A sea of change at UCSF Medical Center

A combination of "luck, timing and passion" led to San Francisco hospital's first major foodservice renovation in two decades.

Dan Henroid, director of nutrition and foodservice at UCSF Medical Center in San Francisco, has a simple philosophy about starting a new job: Hit the ground running. That attitude has served him particularly well at this 650-bed, two-hospital complex, where he became foodservice director three years ago. It helped spur administrators to approve a nearly $8 million renovation of the hospital’s cafeteria and kitchen, which recently entered its first phase.

“You know how people say that when you take a new job you take a few months to get your feet wet, get the lay of the land?” Henroid says with a smile. “I don’t work that way.”

Because he doesn’t, hospital employees will soon see the first major change to their cafeteria in 21 years, when a new deli café opens later this month. The small outlet will include a grill, a grab-and-go element and a Peet’s Coffee station.

The department will quickly follow that opening by closing the main cafeteria for about 10 months. When it reopens in October 2010 as the Moffitt Café, the 379-seat facility will feature a servery with several action stations, a brick pizza oven, a chef’s table and enough cooking equipment that staff will be able to spend less time in the kitchen and more time interacting with customers.

“We have a ton of culinary talent in the back of the house,” says Henroid. “I want to give them a chance to showcase their skills in the front of the house.”

Customers will be welcomed by a digital greeter board and a wider entrance, and their exit will be speeded by a bank of cashiers, including an express line for customers using the department’s cashless payment system.

One of the hallmarks of the new facility will be a large upscale deli and pizza area, to be installed where a wall and bank of beverage machines separates the servery from the dining area.

“We will do anything here you can do in a brick oven,” says Henroid, “pizzas, strombolis, calzones, you name it. If we can do tandoori in there our chefs will probably come up with some menu items for that.”

A Fresh Start station will feature both prepared salads and an area for custom-made salads, and a bevy of “swappable” equipment will give chefs the ability to switch out stations from one type of service to another.

After the Moffitt Café is completed, the 1950s-era kitchen will receive a makeover that will include a pod assembly station that will enable the department to do room service for the UCSF Children’s Hospital, which occupies two floors in the main building.

“We wanted to come up with something that would expand our services, that would stand the test of time and address some of our limitations,” Henroid says of the overall project.

He calls the chain of events that has led to the renovation a combination of “luck, timing and passion.” It began with a repair job on two serving islands in the middle of the cafeteria servery, which were believed to be the source of a leak that was dripping down into the emergency unit.

“We started working on the project and quickly came to the conclusion that we had taken a step backward in terms of the aesthetics of the area,” Henroid recalls.

At the same time, he became aware that the medical center had plans to build a new facility in the Mission Bay section of the city, scheduled to come on line in 2014. Henroid’s department already prepares and ships meals to UCSF Medical Center-Mount Zion, and he was concerned that the kitchen did not have the capacity to take on another satellite operation.

“So, I said, we’ve got the architect and the project manager and we’ve got the resources, so let’s take a shot at the big time,” he explains. Within two months, his team had a proposal before the hospital’s COO, who supported the project to the tune of $6 million. That was “backfilled” with another $1.5 million.

Despite what Henroid and his managers thought about the need for a facelift, selling administration on the project was not an easy task. UCSF Medical Center is simply one wheel in a vast system that is the University of California, and its foodservice department is merely a cog on that wheel. So, to plead his case Henroid played the vanity card.

“I knew the COO had plans to redo the second-floor hallway [outside the cafeteria],” he notes. “So one of my angles was, how is that going to look? You have this brand-spanking new hallway and you walk into a 1988 cafeteria.

“We are No. 7 on U.S. News & World Report’s list of best hospitals no one’s ever heard of and we’re very proud of that,” he continues. “Does that [cafeteria] reflect a No. 7 ranking?”

Finally, he says, he argued for patient satisfaction, an important measurement for hospital administrators.

“If you want to improve patient satisfaction scores in foodservice, do a good job in the front of the house, too,” Henroid explains. “It does impact what nurses say about you. To them, what you do in the front of the house mirrors what people think you do in the back.”

Henroid’s team is eager for the renovation to begin.

“It will change the customer perception of what we do,” says cafeteria manager Frank Rivera. “People who have worked here for a long time are thinking, we’ve had this for the last 20 years, and they’re getting tired of it.”

But there is still a lot of work to do, and some uncertainty about the impact the cafeteria shutdown will have on revenue. The department generates $4.6 million in retail sales annually—4,000 transactions a day—and another $2.4 million in catering. To effect the change, staff will have to convert much of the cafeteria’s seating area to a massive takeout operation. There will be a carving station on the line, but much of the food will be pre-packaged for grab-and-go.

Pizza will be sold in the Moffitt Café Express and, fortuitously, there is another satellite unit on the ninth floor, called 920 Express.

“Elevators in a hospital can be a pain,” says Henroid, noting that there are 16 floors to the main tower. “We thought, instead of having people come all the way down to the second floor, why don’t we go to them. So we identified this space and scraped together the capital to do this.”

The 920 Express is a completely cashless operation that also uses an online ordering system Henroid says is similar to that used by the upscale sandwich chain ’Wichcraft in New York City. The system allows customers to order and pay for meals in advance, up to seven days ahead of service. A ticket is generated 30 minutes before the customers’ indicated pick-up time, so that their meals can be packaged and ready to go when they arrive at the cafeteria.

Henroid says this system will be moved to the Moffitt Café Express once it opens and should ease traffic flow and help maintain business.

Another timely program should also help with takeout business. In May 2007, the department switched to all disposable serviceware for the cafeteria. The move helped save labor, because staff are no longer required to sort dishware. In accordance with the UC system’s policy on sustainability and the environment, all serviceware is compostable, resulting in 84% of the waste stream being diverted from landfills to recycling.

Still, managers are understandably concerned about the toll the renovation will take on staff, as well as number of competitors in the neighborhood waiting to snatch up their business.

“There is going to be a lot of work to get everybody ready,” says Associate Director Jack Henderson. “There are going to be some long hours around Christmas, and we’ll be switching some things literally overnight. We’ll have to work hard just to keep sales where they are. But we’re all pulling together. This project has been a great unifier.”