A Towering Difference
It’s hard to overestimate the impact a new and well-designed kitchen and servery can have on the morale of hospital employees, foodservice staff and visitors. Case in point: the new facilities recently opened at St. Jude Medical Center, Fullerton, Calif.
Originally built with 100 beds in 1957, St. Jude has grown over the years, adding beds and buildings. But during that time, the original space allocated for foodservice production in the main building remained largely the same and grew more constrained as production needs increased for what is now a 350-bed hospital. The main building’s original small, second-floor servery was built around a steamtable line, beverage station and salad bar, and had one, very limited action station that had been added in a former storage area. Employees still used a dumbwaiter to transport food from the similarly undersized basement kitchen to the servery.
With California’s new seismic building codes, St. Jude determined that the most economical path to code compliance was to tear down and build new. Hospital officials began planning a new seismic safety code-compliant tower in 2008 to replace many of its older buildings, including the main building.
"Preliminary planning and design work required extended lead and review times and extensive coordination with the architect, says Richard V. Dieli, FCSI, Principal at Dieli Murawka Howe Food Service Designers, San Diego, who served as the primary consultant on the project. Construction/buildout began in ’12 and took 18 months, with the kitchen and servery opening with the new tower in November ’14.
“The executive team spends a lot of time with the staff members here and they were very aware of the existing facility’s constraints,” says Karen Cannizzaro, St. Jude’s V.P. of Facilities and Plant Operations. “They wanted to improve the services offered to hospital employees and patients and to provide resources for that. At the same time, they set high expectations for the foodservice team once the project was completed.”
Although the new building’s design constraints meant that the new 9,500-sq.-ft. kitchen and 2,554-sq.-ft. retail servery (and 2,887-sq.-ft. dining room) would not be in contiguous spaces, they would both be on the high-traffic first floor. Facility planning focused on ensuring that movement between the two areas would be as efficient as possible, with a dedicated corridor to connect them. The design team paid special attention when laying out the spaces to ensure that there was room to stage transport carts at both ends of the corridor and that the space before the service elevator to patient floors was clear and accessible. One advantage of the new kitchen is that it has its own receiving dock and is conveniently located near dry, frozen and refrigerated storage areas.
All 2,300 sq. ft. of dry and cold storage space was sized to hold the hospital’s emergency-storage and contingency-planning supplies as well as regular supplies, Dieli says.
Staffers moved offices into the new tower in preparation for opening on a Monday in mid-November ’14 and the foodservice department began accepting deliveries there that week. Since all of the equipment was new to the kitchen staff, training from manufacturers was scheduled for two days in advance of the move.
Retail foodservice continued at the old facility through the following weekend, with patient service migrating on Saturday night, beginning from the new kitchen on Sunday morning. By the following Monday morning, the move was complete.
“It was a crazy time,” says Karen Freeman, R.D., Director of Food and Nutrition Services at St. Jude. “But in retrospect, the advance planning and the tight oversight of our construction project manager helped it go pretty smoothly.”
Expanded Retail Services
For St. Jude employees, the new café represents a dramatic change in terms of ambience, food selection and quality, and service level.
An upscale coffee and smoothie bar sits directly outside the entrance to the café servery and offers baked goods and grab-and-go snacks. Inside the café, contemporary lighting, colored ceramic tile facings and a mix of action stations and merchandisers present a fully modern feel. Digital menu boards at each station show the day’s offerings and nutritional data.
Traffic congestion, which was a problem in the past, has been eliminated by a scatter system that helps distribute customers to five primary serving/cooking platforms around the perimeter of the servery and an island salad bar in the room’s center. (The salad bar is built around—and “camouflages”—a large central column that supports the floors above).
Moving in a counter-clockwise direction, customers find air-curtain display cases with grab-and-go parfaits, pre-packaged salads and a small selection of kosher items. They move past a beverage fountain area to the Grill, a Comfort station hot food bar, a Bistro deli station, the More Than A Pizza hearth-oven station, and finally, to the Innovation station. Here, a rotating menu centers on sautéed entrees and specials, like the streetstyle tacos offered every Taco Tuesday. When demand at the Innovation station becomes too great, the Bistro, equipped with an induction cooker and sauté station, helps pick up sauté production.
Located at the pizza station, the hearth oven has proved especially flexible and has in turn helped expand menu variety at the Bistro deli, says St. Jude’s Executive Chef Will Gotay.
“We recently added pretzel roll sandwiches at the Bistro and if a customer wants, these can be toasted in the hearth oven,” he says. “We also use it to bake breadsticks, hot croissants in the morning, roast vegetables and do things like re-glaze and crisp up chicken.” He adds that the hearth oven also is used to prepare specialty items like a s’more pizza, a snack that was an immediate hit with nursing staff.
