Tight Spaces, Long Trips

Working in cramped kitchens and shipping food across campuses presents its own unique challenges.

FoodService Director - design - tight spaces - Ohio State Medical Center

The 700-bed University of Iowa Medical Center (UIMC) in Iowa City is one institution where the foodservice department is overcoming design limitations by moving more food at night and using radio communication to help speed its room service program.

Joan Dolezal, director of food and nutrition services at UIMC, says her staff must transport food from a quarter to a third of a mile from their main kitchen to reach patients. "We have this elongated building," Dolezal explains.

"Instead of things going up and down like so many [operators] do in towers, ours is kind of long and spread out."

Kitchen staff prepare and/or transport food nearly 24 hours a day, thanks in large part to the hospital’s room service program, which runs from 6 a.m. to 8 p.m. One major challenge presented by the program has been the lack of dedicated service elevators. Part of the solution, says Dolezal, has been using smaller carts for food transport.

"It makes the elevators a little more accessible," she notes, "as opposed to having a very large cart full of supplies or a lot of trays, and the elevators being full car after car after car. You then have to stand there and wait to find space."

Dolezal has gone to nighttime distributor deliveries, and now has her staff restocking and distributing items to inpatient nursing units, retail areas and vending machines at night. The reason? "Simply because elevators are more available then," she says. "That has worked out very well for us."

Imperfect design: The Spokane Public School district is Washington state’s second largest, operating more than 50 sites for its 30,000 students. The district’s nutrition services department operates a central production facility in a training center—actually a modified middle school—that both prepares student meals and services a $300,000 catering operation. Food deliveries travel as far as 30 miles.

The operation is an excellent example of making the best of what you have. The training center contains an older school kitchen, says Douglas Wordell, RD, nutrition services director.

"I wouldn’t say we’re the model for perfect design," Wordell concedes. “We’ve actually had to sort of 'hodge-podge' it." As far as production is concerned, he adds, "There is nothing really fancy. We remodeled and refit this kitchen. We had to place the coolers and freezers off on one end of the kitchen because it was the only space available. If we had our druthers we would [gut] and rebuild it, but that’s not in the cards."

Deliveries are made using a pair of vans equipped with insulated containers. Another truck, used for summer meals and large catered events, is equipped with a generator. "We will do a conference from time to time and use the truck both for transport and to keep the food hot," says Wordell.

The training center recently added a retherm oven for holding. It was placed in the middle of the food production area, Wordell points out, "just because that’s where we had the space. A part of the theme for the service is that we’re making what we have work as well as possible. Within design you have got to build in flexibility. We have to be flexible with what we’ve got. We don’t have a choice."

Out of the basement: Several years ago, recalls Patrick Bailey, vice president for equipment and supplies dealer F. G. Schaefer Co., Inc. in Cincinnati, his company was approached to design a catering kitchen for the city zoo. 

"With little funding and after searching the entire facility, it was decided to locate the kitchen in a basement area below the main Safari Restaurant," he notes. "This location is immediately off the main foodservice loading dock, [which] allowed for fairly easy loading and transporting of finished product. Walk-in coolers and freezers were located on a portion of the large dock, and dry goods storage space was acquired immediately inside the facility."

"It’s a 76-acre zoo," says Eric Loyall, a district manager for Sodexho Leisure, which manages foodservice at the zoo, "and we have done events in probably every single area you can imagine, from picnic shelters, which are a 10-minute drive away, to the buildings next door." Small satellite kitchens dot the facility. Food is transported to the various venues in insulated cabinets via several means of transportation, including golf carts, traditional carts and vans.

According to Bailey, the basement space provided "numerous challenges for both our design and their operations folks, as well as." Of critical import, says Loyall, is working to make "every step as efficient as possible. That’s why we put the operation in the basement, because the basement is attached to the warehouse and the loading docks."

Vehicle design: Foodservice consultant Georgie Shockey, FCSI, principal of Ruck-Shockey Associates Inc. in The Woodlands, Texas, believes that design considerations must extend to the transport vehicles, such as carts and hand trucks, which she calls the most important component. "The items that are being moved have to be taken into account—bulk food, plated meals or just supplies," Shockey says.

