hot line with four combi ovens, a charbroiler, soup kettles, pasta cooker, fryers, a griddle and a range. The catering menu mirrors the retail menu. "But we'll accommodate special orders from customers and prepare just about anything they'd like," Morin says.

Across from the catering area, an on-site bakery holds a countertop steam-jacketed kettle for sauces, glazes or boiling water; a range to melt chocolate and other dessert sauces and toppings; countertop mixers and floor mixers; a cooler and freezers; and a roll-in rack proofer and baking oven that accepts roll-in carts, which is one of Thorne's favorite pieces of equipment due to its versatility. The ovens support staff production of pies, pastries, rolls, banana muffins and cakes. For new parents and orthopedic patients who "graduate" to recovery after knee or hip surgeries, staff deliver eight-inch round cakes, along with a special meal and a bottle of sparkling grape juice.

The Retail Café

The servery's configuration consists of free-form curves and references exterior building forms and the connection to nature. Ceramic wall tile and flooring reinforce durability and are easier to clean. "Floor tiles are tied into the exterior material pallet," Collard says. "Wall tile patterns and colors highlight specific stations in the servery."

Collard explains that dropped soffits in the servery help visually separate circulation and serving areas. Backlit translucent panels, accent colors and pendant lights in the ceiling highlight various serving stations. Wood veneer adds warmth to the space and is used on surfaces less susceptible to abuse. Acoustic ceiling tiles above circulation zones help reduce noise.

In the dining area, a large glass partition separates the dining area from the main corridor while allowing natural light in and views out to the exterior dining courtyard. Built-in planters help separate the dining area into more intimate zones and provide a connection to nature. Free-form, curved dropped soffits further break down the large seating area into smaller areas.

Light coves integrated into these forms provide soft diffuse lighting. A cluster of sculpted glass pendant lights highlight one zone of the dining area. In order to reduce noise in the seating area, carpet was used on the floors and acoustical tiles were installed between the dropped soffits. Wall surfaces consist of alternating materials: painted gyp board, tile and wood veneer.

In the retail area, Osatinski says the design ensures that waiting times are kept as short as possible. "We didn't want people to stand in line twice, to wait for food and wait to pay and then have little time to relax and eat," he says. "So we separated à la carte service stations from grab-and-go stations. Also, we designed and shaped the cashier stations for rapid checkout so the employees can maximize their free time at lunch."

"From an operations point of view," Thorne says, "it would have been advantageous to have two more registers. During the main crunch time at lunch, it can get busy, and people do have to wait to check out occasionally."

When designing the servery, Truitt says assembling the serving counters presented an enormous challenge to the installers. "The main counter is a continuous serpentine shape with stone countertops and backsplashes that wrap around columns, and radius walls that required a lot of detail work in fitting the stone to ensure a good fit in a highly visible area," he says. "All the counters were shipped in many pieces and required assembly and adjustments to properly fit the space."

Customers frequenting the retail café select from various themed stations. At the left side are chef's favorites; hot and cold wells hold menu items such as fried chicken, baked fish, fried potatoes, soups and sauces that staff prepare in the lower-level kitchen and bring up in designated elevators. At the station, staff prepare vegetables. Two double-stacked combi ovens cook rotisserie-style meats, and staff occasionally carve to order.

Adjacent to the chef's favorites area is the international cuisine station. Refrigerated rails and induction burners enable staff to prepare stir-fries, sizzling salads, noodle bowls, tacos and burritos, all made to order. "Having ample in-counter cooler space and the induction burners allows for versatility when planning menus with featured items like bananas foster," Morin says.

Next in the lineup is the pizza station, where staff roll dough, dress it with ingredients and then bake it in a brick pizza oven. Customers can select from the featured pizzas of the day or select preferred ingredients, and a cook will bake a pie to order. Staff also bake menu items such as lasagna and cobblers, calzones and cheesy bread in the pizza oven, another one of Thorne's favorite pieces of equipment. "It's awesome because we can bake the perfect pizzas with our handmade pizza crusts," he says.

At the adjacent pasta station, customers watch as staff prepare pasta dishes on induction burners. Customers choose among three to four different pastas and three to four sauces and watch as a cook combines ingredients and flavors.

To the right of the pasta station is the grill, where staff work at an island cooking suite that includes a four-burner range, a six-burner range with an oven beneath, a griddle range, an overhead broiler, four induction burners, two charbroilers and a fry station. Menu items include everything from eggs and hash browns during breakfast and burgers and wraps at lunch and dinner. In addition, staff prepare items to order such as specialty French toast, gourmet breakfast sandwiches, quesadillas, toasted sandwiches, charbroiled chicken and veggie burgers.

