Foodservice has become a differentiator in today's hospitals. Progressive facilities competing for patients are instituting revolutionary room service programs; installing serveries with a variety of offerings; providing upscale, seasonal fare; and even creating destination restaurants with takeout programs rivaling the top chains.

By relocating the coffee service inside the store from a coffee cart in one of the dining rooms, gross sales increased dramatically at Moffitt Café at the University of California San Francisco Medical Center. The store also provides grab-and-go food, bottled beverages, pastries and made-to-order sandwiches

"Many chefs are moving to the healthcare arena, and it has become important to have someone with culinary experience on staff," says Elizabeth Yesford, senior director at Providence Hospital in Washington, D.C. Yesford is also an Association for Healthcare Foodservice (AHF) board member and its 2012 president-elect. "Hospital foodservice is like hotel foodservice on a diet, due to the clinical needs involved." These changes are no surprise, considering retail sales in the healthcare foodservice segment have more than doubled in the last 20 years. For 2011, this segment is expected to reach retail sales of more than $22 billion, according to Technomic, a Chicago-based foodservice industry research firm. Retail sales in hospitals are forecasted at $10 billion for this year, an increase from approximately $8.5 billion a decade ago.

 "The healthcare retail component has arrived and is here to stay," says Marsha Diamond, MA, RD, foodservice business development consultant with M. Diamond, LLC., in New York City. That's because hospitals are looking for additional revenue streams.

"Many hospitals found the best way to accomplish this is with a better brand," Diamond says. "This trend of branding healthcare foodservice as an image has been coupled with patient foodservice."

The goal of these initiatives is to transcend the former hospital cafeteria stigma and create a retail environment that exceeds the expectations of employees, visitors and patients. As a result, more hospital foodservice programs are looking at overall trends and adjusting menus to better suit customers. For example, more operations have incorporated healthier options, seasonal ingredients, flavor fusions and updated comfort foods.

In an effort to create healthier offerings, Providence Hospital has instituted Meatless Mondays, Fryless Fridays and 500-calorie meals for $5. Broilers have become more predominant for food preparation.

"Dieticians also are more involved with foodservice operations than in the past," Yesford says. "There are now more synergies between hospitals' culinary and nutrition staff." Speed of service remains a top priority in this segment. "Hospitals not only have to be more accommodating with timelines in terms of providing patient meals, but retail customers also are in a hurry to get in and out," Yesford says. To address this need, Providence Hospital has created a to-go menu for phone-in orders.

Because controlling cost and waste is a big factor in the hospital foodservice segment, as it is for restaurants, portion control awareness has become more prevalent.

Although many hospital foodservice programs are still contracted out, those that are self-operated continue to raise the bar when it comes to performance and food quality. "Self-operated operations are taking more pride in their programs," Diamond says. "These programs have taken foodservice to the next level. Not only will an improved foodservice operations increase patient satisfaction and hospital brand recognition, but it could provide comfort to guests and families, help patients heal and save hospitals money in the long run."

Key Equipment

• Griddle
• Combi oven
• Broiler
• Convection oven
• Steam jacketed kettle
• Steamer
• Fryer
• Wok
• Salamander
• Walk-ins

E&S Considerations

• Versatility: Space is at a premium in hospitals, especially in retail servery operations. Versatile equipment that can be easily changed out provides added menu flexibility.
• Cleanability: Sanitation and food safety are paramount in a hospital setting, so it is imperative that equipment can be easily cleaned.
• Speed of Service: For both patient meals and retail operations, time is of the essence. For this reason, equipment that helps expedite service has become essential in hospital kitchens.

Case Study: University of California San Francisco Medical Center (UCSF)

Q&A with Eric Eisenberg, executive chef Swedish Health Services, Seattle