Tony Almeida will forever be known for being among the first directors of a large hospital foodservice program to implement full-scale room service. Even today, more than six years after taking that step, Robert Wood Johnson University Hospital (RWJ) remains a benchmark model and a must-see site for many other directors and administrators thinking of taking the room service plunge.
That achievement alone would be enough to earn Almeida serious consideration for a Silver Plate. But his career has demonstrated excellence on many best practice fronts. On the retail side, for example, he's taken RWJ's sales from around $650,000 when he first joined the organization as assistant director in 1988, to more than $4 million today.
Winning the 2010 Silver Plate Award in the Healthcare category is simply a well-earned recognition of these and other achievements (for more on Almeida and the RWJ foodservice program, see the cover story in the August 2004 FM)
Almeida has spent the bulk of his career in hospital foodservice, going from serving as a potwasher at Elizabeth (NJ) General Medical Center while still in high school to getting his degree in foodservice management and joining RWJ at a time when the foodservice operation was contract managed (to ServiceMaster).
What’s on Almeida’s Plate?
Annual Retail Sales: $4 million
He played a key role in the transition shortly thereafter to self-operated status, and was named director of the department in 1992. A couple of years later, he took on responsibility for environmental services as well, a department that today employees 200 FTEs in addition to the 155 Almeida oversees in dining and nutrition services.
In 2002, he opened a new, state of the art retail cafeteria called the Dining Room that bristled with self-branded, commercial-style food stations offering everything from deli sandwiches and grilled items to gourmet salads and ethnic specialties. It replaced an antiquated cafeteria tucked away in a basement space with a spacious, colorful 16,000-sq.ft. cafe flooded with natural light from windows overlooking the main entrance.
A concurrent opening in RWJ's Children's Hospital of the Safari Cafe was similarly dramatic — and successful. That new cafe grew revenues from around $20,000 to $210,000 last year.
Catering revenue also has been enhanced under Almeida, going from $200,000 15 years ago to more than $800,000 now.
The 2003 conversion to room service dining is undoubtedly Almeida's signature accomplishment. He had previously received the go-ahead for a major three-phase $3.5 million renovation of his 1950s-vintage kitchen and was in the middle of phase two when administration asked him to consider room service dining.
At the time, room service was confined primarily to smaller hospitals, and to limited use (such as in maternity wards) in a select few larger institutions. Almeida knew that if he was going to do it, he wanted RWJ's service to be “full-house” (that is, hospital wide).
The conversion was helped by administrative support and Almeida's comfort level with new technology. By 2003, RWJ already had a decade of experience with automating dining operations. It was one of the first to implement spoken menus using hand-held order input devices, way back in 1993.
The conversion produced a dramatic leap in patient satisfaction, from under 50 percent to over 90 (96 in the latest survey) on the Press Ganey scale measuring satisfaction with food quality.
First Person Singular...
Who would have thought 20 years ago that technology was going to play such a key role in foodservice? In our room service dining system, we track trays electronically, with bar codes. How crazy is that?
What’s next? Take these iPhones. I actually went out and bought myself one because the hospital gives us Blackberries. It’s like I don’t need a computer anymore because it’s in my pocket. I don’t need to be in my office. I can walk the halls, talk to people, see my customers, then reach in my pocket and get my e-mails, answer them and move on.
We have a sophisticated room service program but the patient still has to pick up the phone and call. I think the next step will be to let them do that at bedside with a computer terminal.
It’s really challenging to get young people to talk to us anymore. How are we going to teach people customer service 10 years from now? They just want to pick up their cell phones and text message everybody. I agree that’s it’s a kind of communication, but in our industry, you have to be face to face. People need to look up, to smile, to say ‘hello.’ At a “culture of kindness” orientation talk I did recently, one young lady actually sat in the back text messaging through my whole presentation. That’s the mentality and, from a management standpoint, we’re really having a hard time dealing with it.
Everybody loves room service dining, but it takes a commitment from the organization because it’s not a cheap program to run. New Jersey is almost bankrupt. We’re following California quickly and the governor is cutting funds for charity care, so the dollars are really starting to shrink and shrink and shrink…
I think we’ve done an excellent job running our retail operation like a business. We’re the owners, it’s our little operation. Remember 20 years ago? We used to give this stuff away. It was a big benefit to the employee. We didn’t have to make money. If we bought it for 50 cents, we’d sell it for 55. Now, it’s a business.
Here at Robert Wood Johnson we have 120 different diet combinations in the university teaching hospital and that was the key when we converted to room service. I knew that if we didn’t get that right, get that programmed properly into the computer, then we were really in deep trouble.
First Person Singular...
When we were designing our program back in 2003 we never anticipated this kind of volume. Back then we were figuring maybe 400 plates per meal. Well, now we’re doing 500 all the time and could probably go to 600, but I don’t know if we could handle more. We now do 1,500 meals a day easy...
We had a really easy transition to room service. We had partnered with another, smaller hospital here in Jersey that had it and we started sending our employees over there on field trips. They got excited because they liked the concept. They came back really engaged and that was big. It was a win-win for us because when they came back they sold it to their co-workers saying, ‘Wow, this is a really cool program, I can’t wait to start…’ It really helped us. The morale started to build.
One thing we’re very proud of here is that we’ve hosted over 90 hospitals from the United States and three international visitors who have come to see our room service program. We’re happy to do it because I think room service dining for the patient is the best way to go.
There’s no better compliment than hearing how patients actually take the room service menu home to show people because they couldn’t believe we have this kind of service. You can’t put a monetary value on that.
My main advice for those thinking of converting to room service is, go see as many as possible, because once you understand the concept, it’s not as challenging as when you first hear about it. For one thing, you don’t need a lot of cooking equipment. We do a 600-bed hospital with a four-burner rangetop. You don’t need to go overboard. The smaller you keep it, the more compact and more efficient you are. At night we can get smacked because everybody’s back from tests and new admissions are in the house, so our guys can be doing 540- 550 meals in two hours on those four cooktops.
I’m excited about the new healthcare foodservice association [AHF] because I thought it should have happened a few years ago. I think it will only make independent self-op operators stronger. One of the secrets to my success, I admit, is our chapter here in New Jersey, the Greater New Jersey Society for Healthcare. We’re a cohesive group and that’s what it’s all about. If you need any sort of information or need help with anything, they’re a phone call away. So nationally, one organization with a lot more members will be even stronger. I think they’re going to get more corporate support and have more funds to do more things for the members.
I think sustainability as a trend is going to continue but the cost factor is going to put some constraints on it. For example, are you going to spend three times as much on organic chicken breast as you are just plain chicken breast? I don’t know. I think that’s a call that’s going to be made by the institution.