The Room Service Journey Glenn Schirg Executive Vice President, Room Service Technologies

In association with

Presented by:

Glenn Richard Schirg, MS

Executive Vice PresidentRoom Service TechnologiesNashvilleTennesseeTampaFlorida

glenn.schirg@gwpltd.co.uk

Adoption of room service was ‘Self Initiated by Food Services to Improve Quality of Service and Care’

Proactive not Reactive

Rationale for Change• Conventional systems in use are based on 40-50 year old

technology. It wasn’t very good then, it hasn’t gotten any better since

• Study showed patients on cycle or non-select menus consumed about 50 per cent of nutrients provided

• Information systems lagged causing large amounts of duplicate tray $

• Food service was perceived as bad and nothing could be done about it

They were wrong!

Faults in the Old System• Limitations on selections

• Too long between time of order and time of meal delivery. In some cases a 25 per cent turnover in patients occurs within 24 hours for ADT or diet change

• Meals were served at the convenience of nursing services, not patient

• Patients served “ready or not”. Like or leave it

• Tremendous waste

• Menus never caught up with patients

What Happened?• Baby boomers are the most highly educated consumers ever

• Baby boomers question everything

• Baby boomers expect quality and service

• The patient/doctor or patient/provider relationship has changed

• Healthcare users see themselves as customers, not patients

• Competition between providers to provide best service is strong. (All doctors are experts?)

Concurrent Events to this Change• Nutrition based software became readily available

• Enables tracking and monitoring of patient meals and intake

• Provides instant counseling for noncompliance

• It is now possible to take a patient meal request by phone and transmit to production areas

• Window between the order and meal delivery is closed. No diet changes, condition changes or interference with tests

Room Service Process• Menus are restaurant style, designed specific to diet regimen

• Patients order at their leisure, specify time of service

• Catering takes order by phone (85 per cent target)

• Foods are prepared a la carte and to order

• Meals are plated, trolleys are dispatched to nursing units in 15 minute increments

• Meals are delivered by Ambassadors

• NO HANDOFFS

Programming• Programs are custom to each facility using shared concepts

• Stakeholders work to develop policies and procedures

• Commitment and buy-in by stakeholders is critical element

• Manner in which patient care is delivered changes

• Requires a change in the corporate philosophy

Major Elements• Insulin/medicine dependent diabetics

• Medications administered with or without food

• Patients requiring assistance

• Identification of resources to assist those patients

• Customer service training for all culinary staff

• Area specific training:– Call Center

– Ambassador

– Cooks

– Tray assembly

From This

And This

To This

And This

Served by Professionally Trained Staff

Having Fun - Job Satisfaction

Catering Service Outcomes• Food Expense reduction ranges from 15-25 per cent

• Labor-staffing increase is the norm for catering but not overall

• Increase is dependent on current system used and who passes/retrieves meal trays

• In many instances, FTEs are transferred from Patient Care Services, as the Ambassadors augment nursing care

• Staff retention

Clinical Outcomes• There is a direct correlation between patient satisfaction and

clinical outcomes

• Studies show that improved patient satisfaction improves clinical outcomes

• Press Ganey states that “If a patient is satisfied they truly are getting better patient care”

• Physician anecdotal comments relate patients “get better faster and go home sooner”

• Patients learn to manage their diets

Patient Satisfaction• Most US Hospitals retain an outside consulting company to

measure and monitor patient satisfaction

• In the United States;Press-Ganey has a market share of 50 per cent

• The following slide reflects the change in patient satisfaction for food service at the Piedmont Hospital in Atlanta, GA, a premier 500 bed facility before room service, and one year later

Data is used with permission

Changes in Patient SatisfactionBefore and After (Press-Ganey)

Halo Effect• Corresponding increase in patient satisfaction with

Nursing Care

• Increase of 1-2 points in overall hospital satisfaction (This is significant)

• Press-Ganey Reference

• Increased market share

• Failure to act = ratings and ranking drops with no change in services

Nursing Service Scores• Medical Cities Hospital-Dallas, Texas

• Uses Gantt Scoring to measure patient satisfaction (4.0 scale)

• Scores prior to pilot program: Nursing 3.4 Catering 2.5

• Scores post room service pilot program: Nursing 4.0 Catering 3.4

• Highest scores ever posted by this hospital

• Unites piloted were Oncology and OB/GYN

Unit Based Staff

Summary

Room service provides the opportunity to create a programme which addresses all of the issues identified in the National Standards for Better Health

Research• University of Wisconsin-Stout

• Masters Degree Thesis

• Completed May 2006

• The research paper is available from GWP at the following web site:

www.gwpdesign.com

The IMPORTANCE Ratings

Three features were rated as very strong:

1. The personal care provided by the Ambassador

2. Ability to choose what they want for each meal

3. The ability to set their own meal times

Many other features were considered strong as well

For Additional Information

Feel free to contact me at:

glenn.schirg@gwpltd.co.uk