In the middle of the servery, customers can select frozen desserts such as soft-serve ice cream and novelty items. Another freestanding station features myriad salad offerings, soups, a deli station and grab-and-go menu items for Simply to Go.

Additional desserts, such as pies, cobblers, cakes and cookies, are available at a station that sits adjacent to the third-shift grill, open from 8 p.m. until 6 a.m. This area offers coffee, beverages and light menu fare.

The warewashing and dishwashing is split between two areas. In the retail area, staff use a dishwasher to clean trays and dishes. On the kitchen level, carts bring dishes from patient areas to the sanitizing area where all dirty carts and dishes are cleaned and transported to a clean area for pick up. A refrigerated area on the loading dock holds garbage. "The Indiana health department is very, very, very strict about everything from separating dirty and clean dishes to efficiencies of hoods," Osatinski says.

A pulping and extracting system contributes to sustainable practices. "This is a very green product that significantly reduces water, waste and labor, all of which results in savings for the hospital," says Truitt. "The challenge here was coordinating with the plumbing contractor on routing the slurry lines through the building because the system was on two levels of the building, which had to be tied together into the main kitchen pulper room."

Sustainability Features

"Great care was given to the project design to minimize the use of domestic potable water as well as control the amount of storm water generated," Collard says. "Throughout the project, low-flow and sensor-controlled water fixtures were used to minimize water consumption where possible. When selecting the vegetation for the site, the landscape design team used native planting materials wherever possible to minimize the need for irrigation once the plants are
established and healthy.

"With regard to storm water, the parking lots were configured around a series of rain gardens to control the amount of storm water diverted to streams and rivers, and which also help to purify the water being discharged by allowing pollutants to settle out of the water prior to reaching the streams and rivers. When not being used as rain gardens, these areas provide open vegetated spaces which help to reduce the amount of heat generated due to solar energy absorbed and retained by the asphalt pavement."

While designing the building itself, the design team was careful to incorporate an efficient building enclosure including insulation systems and efficient glass, to select highly efficient equipment for the heating and cooling of the spaces, and also to minimize or even eliminate the use of environmentally harmful CFC and HCFC materials for cooling systems. "Where possible, the materials used inside the building minimize the impact on the environment by utilizing products with recycled material content or products which do not require extensive use of harsh chemicals for maintenance," Collard says.

In addition, to improve the environmental quality for the occupants of the building and minimize electricity use, many spaces use natural daylighting, and the lighting systems are set up with occupancy sensors to turn lights off when spaces are not being used.

Other sustainable features include:

• Use of refrigerant substances and containment methods that prevent ozone depletion or decrease the greenhouse effect
• Allocation of space throughout the building to collect recyclable materials
• Availability of large, outdoor landscaped areas for public and staff use
• Use of highly efficient plumbing fixtures and sensor faucets to reduce water consumption by more than 20 percent
• Review of the design for efficiency and appropriateness by a commissioning group separate from the design team, to assure that the building will exceed requirements for energy use
• No tobacco smoking allowed on the campus either during construction or after occupancy
• Systems designed to monitor the airflow quantity and quality in the hospital
• Use of low-VOC-emitting adhesives, sealants, paints, wall coverings, carpeting and flooring systems
• Thermostats throughout the facility that allow occupants greater control over their environment to assure their comfort

Reinventing and redefining the way hospitals operate in today's highly competitive, cost-conscious environment requires much foresight and imagination. At Parkview Regional Medical Center, foodservice is very much a part of this new model. A spacious kitchen equipped not only for today but tomorrow, room service that is responsive to patients' needs around the clock, and retail offerings that please staff, patients' families and the community are all bringing food to the forefront of this healing environment.

Facts of Note:

