Stories from the front lines: Establishing foodservice in alternate care sites

Spectrum Health, a major not-for-profit, integrated, managed care healthcare organization based in Grand Rapids, Mich., operates 15 hospitals across Western Michigan along with a dozen urgent care centers. When the coronavirus pandemic hit, the system needed to be ready for dealing with potentially large numbers of infected patients at not only its own facilities but also in alternate care site (ACS) locations.

While establishing the clinical and patient care infrastructure of such sites necessarily received the most attention, other areas were not neglected—including provision for patient and staff feeding. What went into developing and deploying capacity in this area? As part of a submission to Food Management about its response to the COVID pandemic, Kevin Vos, senior director of hospitality support services for Spectrum Health System, outlined how the system approached this challenge. Here’s his story.

Photo credit: Spectrum Health System

Photo: Kevin Vos, senior director of hospitality support services for Spectrum Health System

“Part of Spectrum Health’s surge capacity plans in preparation for continued community spread of COVID-19 involved coordinated activities across our system include leveraging our hospitals as efficiently as possible. Examples include converting medical surgical beds to accommodate ICU-level patients, ensuring all semi-private rooms are appropriately outfitted and considering alternative sites of care such as the Cook-DeVos Health Sciences Building at Grand Valley State University. Representatives from all disciplines were actively engaged in this comprehensive process. Our planning teams deployed resources and supplies as needed to meet the needs of our system COVID-19 preparedness and response efforts.

Food service in an Alternate Care Site (ACS) is an often-overlooked part of planning, yet it is essential to both the patients and the staff. When evaluating the ACS plan in 2006 with Grand Valley State University we knew that food service was a mandatory part of the playbook, but how could we operationalize feeding up to 400 people (patients and staff) in a university setting? We know that food can be provided anywhere, but the optimal location for the team within a building has to be carefully planned.

Team members in this type of work environment will experience stress and fatigue at higher rates than their normal duties. While many things can be done to reduce this, the nutrition team can play a large role in reducing stress by providing the right food at the right location. During our build of the ACS we converted the pre-existing food court in the lobby into a snack and coffee bar. This allowed our staff to replenish beverages and food on their way in and out of the facility. We also worked with community coffee services to ensure that coffee and water was available in all break rooms. Setting up a dine-and-deduct program for the snack bar allowed for the food and nutrition team to staff this space minimally while providing a service to our employees that they expect when coming to work.

Then we turned our efforts to patient meals and how Nutrition Services could provide patient food at this Alternative Care Space (ACS). This involved looking at all aspects of critical control points of food production: storing, preparing, holding, service and sanitation as well as logistics and utilities. This started with a review of our current Nutrition Services emergency preparedness policy and the current emergency menu. Then the culinary production team augmented this menu to develop a five-day cycle menu with meal alternatives for vegans, altered consistency and allergen-sensitive patients that could be executed from an educational building two blocks away from the main medical campus.

Next was to consider the logistical planning for food transportation from the main medical center to this location as there was no production kitchen on site to use. In addition, we had to outfit the ACS for meal service and sanitizing all equipment used to serve patients once the hot food arrived on-site. This involved determining a location within the educational facility. Utilities had to be carefully planned to allow for enough power to run equipment. The typical power service provided in a university classroom allows for computers and projectors but may not allow for cooling and heating units and does not take into consideration coffee pots and drink refrigerators. We were able to offer this in our ACS by increasing the number of outlets and circuits to the classroom that we were using. This was a pre-designed plan that took the electrician team just a few hours to complete. By ensuring that the greatest amount of circuits was being used, we decreased the risk of equipment failure and electrical failure in the space.

Providing food service for patients is not a simple task, while establishing the ACS we had to ensure that the team had

Finally, we had to build out our dietary software with new room locations and patient beds assignments.

In summary, this undertaking involved collaboration between many different teams from the hospital all led by our Emergency Preparedness team. The Emergency Preparedness Department facilitated the two-week planning that allowed Spectrum Health to work through barriers very quickly and effectively.  We are thankful for the partnerships that Spectrum Health built with Grand Valley State University prior to COVID-19 that helped us not only succeed but exceed expectations while we built out our alternate care site.

Thankfully Spectrum Health did not have to open this new service location, but the exercise was invaluable to testing the emergency preparedness plans across our system. And in the end, the lessons learned have been captured and will inform the next iteration of the Nutrition Services Emergency Preparedness policy.”