The bright dining room area (with windows) was designed with multiple seating options that range from booths to tables for large and small groups as well as outdoor patio seating.
The new servery is open from 6:30 a.m.-7:30 p.m.; it then closes until 9 p.m. when it reopens for limited service until midnight to accommodate night-shift employees. Not all stations are open in the late period; those that are rotate to provide variety from night to night.
Another reason for those late hours are the tower sleep-in facilities for visiting families, a common feature in new hospital designs. “St. Jude has virtually eliminated formal visiting hours,” Freeman says. “Visitors can come and go 24 hours a day and about 20% of late night transactions are guest snacks or meals.”
During the project’s planning stage, St. Jude officials considered moving to a room-service model for patient-meal delivery but decided against it, except for the new mothers wing, Freeman says. That decision was made after an analysis of labor costs and partly because of the nature of the patient base. “Patients today tend to be sicker and older, and we find that a select, spoken-menu model provides better customer service and higher patient-satisfaction scores,” she says. As a result, production is handled with a traditional trayline. Patients receive a trifold, color, restaurant-style menu with about 30 entrée choices plus a variety of sides. Lunch orders are taken as breakfasts are delivered; patients order dinners and breakfasts for the next day after lunch.
Freeman says the new kitchen has permitted an expanded menu selection and significantly improved food quality and plate presentations. “The new kitchen has equipment that the culinary staff did not have before, like a blast chiller, high-speed slicers and the increased capabilities of the new, programmable combi ovens,” Chef Gotay agrees. Freeman adds that patient satisfaction scores were also improved when the department switched from its existing beige plates to plates in multiple colors. This allows kitchen staffers to select a plate that provides a more attractive plate presentation depending on the food ordered.
Behind The Scenes
Café employees provide final finishing production for hot menu items, with advance prep taking place down a corridor in the main kitchen. They wheel station ingredients into the servery during slack periods.
“Our goal is to create most action meals in about three minutes,” Chef Gotay says. In fact, that’s why the planning team decided against a Mongolian grill station suggested in the initial planning. It was eliminated primarily because, “our employees only have a half hour for lunch and speed of service is critical,” Freeman explains. Instead, pre-prep with a quick finish is the service model. In refrigerated cases behind each station, cooks store prepped vegetables and other ready-to-cook items and they hold prepped proteins in heated wells adjacent to where they will be used.
Back in the main kitchen, food carts filled with patient meals queue up to the south of the trayline and runners deliver the carts to the tower via service elevators in the south central portion of the building. Staffers move carts going to other destinations using a corridor that links to other buildings.
Retail service employs disposables so warewashing equipment is sized primarily for cooking tools, patient trays and patient permanent ware.
A number of the equipment upgrades have improved labor utilization. Chef Gotay points specifically to high-speed slicers that have simplified vegetable prep work and to the new blast chiller. “The chiller extends the life of our products and lets us produce more food in advance,” he says. “It also simplifies HACCP log-keeping and makes it easier to get temperatures down well within required time windows.”
The new combi ovens also have extended the department’s capabilities. Freeman says, “at Christmas, we were able to do 200 Cornish hens and prime rib, keeping up with demand to feed 2,800 people in three days. We never could’ve done that before.” She notes that features like variable-speed exhaust fans and demand-defrost refrigeration controls throughout all the new foodservices were among specifications to improve energy efficiency.
After the first year of operation, “our patient satisfaction scores have gone up considerably because of the food and presentation quality,” she adds. Retail customers have shown their approval by “voting with their feet”—retail transactions have grown from about 1,200 per day in the old facility to about 2,400 per day in the new building. Coffee bar sales have grown from $3,000 per month to about $12,000 per month. The café also has begun to attract regular customers from medical offices and other buildings in the area.
ST. JUDE MEDICAL CENTER
Facilities: Main Kitchen and Servery
Opening Date: November 2014
No. of Seats: Main Dining Room: 193; Physician Dining Room: 24
Patient Meals Per Day: 700
Retail Transactions Per Day: 2,400
Foodservice Budget: $2.71 million; Equipment Portion: $1.8 million
V.P. of Facilities and Plant Operations: Karen Cannizzaro
Director of Food and Nutrition Services: Karen Freeman, R.D.
Foodservice Consultant: Richard V. Dieli, FCSI, Principal, Dieli Murawka Howe Food Service Designers, San Diego
Architect/Interior Design: Taylor Architecture, Irvine, Calif.
Construction: McCarthy Building Companies and Petra-ICS, Newport Beach, Calif.