• Ownership: Parkview Regional Medical Center
• Opened: March 17, 2012
• Scope of Project: A new 446-bed, 1.1-million-sq.-ft. hospital with 7 floors, including foodservice.
• Foodservice Size: 24,500 sq. ft., which includes a 13,000- sq.-ft. kitchen that supports the café, room service program (At Your Request), catering, a 6,800-sq.-ft. dining room, and a 4,900-sq.-ft.. servery. (The café is now called PRMC Café, but an official name will be selected by a contest soon). The medical center also contains a 750-sq.-ft. physician’s dining room with support kitchen; a heart wing with a 1,350-sq.-ft. heart café and 3 pantries (one is 105 sq. ft.; two are 130 sq. ft.)
• Seats in Dining Room: 450
• Average Check: $4 to $5
• Total Annual Sales: $3.4 million (catering, $1.3 million
• on-site and off-site)
• Daily Transactions: 2,000 on average
• Hours: Café, 24 hours/day; for third shift, open from 8 p.m. until 6 a.m., grill and to-go stations are open, and deli and salad stations rotate (one/week, deli bar or salad bar is open; if cleaning is taking place, grill is closed). Room service is available 24 hours/day.
• Menu Specialties: Main servery features 7 different stations including grill, pizza, pasta, chef’s favorites, international cuisine, soups and salads, deli, desserts, as well as third-shift café and grab-and-go items.
• Staff: 127 FTEs, including vending, retail (35 of total) and room service
• Total Facility Cost: $370 million
• Total Foodservice Cost: N/A
• Equipment Investment: $5.3 million
• Website: www.parkviewregional.com

Key Players

• President: Sue Ehinger
• CFO: Mike Browning
• Vice President of Changing Spaces and Construction: Mark Hisey
• Director of Nutrition Services, Sodexo: Eric Thorne
• Operations Manager, Sodexo: Mike Morin
• District Manager, Sodexo: Charlie Baumer
• Clinical Nutrition Manager: Trisha Hockemeyer
• Architects: HKS Architects, Dallas; Bradley Collard, AIA, LEED AP, associate principal and senior vice president; Jeff Stouffer, AIA, principal in charge
• Artist/Craftsman: Greg Kennedy, Dallas
• Interior Designers: HKS Architects and Ellerbe Beckett
• Foodservice Consultants: Systems Design International (SDI), Greenwood Village, Colo.; Eli Osatinski, president; Sam Guzman, project manager (he left SDI in the spring of 2012)
• Equipment Dealer: C&T Design and Equipment, Indianapolis; Randy Truitt, CFSP
• Construction: Pepper Construction and Weigand Construction LLC, Indianapolis

About the Key Players

Bradley Collard, AIA, LEED AP, Associate Principal and Senior Vice President, HKS Architects

For 19 years Collard has specialized in healthcare facilities. He serves as a project manager and project architect. In addition to Parkview Regional Medical Center, his projects include Baylor Medical Center at Waxahachie Replacement Hospital in Texas; Parkview Heart Institute; the emergency department at Parkview Regional Medical Center; an office building at Parkview Regional Medical Center Park; Hamon Tower at Texas Health Presbyterian Hospital Dallas; a parking garage at Texas Health Presbyterian Hospital Dallas; and Exempla Good Samaritan Medical Center in Lafayette, Colo.

Eli Osatinski, President, Principal in Charge, Systems Design International

Osatinski received a bachelor's degree in mechanical engineering from the University of Miami in Coral Gables. From 1973 to 1976, he worked for the international hotel design group, Amimpex Inc. Due to his fluency in five major languages and the fast growth of the international hotel market, Osatinski had sole responsibility for designing and implementing global projects for InterContinental, Sheraton, Hyatt and Hilton.

Subsequently, he formed his own design and consulting firm, PLAN-IT, in Coral Gables, Florida. In 1978, Osatinski joined TRA as executive vice president and partner. TRA grew from a three-person company into the second-largest hotel design firm in the country. In 1984, Eli started Systems Design International Inc., a collaboration of internationally experienced design professionals specializing in food service, laundry and back-of-house design.

Randy Truitt, CFSP, Designer and Sales Consultant for C&T Design and Equipment Company

Truitt has more than 15 years of design and project experience in the foodservice equipment market. He has been with C&T Design for the past 17 years, serving as a sales consultant and project manager handling various clients in healthcare, corrections and other institutional markets. Before joining the C&T Design team, Truitt worked in the architectural field for five years in Indianapolis.

Truitt has worked in multiple school systems, universities and healthcare facilities in Indiana, Ohio and Kentucky. He has successfully completed more than 150 projects in the foodservice industry.

Eric Thorne. Corporate Director of Nutrition Services, Sodexo

A 20-year veteran of the foodservice industry, Eric Thorne has been in his position at Parkview Health System since June 2012. Thorne's background includes working with St. John Providence Health System in Detroit.

Thorne places a strong focus on customer service and realizes the importance of providing the proper training to make each of his employees successful. He works hard to seek systematic and strategic solutions that solve the problems of today as well as prevent new ones in the future. Thorne expresses a passion not only for foodservice but also for serving people, and says he genuinely cares about the customers and staff.