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Consulting Report for Haven Hospital

Consulting Report for Haven Hospital . Haven Hospital Food and Nutrition Services Department 555 N. 5 th Street Baltimore, Maryland Nutrition Solutions, Inc. 77 Spruce Street Silver Spring, Maryland Natalie Frison, RD Luz Padua-Perez, RD Submitted 14 October 2013. About NSI .

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Consulting Report for Haven Hospital

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  1. Consulting Report for Haven Hospital Haven Hospital Food and Nutrition Services Department 555 N. 5th Street Baltimore, Maryland Nutrition Solutions, Inc. 77 Spruce Street Silver Spring, Maryland Natalie Frison, RD Luz Padua-Perez, RD Submitted 14 October 2013

  2. About NSI • Located in Silver Spring, MD • Team of 15 RDs • 12 years of experience in Food Service Management and Clinical Nutrition Services • Contracted by Haven Hospital to assist in improving efficiency, patient satisfaction, and sustainability

  3. About Haven Hospital • Located in downtown Baltimore • General medical services: medical/surgical, GI, cardiology, oncology, 10-bed ICU • 250 beds • 100% occupancy rate • For the past 3 years: • Consistent 10-15% decrease in revenue • 50-60% overall satisfaction rates

  4. Outline • Statement of Problem • Assessment and Findings • Recommendations • Conclusion

  5. Problems • Patient Satisfaction with AYR • Menu Content for Room Service • Staffing and Outpatient Nutrition Program • Equipment Purchasing • Sustainability Initiatives • Goals: Increase revenue by 25%, reduce costs by 15%, and improve patient satisfaction by 25%

  6. I. Patient Satisfaction with AYR • Implemented AYR about 2 years ago • Has not improved patient satisfaction as was anticipated • Assessment: • Conducted surveys • Interviewed patients and food service staff

  7. I. Patient Satisfaction with AYR • Found that: • Patients are confused about AYR • Patients are not calling in orders • Room Service Associates lack customer service skills and knowledge of diets • AYR menu is inappropriate

  8. Recommendation 1 • Laminated flyers in patient rooms • Step-by-step instructions on how to place order • Visually appealing • Large font, graphics, bold colors • Simple explanation will increase number of patients calling in to order

  9. Recommendation 2 • RSAs should participate in monthly in-services • Improve customer service skills • Learn about diets and restrictions

  10. Recommendation 3 • Design new menu for room service • Larger font, visuals • Organized into sections • Use symbols for diets

  11. II. Revision of Room Service Menu Selections • Current menu items not appropriate and not cost-effective • Surveys indicated that menu is too “fancy” • Current cost is $7.50 • Reduce to $5.36 • 28% reduction in cost • HS snacks not cost-effective

  12. Recommendation 1 • Replace “fancy” items with popular, less expensive items • Reduce average meal cost per day from $7.50 to $5.36 • Savings of $195,275 per year • 3-day standard menus

  13. Table 1. One-Day Standard Menu Cost Total Cost: $1.71

  14. Total Cost: $1.65

  15. Total Cost: $2.00

  16. Recommendation 2 • Simple, cost-effective HS snack available to all patients • Appropriate for diabetic patients • No other snacks needed • Cost was $3.75 per patient per week • Reduced to $2.37 per patient per week

  17. Table 2. HS Snacks Weekly cost per patient: $2.37

  18. Haven Hospital needs to: Improve nutrition services at the hospital Establish an Outpatient Nutrition Program to increase revenues Assessment: Clinical Nutrition Manager 2 Registered Dietitians: 20 hrs direct pt care; 13 hrs indirect pt care; 7 hrs non-pt care Average number of pts/medical unit Conclusion: understaffed Current budget for nutrition staff: $320,000 III. Staffing and Outpatient Nutrition Program

  19. Recommendation 1: Nutrition Staffing • Hire 1 RD, 1 DTR • Will work at the hospital and the Outpatient Nutrition Program

  20. Recommendation 1:Nutrition Staffing • Assignment of RDs to medical units based on % of patients per unit & RDs experience • RD1: Surgery, ICU, GI • RD2: Surgery, Cardiac, Oncology • RD3 (new): Oncology, GI • DTR will assist RDs • Reduce time spent in indirect pt care & non-pt care

  21. Recommendation 2:Scheduling • For the hospital: • Weekdays • 2 full-time RDs • 1 RD and 1 DTR in the morning • Weekends • Full-time RDs will alternate • Saturday on-site • Sunday on-call • For the ONP • Weekdays • 1 RD and 1 DTR in the afternoon • Weekends • Off

  22. Recommendation 3:Outpatient Nutrition Program • Initially operate Monday-Friday, 1:00 PM-5:00 PM • 1 RD & 1 DTR • Services: consults and education classes • Expand program as revenues increase

  23. Nutrition Staff Schedule ONP= Outpatient Nutrition Program

  24. Assessment: Outdated equipment Affects production Increases energy costs More equipment to meet demands Equipment for retail to increase revenue IV. Equipment Purchases

  25. IV. Equipment Purchases • General considerations: • Essential for Menu/ Production needs • Budget: $20,000 • Increasing revenues for retail • Energy conservation • Reliable brands • Client’s preference • 3 major & 4 minor pieces of equipment

  26. Vulcan-Hart (VC4GD) – 40” Gas Convection Oven • Price: $3,215 • Full size interior: 29”x 22 1/8” x 20” • 5 full size pans • 2 speed fan • 44,000 BTU/hr burner • 1 year warranty • Life: 12 years Why gas? • Cost of gas vs electricity • Client preference

