EDITOR’S NOTE: This extended narrative from Aatul Jain, system executive chef at Saint Peter's Healthcare System in New Jersey, was received in response to FM’s call for Foodservice Heroes nominations, but the editors felt it deserved a separate treatment not only because of its length but because it eloquently highlights a sometimes-overlooked part of onsite dining operations—product procurement and stocking—that has been under intense pressure the last two-plus years due to the pandemic and its effects on the supply chain. This is particularly significant for dining operations in environments like healthcare facilities, which have very specific product requirements due to the special diets they must accommodate and the nutritional content parameters they must follow.
So, here is the story of one of those operations and the back-room heroics that had to take place to keep staff and patients fed properly, as submitted by Aatul Jain and lightly edited by FM…
It was 7 a.m. on January 10th at Saint Peter’s Healthcare System. Following a busy holiday season, the storekeeper, Larry Russock, was returning to work after a week of dealing with significant COVID-19 symptoms himself, with the Omicron wave in full swing.
Having joined the healthcare foodservice industry just nine months prior, this was Larry’s very first, real-time, real-life experience of COVID-19 surge at the workplace. He had heard stories of bodies being rolled past his storeroom in 2020. Yet, he found it jarring to see the ER department sectioned off with makeshift walls, registered dieticians working the patient meal line (due to several staff being out after testing positive) at breakfast, three cooks doing the work of six and meals being served on disposable trays instead of the nice black ones.
The patient servers were donned in complete face shields and meal delivery carts were being loaded quickly with super efficiency. The operation was humming, and people were on their toes with fewer associates at work, but the mood was glum and the stress in the air palpable. Little did he know that there were an additional eight pallets of paper products and a weird amount of dry food stashed in the temporarily shuttered employee cafeteria to manage the increase in dining volume and food consumption he would have to deal with.
Larry (the storekeeper) and Danielle Placanica (the department’s buyer) oversee every food item, cleaning chemical, paper product and small appliance that comes into Saint Peter’s kitchen for the 478-bed hospital, which also houses an entire suite of food services for its patrons. It had been a challenging few months leading up to this COVID spike.
Danielle worked tirelessly every day to problem-solve out-of-stock issues to ensure that there was no disruption to the patient menu offerings, and enough for the hospital’s employees and the infrequent visitors. This was a daily whack-a-mole situation, which is made an even larger challenge due to the nutritional and dietary limitations posed by substitute ingredients and products, contingent to dietitian approval.
Working with multiple vendors to see which has our specific brand of pudding in stock. How often they can deliver. What our storage capacity is or, if it’s out of stock everywhere, what the ETA is. Do we need to find a substitute and if so, getting the dietetic approval process started so that when it is delivered so it can be put on the line for patients without delay. These are seemingly mundane and petty tasks that took place between a few computer screens, phones, texts and occasional video chats, making every sleepy afternoon a hectic time fluttering with wheeling and dealing activity among sales reps, manufacturers, distributors, RDs, clinical managers, chefs, doctors, the storekeeper Larry and, obviously, the person to close the loop…Danielle, the buyer.
All this was and is still essential to put the entire culinary department’s staff in a position to adequately meet the needs of patients. After all, a 99% Press Ganey score doesn’t come by the supplier simply sending ‘any’ or no sub to an item that’s not available!
As the week went on (and the next several weeks that followed), the patient count surged to numbers never seen in the history of the health system. In-patient volume surpassed those from 2020 and 2021, meaning the hospital was essentially past capacity and likely trying to send patients home at the Emergency Department.
That Friday came another unexpected and important development. Saint Peter’s employs a room service patient dining model. In a utopian world, patients would call in to the call center, speak with a representative, ordering from a robust menu based on their dietetic restrictions from 7 a.m. through 7 p.m., seven days a week. Once their ticket was generated, the meal would be delivered to their room.
