Five Questions for: Walter Thurnhofer

As the weather turns cold and flu season kicks into high gear, some operations are putting restrictions on when employees can come to work and where visitors can go in hospitals. The hope is that these guidelines will help prevent the spread of H1N1. FSD talked with Walter Thurnhofer, assistant administrator of support services at the 450-bed University of Washington Medical Center in Seattle, to find out about employee restrictions and the department’s switch from self-service.

What restrictions has the hospital placed on employees?

We had a meeting with all staff in the hospital and told them every day you need to self-screen and if you have any of the following symptoms—fever, cough, sore throat, runny nose or nasal congestion—you need to stay home. In the winter people are going to have those sorts of things and it’s not necessarily the flu. You can get a runny nose just because of the weather so people have to be cognizant of what’s causing it. But if you have any of those symptoms you can’t come to work and you can’t return to work until those symptoms have resolved for 24 hours. So if you wake up with a fever or a sore throat and it takes two or three days to clear up and you feel better and want to come to work you can’t come for 24 hours. Now that’s probably good practice anytime, but with H1N1 it’s made everybody more aware of what’s going on. We have trained our supervisors to essentially check employees as they come to work every day to look for these symptoms. If somebody is sneezing or coughing, they pull them aside and have a conversation with them about their symptoms. If there are any questions, we send them up to employee health and if they verify those symptoms they go home immediately.

Have you seen a lot of foodservice employees who have been sent home because of these restrictions?

We haven’t had too many problems yet. We’ve had at least one case that was confirmed H1N1 in one of our employees in the department. We’ve had a number of cases of flu-like symptoms. We’re really just getting into the flu season so I expect it will be an interesting few months. These guidelines went into place in October.

Out of a staff of about 200 employees, we’ve probably had about 20 to 25 who have shown some kind of these symptoms and been restricted from work—either self-restricted or we have sent them home. We’ve had a fairly good chunk already just in the last couple of months. This is definitely above average. You are always going to have one or two people here and there who call in sick, but we have made people so aware and we are checking so closely that that number is probably well more than double the usual amount.

How are these restrictions affecting how the department runs?

We’ve set up a system where every department has to call into a central staffing office twice a day or by 8 a.m. and 4 p.m. and register what their department staffing level is and whether they are having any implications for service because of short staffing. So far our department has not had any significant impacts, but we have a system set up to monitor that. If a department says, “We’re just getting hammered today and half our staff is gone,” if there are things that other people can do to help them, other departments will send staff to help the department that is in trouble.

For instance, in food and nutrition you don’t need to be highly trained to transport trays up to the floors up and back. Anybody can be trained to do that in a matter of minutes. Or we could redeploy some of our dishroom crew into other functions that they are cross trained for and bring people from other departments into run the dishwashing program with some oversight and a little bit of guidance. We can’t bring in a nurse to cook meals because they wouldn’t know what they are doing, but we do have this cross-coverage scenario set up through our disaster response plan.

I expect these restrictions will be forever. The good news is during certain parts of the year, you don’t get a lot of flu activity.

What restrictions are in place for visitors in the cafeteria or other retail locations?

We don’t have any restrictions in our retail operations for visitors or employees.

We have customers who have been concerned with self-service and the spread of pathogens and we’ve had concerns ourselves. The truth is the flu has been around forever and it kills tens of thousands of people every year and it sort of intrigues me that this one strain of flu has caught everyone’s attention so much. Be that as it may, it’s probably a good thing to make people aware of flu in general and people are now starting to say, “Hey, isn’t self-service a good way to spread pathogens from person to person?” and it is. These buffets, self-service, all-day operations are problematic. We can screen people at the door and put out hand sanitizer, but the fact is that some people are going to come through who didn’t wash their hands in the bathrooms or have flu or cold issues and have been touching their nose or eyes and then handle utensils. Then the next person comes along and it’s transmitted.

How are you responding to these concerns about self-service?

We are in the process of eliminating our self-service program completely. We have had in the past a beautiful self-service make-your-own sandwich bar with all kinds of wonderful things on it and we’ve already eliminated that. We do have made-to-order sandwiches at the grill and deli, but we no longer allow the self-service sandwich bar. We do still have a salad bar and we’ve requested money—about $150,000—to totally tear it all out, revamp it and have made-to-order and grab-and-go salads. We are going to expand our made-to-order sandwich operation and put in a display cooking station. People like to make their own stuff, but many people understand the risk you incur that is just inherent in these open food bars. We want to give customers something back so they feel like they haven’t lost anything but have gained something. I expect will get funding approval for that.

We have a wonderful infection control staff and they are very supportive of making this change and have been encouraging us to do it. We will have no self-service other than things that are fully wrapped, grab-and-go type things. In terms of open, exposed foods we will have virtually nothing.

Something else that came up that we didn’t think about initially was our flatware. We have it out and people can grab a fork or spoon. We have disposable serviceware. We are in the process of going to the single-serve dispensers so that nobody can touch your fork or spoon but you. We’ve had lots of customer comments about this; they don’t want somebody getting their fingers all over the fork they are going to eat their lunch with.