  27. Vulcan-Hart (VC4GD) – 40” Gas Convection Oven • Oven Performance (FSTC/ASTM) • Energy consumption: • Input: 44,000 Btu/hr • Idle: 11,850 Btu/hr • High cooking energy efficiency • Fast cooking times • Heavy load cooking uniformity

  28. Southbend (EZ24-5)-Electric Counter Steamer • Price: $4,317 • Size: 29.5" x 24" x 25" • 5-12" x 20" Pan Capacity • Convection (pressureless) • Connectionless • 15 kW • 1 year warranty • Life: 10 years

  29. Southbend (EZ24-5)-Electric Counter Steamer • Pressure vs Convection • Countertop • Saves Space • Unit mobile (connectionless) • Capacity is sufficient to meet needs

  30. Southbend (KECT-20) – Electric Steam Kettle • Price: $7,055 • Capacity: 20 gal • 2/3 jacketed • Tilting • Countertop • Cook up to 290°F at a maximum pressure of 50 psi • 1 year warranty • Life: 15 years

  31. Southbend (KECT-20) – Electric Steam Kettle • Essential: soups, pasta • Based on production needs (250 pts): • 2-20 gal kettles • Existing 20 gal kettle at facility • Increased productivity patient services & retail

  32. Eagle (SHT4-NG) – 4-Well Gas Hot Food Table • Price: $1,244 • Size: 34.5" x 63.5" x 30.5" • Total: 14,000 Btu • 22 gauge type 430 stainless steel • Eight inch wide polypropylene cutting board • Warranty: 1 year from installation • Life: 10 years

  33. Eagle (SHT4-NG) – 4-Well Gas Hot Food Table • Essential for hot holding - food safety for patients • Gas – saves money • Low energy requirements (3,500 BTU/burner) • Individual gas valve for each well - better temperature control

  34. Bunn (LCA-2 LP)– Coffee Dispenser • Price: $1,513 • Size: 23.2" x 15.78" x 20.9" • 1 gallon capacity • 120 cups/hour • Warranty: 2 years parts, 1 year labor • Life: 8 years

  35. Carlisle (6611) – 6 ft Six Star Portable Food Bar with Legs • Price: $1,971 • Increase sales for all meals • Features: • Acrylic shield to protect buffet • Polyethylene-resistant material • Mobile Unit • Adequate size for cafeteria

  36. 14 Gauge Advance Tabco Premium Series SS-306 • Price: $574 • Size: 30” x 72” • Stainless Steel • 14 Gauge- Heavy Duty • Compensates for space lost with countertop equipment • Adequate size for space

  37. Total Cost of Equipment • Major equipment(> $2,000) • Convection oven: $3,215 • Pressureless steamer: $4,317 • Steam jacketed tilting kettle: $7,055 • Total: $14,587 • Minor equipment(< $2,000) • Steam table: $1,244 • Coffee dispenser: $1,513 • Food bar: $1,941 • Work table: $574 • Total: $5,272 • Equipment Total: $19,859

  38. V. Sustainability Practices • Want to initiate sustainability practices • Assessment: • Looked at current practices • Talked with staff • Considered cost and ease of implementation • Focus on: • Water intensity • Organic and non-organic waste • Carbon intensity

  39. Recommendation 1:Water Intensity • Detect and repair leaks • Cost: Repairing leaks • Advantages: • Prevent water damage • Expand life of equipment • Disadvantages: • Requires time and effort

  40. Recommendation 1:Water Intensity • Increase water efficiency of equipment • Replace old equipment with energy-efficient models • Run only full loads of dishes and load equipment to capacity before using • Cost: Purchase of new equipment • Advantage: Decrease in monthly bills • Disadvantage: Initial cost of equipment

  41. Recommendation 1:Water Intensity • Educate employee, patients, and visitors • Training for employees • Flyers with how to save water and why it is important • Post monthly water use • Cost: Production of flyers • Advantages: Improve water efficiency in hospital and in community • Disadvantage: Motivation of participants

  42. Recommendation 2:Organic and Non-organic Waste • Reduce waste • Optimize production and minimize leftovers • Use reusable dishes • Reusable glasses rather than bottled beverages • Green cleaning products • Cost: Purchase of dishes • Advantage: Decrease monthly costs • Disadvantages: • Initial cost • Increase in labor to clean dishes

  43. Recommendation 2: Organic and Non-organic Waste • Reuse leftovers • “Chef’s Specials” on weekend for entrées and soups • Leftover breakfast meats used for meat pizza • Cost: None • Advantages: Reduced prep and cooking time • Disadvantages: • Space to store leftovers • Customers’ focus on freshly made food

  44. Recommendation 2: Organic and Non-organic Waste • Recycle • Recycling bins in cafeteria, hallways, offices • Flyers to promote recycling • Cost: Monthly fee for recycling • Advantages: • Ease of implementation • Image of hospital • Disadvantages: Motivation of participants

  45. Recommendation 3: Carbon intensity • Reuse organic waste for composting • Coordinate with local farmer • Cost: None • Advantage: • Helping local farmers • Image of hospital • Disadvantage: Need space to store compost

  46. Recommendation 3: Carbon intensity • Increase energy efficiency • Replace old appliances with energy-efficient models • Properly maintain equipment • Replace standard bulbs with LED bulbs • Cost: Purchasing new equipment • Advantage: Lower energy bills • Disadvantage: High cost to replace equipment

  47. Summary • By implementing our recommendations, Haven Hospital will see an increase in revenues, a reduction in costs, and an improvement in patient satisfaction.

  48. Questions

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