Due to the accentuated patient volume, their differing conditions, and staffing shortages across the hospital (there was a nurse crisis and doctors were falling ill too) many patients were unable to call in their orders. The result: the hospital switched to a policy that any patient who did not call in an order would receive a house tray.
In practice, this created about 120 more trays per meal, or about 33% more meals, with about one ticket being printed every 20 seconds to two cooks on the line. Imagine when the printer just kept rolling like a restaurant’s busy weekend peak night…but in this case, it happened three times a day and it had started around January 4th—and the end didn’t seem to be in sight.
This also meant that Danielle, in addition to everything else, now had to procure enough disposable trays and serving ware to keep up with a pace of thousands being used each day, while competing with other buyers (hospitals, colleges and retail operators) in the area dealing with similar circumstances. In a three week span she was able to secure over 45,000 paper trays, which included coordination with the loading dock so that there was a place for them to be stored.
Forget ventilators, we were scrambling for trays and disposable cutlery kits! Let’s not forget the yogurt wars. With a yogurt shortage, the distributor rep would email the customers a list of what was available at 11 a.m. and Larry and Danielle would coordinate how much to order and try to get the order into the website within seconds of that email so the hospital could be allocated the yogurts it needed in real time. What a race for probiotics!
Leaning on the wisdom she gleaned from the first COVID-19 wave, Danielle knew the drill. Check in with vendors, get ahead of everyone else and make sure to stay two steps ahead. And it wasn’t just paper trays or dairy—there was the overwhelming amount of various kinds and cuts of chicken being used daily, there was ensuring that 200 cases of water were in house at any given time, there was assisting other departments in getting access to rapid COVID-19 tests, there was managing an enteral nourishment supplements’ shortage and other transportation and delivery delays, including a six-week lead time for reagents and calibrants (for testing). After all, the buyer had to help the health system’s central buying team with their tasks too. Guess what, they were hit by the bug too! They were short staffed as well.
As Danielle was working her magic, it was Larry’s job to find space for everything that was seemingly pouring in. From the start his motto was ‘Tell me what we need and I’ll find space for it’. PARs for staple items doubled: 80 cases of chicken breast, 60 cases of chicken tenders, 12 cases of mayonnaise, 35 cases of back ordered condiment cups, and, of course, the 45,000 paper trays.
During normal times an average day for him would be unloading about six pallets of deliveries a day. While COVID-19 cases were surging, deliveries could spike to 18 pallets, which would wrap all the way along the kitchen hall, down another small diagonal one, and finally into the main hallway. In addition to taking on the surge of products, it also fell to him to return to ‘normalcy’ once the patient spike had subsided. At the end, within two short days, he was able to convert six pallets in the cafeteria down to two in the kitchen hallway.
In the past two unsettling years, we have acknowledged cooks and servers, waitstaff and bussers, dietitians and directors. But as the global supply chain upheaval continues, we may have overlooked the people who help keep our ‘flow of food’ going.
In textbook descriptions, once a menu is made, the flow of food starts with purchasing and receiving that food. At Saint Peter’s University Healthcare System, NJ, two key people who consistently help the Department of Culinary and Nutrition ensure that our product lines are always appropriately stocked and ensuring excellent patient, visitor and employee care, are the department’s buyer, Danielle Placanica, and storeroom lead, Larry Russock.
Through it all, Larry and Danielle were exemplary members of our team. On one of the first days while a group of us were folding disposable trays to make sure the line was adequately stocked, Danielle reflected, ‘It didn’t matter what anyone’s job was, we were there to help each other’. It wasn’t about WIFM (what’s in it for me) but about WIT (whatever it takes)!
Their dedication and commitment were, and still are, essential to our ability to continue to function. While there are numerous impactful team members throughout the department, I want to make sure these two—rock solid hidden pillars—get recognized for their outstanding contributions, not in creating, cooking, or serving the delicious meals, but ensuring that our guests were kept nourished at all times with a super-efficient access to food!