The size of the vehicle—what it can hold and how heavy it is, and hence easy to move—is important. So is the height of the cart, since "most foodservice workers are just average in height. Operators need them to be able to see over and around the vehicle. Also, do you have any level changes to make going in and out of elevators? Going up and down even slight grades can have an impact on how you plan to move product."          

Robotics’ Human Element

Even with Robotics, 'Design is Absolutely Critical,' as OSUMC learned.

FoodService Director - design - tight spaces - Ohio State Medical Center

The hospital serves more than 2,000 patient meals per day. OSUMC’s network-linked robotic food transport carts are run via a wireless network. The automated carts boost quality and safety by permitting staffers to monitor tray temperatures as they travel among the campus’s six buildings. It has also reduced the number of employee accidents associated with pushing and pulling carts.

Half-ton trucks: Each of the mechanized carriers can move as many as 1,000 lbs. They stop for pick-up and drop-off at a series of predetermined locations, using elevators to move between floors. Each cart has a bar code that, when scanned, sends it to the right destination.

The transport system "supports our entire health system," says Jones. "It’s not just for foodservice." In addition to moving meals, for example, it transports trash and trays containing soiled dishes. After they are unloaded at the dish room, the carts are washed, then returned to duty.

"We’re learning more, and we are building new facilities that will open in 2011," says Jones, referring to new cancer and critical care towers that will increase the medical center’s bed count to 1,140 from 800. A key element of the schematic design that will help define where and how food production will be located in the new facility will be the location of the support elevator.

"Before, you would think about sticking (our department) in the least desirable space that nobody else wanted," Jones says. Now, however, the question of location and access is far more complex because foodservice is "a heavy, heavy user of the robotic system."

"We are in the design phase with those facilities," says Jones, "and we are partnered with the robotics group. They not only look at robotics, they also have to look at elevator support and our delivery model."

An important part of the new towers’ schematic design is “how large a footprint robotics takes,” Jones notes. "You’ve got to have cart turnaround space. This footprint always has to remain open for cart movement; you can’t just stop and park anything there because you’ve blocked the transporters that come automatically," she explains. "That’s why design is absolutely critical."

Dumbwaiter, Smart System

Sloan Kettering’s vertical management system is a blessing in design.

FoodService Director - design - tight spaces - Ohio State Medical Center

"Because we’re a large urban hospital—limited space, vertical building—we’ve always had an 'elevator' in the kitchen," says Sharon Cox, RD, director of food and nutrition services. "This really is an advantage to us because we can get a meal up from the kitchen in less than a minute. We do not have to purchase carts with heating or chilling elements."

The 21-floor hospital’s average census is 400, which means 1,200 meals per day or more using room service. Says Cox, "We don’t have the traditional three meals that some hospitals have."

The dumbwaiter system has been part of Sloan Kettering since day one, says Cox. "If you had to try and install it now it would (cost) millions of dollars, and you couldn’t put it in place. A hospital has to be designed with this in mind."

The movement of carts is designed with an eye on the clock. "We have a timer system," says Cox. "When we get one tray on top of a truck we turn the timer on. When that truck has been sitting there for 10 minutes the timer will go off. Whether we have one tray on there in that 10 minutes or 10 trays, we send [the truck] up at that time."

From a design perspective, says Cox, "The bottom line is the system works only when you have a designated cargo master (dumbwaiter) in the kitchen or a dedicated elevator." The delivery route should be walked, she adds. "You need to assess the time, because when you give a service guarantee you have to know within a few minutes how long it’s going to take you to deliver the trays."

The staff uses walkie-talkie style radios for near continuous communication. Says Cox, "There are no whistles and bells to tell you when a truck is coming up. We have to do that by connecting with the person on the floor saying, 'I’m sending a truck up to the seventh floor.' We use those radios to communicate."

Cox’s department uses a heat-on-demand system that involves putting plates on top of induction heaters. "That maintains our hot temperature, and they go into the dumbwaiter, or cargo master, that way." The staff shares the seven lifts with linen and medical supplies departments.