Custom Fabrication: BSI LLC, Denver
Scotsman/Ali Group water filtration, ice machine
Follett ice storage, transport carts
Detecto/Cardinal mobile scale
Baking Prep Area
Baxter/ITW FEG roll-in proofer
John Boos baker’s table
American Panel roll-in blast chiller
Custom s/s overshelf
Delfield/Manitowoc refrig. sandwich tables, drop-in freezers
Vollrath hot food counter/unit
Master-Bilt/Standex mobile ice cream freezer
Dinex/Carlisle pellet-base dispensers
Caddy conveyor, over shelf stations and frost tops, hot food tables, beverage cart, heated plate lowerators
Douwe Egberts coffee maker
Aladdin/Ali Group mobile dome cover rack
Hatco conveyor toasters
Traulsen/ITW FEG air-curtain mobile refrigs., freezer, roll-in heated cabinet
Grindmaster-Cecilware beverage dispenser
FWE transport carts, roll-in racks
Fisher dipperwell w/faucet
Cleveland/Manitowoc steamer, tilting kettles
Rational combi ovens
Edlund/Ali Group can opener
Hobart/ITW FEG mixers, food processor, chopper
Pitco/Middleby pasta cooker, fryers, dump stations
Blodgett/Middleby convection ovens
Garland/Manitowoc griddle, refrig. bases, charbroiler, spreader station
ACP/Ali Group microwave/convection oven
Traulsen/ITW FEG heated cabinets, roll-in refrig.
Metro/Ali Group dish dollies, pot racks, drying racks
Hobart/ITW FEG power-wash unit, dishmachine
Spray Master cart-wash unit
Aerowerks soiled dish table, double conveyor, auto plate rinse units, scrap trough
Salvajor collector with control panel
Metro/Ali Group mobile storage shelving/dunnage racks
Custom s/s work tables, drawers, utensil racks, prep sinks
FWE mobile tray carts, ladder racks
ColdZone/Carrier refrig. systems
Gaylord exhaust systems
T&S Brass plumbing fixtures
ThermalRite walk-in coolers/freezers
Eagle hand sinks/dispensers
Cambro mobile bins
Anthony/Dover reach-in doors
Cambro dunnage racks
Comfort Food/Grill Stations
Ultrafryer/Standex fryers, dump station
Vulcan/ITW FEG charbroiler, range, griddle-top range, cheesemelter, spreader station, refrig. bases
BSI tray slide w/storage
Hatco merchandising warmer
Delfield/Manitowoc refrig. sandwich table, hot/cold food unit
Hobart/ITW FEG toaster
Wells/Middleby roll warmer, soup wells
Vollrath condiment pans, hot food units
Bistro Deli Station
Delfield/Manitowoc refrig. sandwich table
Star Mfg./Middleby panini grills
Garland/Manitowoc induction cooker
BSI sauté station
Delfi eld/Manitowoc undercounter refrig.
More Than A Pizza Station
Wood Stone pizza oven
Delfield/Manitowoc pizza table
BSI cutting board, undercounter holding cabinet, heated shelf, heat lamps
Garland/Manitowoc induction cookers
BSI sauté station, cutting board
Delfield/Manitowoc undercounter refrig.
Vollrath hot food units
Federal/Standex refrig. and heated display cases
Delfield/Manitowoc refrig. cold pans
Silver King/Marmon drop-in novelty freezer
BSI counters w/undercounter CO2 storage
Douwe Egberts coffee maker w/water filter
Follett beverage and ice dispenser, ice maker w/delivery system
San Jamar cup dispensers
BUNN juice dispenser
Hoshizaki C/T ice maker/water dispenser
Gold Peak ice tea dispenser
Minute Maid juice dispenser w/water filter
Federal/Standex refrig. merchandisers
Panasonic microwave oven
Condiment/Specialty Drink Area
Vollrath condiment pans
Federal/Standex refrig. and dry display cases
La Spaziale espresso machine w/water filter
BUNN coffee grinder, brewer, airpots
Beverage-Air/Ali Group mobile undercounter refrig.
Hamilton Beach/Proctor Silex drink mixer
Curtis airpot coffee brewer
Follett soda/water & ice dispenser
San Jamar cup dispensers
Advance Tabco towel dispensers
Metro/Ali Group shelving, racks, heated holding cabinets
Traulsen/ITW FEG roll-in refrig, roll-in heated cabinets
FWE roll-in racks
Eagle hand sinks, dispensers
T&S Brass plumbing fixtures
ThermalRite walk-in coolers
BSI food shields, all counters, heated shelves, heat lamps/lights