When Northwestern Memorial Hospital in Chicago opened its new $580 million facility in May 1999, the cafeteria could seat nearly double the number of patrons than the old place. The hospital's food service staff was concerned about filling the 13,000-square-foot seating area, which is more than triple the square footage of the previous eatery.
"There was so much extra space that to look at it empty was a little intimidating," recalls Josh Hasson, the hospital's catering manager.
Hasson and his colleagues didn't worry for long: Fueled by new fare featuring gourmet pizza and pastas, sushi, turkey and wild rice soup, and stir-fried bok choy, Northwestern's cafeteria sales are up 35%, compared with before the renovation. On most days, the facility's 655 seats are packed during the lunch rush.
"We have people coming here from the Michigan Avenue retail shops, from Oak Street and even all the way from the Loop," says Sonia Alexander, Northwestern's director of food and nutrition.
Northwestern is by no means alone in upgrading eating areas.
Hospitals throughout the country, big and small, are spending hundreds of thousands, if not millions, of dollars to revamp their food facilities and fare:
* Cedars-Sinai Medical Center in Los Angeles spent nearly $1 million to remodel its cafeteria. The 846-bed hospital's new eating space brims with brushed metal decor and buffet-style serving stations.
* Jewish Hospital in Louisville, Ky., spent $200,000 to redo its cafeteria and menu two years ago. Demand is so high at the 539-bed hospital that patrons can fax in their orders.
* Gila Regional Medical Center, a 59-bed facility in Silver City, N.M., has redecorated and started offering more authentic regional cuisine and gourmet coffees.
Others are in the midst of cafeteria remodeling, including 356-bed Hoag Memorial Hospital Presbyterian in Newport Beach, Calif.; 669-bed University of Massachusetts Memorial Health Care--Memorial Campus in Worcester, Mass.; 149-bed Bi-County Community Hospital in Warren, Mich.; and 1,072-bed Baptist Memorial Hospital in Memphis, Tenn.
Variety of goals. Hospital officials say a new cafeteria can accomplish a myriad of objectives, including boosting employee morale, improving the hospital's bottom line and creating a more pleasant atmosphere for hospital visitors.
"Hospital stays are shorter than they used to be, and revenue streams are less consistent," says Isidore Kharasch, president of Hospitality Works, a restaurant consulting firm in Lincolnwood, Ill. "The best thing they can do in that instance is to find new ways to bring people in."
Food and beverage sales in healthcare settings totaled $17 billion in 1999, a 1% increase from 1998, according to the National Restaurant Association, a Washington-based trade group. Another trade group, the Washington-based National Society for Healthcare Food Management, notes that 62% of meals served in a typical hospital are to nonpatients. That's a major switch from as recently as the early 1990s, when only 25% of hospital meals were served to nonpatients. The association attributes the change to a more business-like approach among hospitals about their food service operations.
Food service executives say managed care plays a significant role in the shifts now taking place. The enormous increase in outpatient procedures means recipients of care are more likely to patronize the cafeteria than in the past.
Such was the case with Northwestern. Along with the increased outpatient foot traffic, its rebuilt hospital combined 22 buildings into just two. "That's vastly increased the customer count," Hasson says.
Moreover, the whittling of margins accompanying managed-care contracts means hospitals have to find every way possible to fatten margins and cut expenses. They can do both by increasing business at the cafeteria, where the economies of scale rapidly decrease operating expenses.
At Gila Regional, where the cafeteria has traditionally lost money, the makeover and new vendor arrangements are projected to cut its food service costs by $25,000 a year, even as revenue has increased nearly 50% from $106,000 to about $156,000 a year.
"There's a desire to be more cost-effective," says Jared Flayer, regional vice president of development at HDS, a Farmington Hills, Mich.-based food service and hospitality company that spearheaded the Gila makeover. HDS has about 100 hospital clients nationwide.
Competition. Hospitals are also coping with the rise of fast food and instant communication. Whereas going to the cafeteria was once the most convenient way of obtaining a meal, a hospital staff laden with cell phones may now painlessly order takeout.
"Cafeterias have to be able to compete with other (food possibilities) out on the street," says Ray Welch, president of the healthcare division of Aramark, the giant Philadelphia-based food service company.
As a result, many cafeteria makeovers boast "demonstration cooking," where patrons can often see the food being prepared in front of them, Welch says. Usually a food service firm such as Aramark, HDS, Gaithersburg, Md.-based Sodexho Marriott Services or Atlanta-based Morrison Healthcare Food Services undertakes the remodeling, often in exchange for 10% to 15% of the projected increase in cafeteria receipts.
The new atmosphere is reminiscent of a shopping mall food court. That's the case with Cedars-Sinai's cafeteria, based on Sodexho Marriott's "Crossroads" branding concept. Under that concept, customers can receive service from various stations that provide theme-based fare, such as Mexican, Italian or vegetarian dishes.
Although Cedars' fare isn't as varied as Northwestern's (which is part of Morrison's "Spice of Life" concept), the daily menu offers a list of solid comfort foods such as fried chicken, pizza, macaroni and cheese, soups and vegetarian dishes such as lasagna and garden burgers. And even though a popular celebrity-packed delicatessen across the street from Cedars beckons customers with rooftop advertising visible from many patient rooms, Cedars' cafeteria sales are up 35% since the remodeling was completed last June.
"It's almost like a fine dining environment," remarks Al Jimenez, a Sodexho Marriott general manager. Indeed, the Cedars dining area is a place so colorful, it's difficult to believe it's in a hospital.
Makeover. Another Sodexho Marriott customer is University of Massachusetts Memorial Health Care, which is undergoing a $750,000 cafeteria remodeling and adding a coffee shop near the main lobby. For years the hospital had offered minimal food service, but it got rave reviews recently when it began offering a full-time breakfast for the first time in nearly a decade. Partly on the basis of that response, the hospital decided to go ahead with a full makeover.
"We give our employees maybe 40 minutes to grab a meal during a workday when they're normally getting flogged," says Robert Freitas, the hospital's senior director of operations. "For those 40 minutes they should have an enjoyable experience."
But for the moment, Freitas is the one getting flogged: The hospital has fallen behind on construction of the coffee shop, which will feature Starbucks coffee and light meals when it opens later this year. It seems the arrival of gourmet coffee can't come quickly enough for the hospital's staff, which is deluging Freitas with inquiries. "I'm getting killed," he says.