How Harris Health successfully made the transition to self-op

When an operation has contracted out its foodservice for nearly two decades, making the leap to self-operated can be daunting. But it can be done.

For Harris Health System in the Houston area, a few details had changed over 17 years of contracting out—after a decade with one foodservice vendor Harris switched to another, and at one point the hospital system had gone back to managing the foodservice labor—but generally the situation had remained status quo.

And no one was thrilled with the status quo.

Patient satisfaction scores about the food were middling. Retail customers didn’t love the options at the cafes on Harris's campuses, with myriad complaints from customers and patients alike—including that nearly every menu item contained meat. Performance metrics weren’t being met (though the team granted some lenience due to factors like Hurricane Harvey in 2017).

Plus, employees were unhappy about several aspects of work, even down to details like $5 incentives to recognize a job well done: The rewards were designed to be redeemed for healthy food items, but only a measly two menu options—a yogurt parfait or fresh fruits—qualified under those healthy guidelines.

The irony of that last point encapsulated the problem for Shweta Misra, who became Harris’s Food Service Director in early 2018.

At first, she tried to solve the problems from within: In one of her first moves, for example, she removed a liquid butter-style product that was high in sodium and replaced it with real butter and olive oil. Bigger changes quickly met roadblocks, however.

“I had a lot of thoughts about what could be changed, but when I spoke to the [vendor’s] team, they said, ‘Well, no, these are the recipes and this is how we do it.’ ‘We have a lot of meat because it’s Texas.’ That kind of thing,” Misra says.

After a few months of speaking with the vendor’s team and with Harris corporate, the next step was clear. Misra would make a case for Harris Health System foodservice to go self-op, and she planned to start everything entirely from scratch.

With support from Harris Vice President of Operations Christopher Okezie, in 2019 Misra began creating a business plan to ultimately present to senior leadership. But the following year brought to Harris the COVID-19 pandemic, a new CEO and a survey report from the Centers for Medicare & Medicaid Services that required corrective action plans.

“We were flying a plane while we were building the plane at the same time,” Okezie says of that period. “From a human emotion perspective, it really did feel like the anxiety that goes with flying at 50,000 feet and trying to make sure every last detail is taken care of.”

What spurred the team on, he said, was the staff’s desire to bring foodservice entirely in-house.  That staff buy-in was helpful for motivation, but Misra and Okezie also had to make a business case to senior leadership. It costs more, of course, to purchase healthy, fresher foods. Inflation meant food prices had risen, especially since senior leadership hadn’t been updated on food costs in a while.

“We had to explain, ‘Yes, this deli meat we were using costs 99 cents a pound, but this new one has pronounceable ingredients. It’s better for the employees, the patients, the families and everyone who comes to Harris,’” Misra says. 

Presentations abounded as they explained all the needs: new positions like a corporate chef and dietitian, revamped retail concepts, necessary technology and more. Ultimately, senior leadership was convinced, and the plan moved ahead in the peak of the pandemic: First, Harris’s retail locations began to move to self-op in May 2021, and patient-side foodservice did the same in August 2021.

Patients suddenly had a bevy of choices, with plant-forward options always available: Chinese ginger flank steak or sautéed tofu served over steamed rice with broccoli; chicken or vegetable pot pie with seasoned green beans; beef or chickpea meatballs over spaghetti with organic marinara and roasted broccolini. Retail customers were greeted by new concepts like the Local Foliage salad bar and Southern Soul comfort food station among many others, which serve hot entrees, made-to-order deli sandwiches, homemade soups, grill items, pizza, barbecue and more.

Patient meals were also transformed to include more plant-based options. 

Still, Okezie says, “it’s not easy, from a business perspective, to try to win back people who had lost confidence in the quality of our offerings.”

It did take time. But eventually, the team overheard Harris staff telling each other in the halls about the great falafel dish they had at lunch. Employee turnover dropped. Retail customer satisfaction scores ultimately leapt from 71% to 98%.

Yet it was a single compliment from a tough customer that showed Okezie the changeover was truly working. A doctor at one of Harris’s hospitals, known for his calorie counting as well as his high standards, stopped Okezie during a visit. Okezie braced himself for a complaint.

“Instead he said, ‘The salmon sandwich I had at lunch was the healthiest, most delicious, simply best sandwiches I’ve ever tasted in my life—and it was less than $5!’” Okezie says. “The accolades and ratings are always nice, but it’s those smaller a-ha moments that show you’re capturing something entirely new.”

At only about two years in, Harris’s self-op foodservice program is still relatively new, and Misra has several plans for the future: culinary training for dietitians, medically tailored meals through a home hospital program and more.

For other operations seeking to make the leap to self-op—or even simply preparing for a different kind of operational change—Okezie stressed the need for staff buy-in.

“Any time you’re looking to make a big transition, if you can get your people fully subscribed to your vision you’ve already done 70% of the work,” he says. “When you empower them through skills training, communication and explaining why you’re doing what you’re doing, they’re going to bring their excitement and their ideas. People like me need to empower, listen and then get out of the way.”
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Get to know Harris Health’s Shweta Misra

See what’s in store for Misra’s operation, which was named FSD’s November Foodservice Operation of the Month.

Q:  What is it that makes your operation excel?

People here really care for the patients. It’s the whole corporate culture. [Our CEO] Dr. [Esmaeil] Porsa always says, You start by leading with love. That is, in a nutshell, what we’re about and why there’s never a day that I think, Ugh, I have to go to work.

Leading with love is our core motto, and it means thinking about the person beside you before you think about yourself—thinking about how you can make their day better. As just one example from the top, Dr. Porsa sent me an email telling me I had kept my promise [about improvements in the foodservice division]. A CEO does not have to take time out of their day to share that. But he did, and it meant so much. He was happy with our work, and he sent me a message that made me and my team happy and energized. That is leading with love.

Q: What are your goals for the operation in the coming year? 

We still haven’t gotten to my ultimate goal, which is to be the best-in-class [foodservice operation] in Texas. To get there we’re working on several [initiatives]. One of them is starting in January, in which our dieticians will go through a rigorous culinary training program. They learn about nutrition in school, but not actually culinary. When you learn how to chop, to grill, to handle a knife, those tools and resources inform how you approach it.