Mayo Clinic points the way forward in healthcare dining service

The Mayo Clinic is one of the most celebrated medical institutions in the world, famed for a series of breakthroughs in treating patients and curing diseases. Perhaps not as prominent as its clinical achievements but still playing a critical role in the organization’s culture is the quality of the patient and staff foodservice operation, which has been the responsibility of management company Morrison Healthcare for the past five years. Over that period, Morrison has implemented a number of innovations that have enhanced the quality, variety and accessibility of foodservice at Mayo Clinic locations.

“At the end of the day our goal is to make our operation as flexible as possible so our staff can eat what they want when they want while making those better-for-you choices easier for them,” offers Operations Administrator Kelly Morse Nowicki, who oversees Mayo Clinic’s dining program. To help achieve that goal, she says “we implemented scan-and-go, self-checkout, app-based ordering with a delivery model and more unattended retail as well, converting more of them away from the traditional vending and more into micro-markets. We’re even looking at making some of them a hybrid where we can have an attendant during certain times and have hot food, and then keep it at 24/7 operation for after hours.”

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Morrison was selected as the management company operating dining services at Mayo Clinic through an RFP developed with the assistance of consulting firm Innovative Hospitality Solutions (IHS), which has been working with Mayo Clinic as a “trusted advisor” for the past six years, says IHS Principal/COO Gary Gunderson.

“Kelly [Nowicki] refers to her team as a ‘three-legged stool’ with the Mayo Clinic leadership team, Morrison and IHS all really at the table,” he observes, “and what we have seen over the past five years is that it has been one of the best [foodservice] programs in healthcare.”

“I think what Kelly has accomplished at Mayo Clinic is going to spill into other hospital systems,” adds IHS Senior Associate Laura Lozano. “We know this because of the calls we get from other systems about them and what they’re doing.”.

Technology and customization

Mayo Clinic’s app-based food ordering system allows a degree of customization—diners can customize their grain bowl orders, for instance—but the primary driver of meal choice is the range of options being offered, Nowicki says. “I think what’s important to highlight is that we feel variety is the best option for us to meet our customers, who are very diverse, so being able to have variety to meet them where they’re at” is important.

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To achieve that variety, Mayo Clinic Dining offers many different cuisine concepts, though what and how many are offered depends on the location as some retail markets are bigger than others and allow for more station opportunities.

“If it is a smaller space, we would have more of a weekly rotation,” Nowicki suggests, “but they always have variety there, and then we also have some of the made-to-order [platforms] that can still allow that customization. Our omelet stations oddly are the most popular, and those obviously are easy to customize. We really try to make things so that people can enhance them the way they want them.”

The remote ordering system has a delivery component through which, for example, nurses can place an order and get it delivered up to their unit in the time frame they’ve chosen. Currently, deliveries are made by staff members, but Nowicki says she would love to see robots take over this task at some point.

Mayo Clinic’s main complex is in Rochester, Minn., where it spans two campuses: the massive St. Mary’s that is one of the largest in the country, and the smaller Methodist campus, located a couple block away. Each has a main cafeteria and satellite retail options, some manually attended and serving menu items like custom-made coffee drinks and panini sandwiches, while others are unattended retail spaces stocked with grab and go selections and situated closer to where hospital staff work “so they don’t have to walk far,” Nowicki explains.

Meanwhile, technology allows the cafeterias to be open 24/7, though not all stations are open all the time.

“That’s the beauty of having this scan-and-go and self-checkout system,” she says. “With those cafeterias being 24/7, people can go down there any time to get something to eat or drink and relax.” To accommodate round-the-clock service, the program increased its grab and go selection and added bowls that can be heated to provide a fresh-made option, “so even if we don’t have stations open, you can still get something that isn’t just from a vending machine.”

There’s also a ghost kitchen at St. Mary’s that has been operating for about a year, serving an extremely popular naan flatbread pizza that can be made and ready for pickup quickly. Another, more extensive ghost kitchen operation was opened in Mayo Clinic’s Florida campus in Jacksonville “and we’re learning a lot in that experience because it has a lot more customization, so the wait times are longer,” Nowicki explains. Despite that, however, “the staff is really happy with it, especially having it available in the third shift, which is something we’ve never done down there.” The Florida ghost kitchen operates 22 hours of the day, only closing two hours overnight for cleaning.

A flexible approach to patient dining

“In an ideal world we would be 100% room service,” Nowicki suggests, but while most locations are, she notes that there are exceptions driven either by the clinical priorities of a specific unit—behavioral health locations, for instance, prefer all meals to be delivered at set times with nurses then delivering the trays—while others are out of operational necessity.

“We work with our critical teams to adjust our [patient meal] delivery and service, and we’re also not immune to staffing challenges, so in some locations it has been easier for us to deliver meals on a set time given available staffing,” she explains. “As we come out of the staffing crisis, we’ll go back to room service to the degree it makes sense, but in some of our smaller critical access hospitals that have very low daily census, we’ve found that delivering at a certain time works almost better than room service and everyone seems to like it more, so we’ll probably keep the blended model [in those locations] going forward. This is something that was born out of necessity, but actually turned out to work quite well.”

Menu diversity and authenticity are other critical components of the Mayo Clinic dining program, serving not only a culinary mission but a social one.

“We’ve really been challenging our team to think of menuing as part of Mayo Clinic’s inclusive agenda,” Nowicki says. “We work very closely with many of our ERGs so that it resonates with the diversity of our customers.”

Thinking in diversity terms in menu development not only helps the program provide satisfying meal choices for customers’ varied preferences but extends overall menu variety.

Making menu choices safe and as healthy as possible are other priorities. Nowicki cites the growing need to provide selections that are free of food allergens beyond just the most common ones, and of course a healthcare facility has to accommodate a variety of diet restrictions—Mayo Clinic, for example, currently has more than 150 diets listed in its in-patient menu database.

Prominent among special diets is vegetarian/vegan dining, and the program is “aggressively” adding more plant-based dishes, she says. Also getting extra attention is reducing sugary beverages in favor of healthier hydration alternatives like water.  

“While we certainly still offer a full variety of beverages, we’re really focusing on hydration, for example by having our value meals come with water as an add-on rather than a soda,” Nowicki notes. “We’ve really been able to drive out a lot of sugar this way and really not see a dip in our retail sales despite the changes.”

Another health-based priority is reducing sodium content in dishes—a big challenge when it comes to patients on salt-restricted diets who need to eat but find low-salt dishes to be bland and unappealing. To counter that, Mayo Clinic recently initiated a pilot program with cardiovascular patients at its St. Mary’s campus in which they were introduced to three specially developed Mayo Clinic spice blends designed to serve as healthy flavoring alternatives to salt.

“We basically learned two things,” Nowicki reports. “One was that it got them to eat more, and the other was that it gave them a sense of control over their food, which is important for hospital patients because they have so little control over just about everything else.”

With the successful pilot, the dining team is now looking at expanding the program and creating spice blends for all patients.

The way forward

Given the challenges that the healthcare foodservice market has faced over the past several years, Nowicki says she sees a growing need for flexibility going forward.

“I think the future of dining and foodservice in healthcare needs to have a robust, multi-faceted approach,” she suggests. “We need to make choices on the wellness side, on what’s better for the environment and on making everything safe and delicious, but we also can’t forget about the hospitality side. Hospitality isn’t necessarily just bringing food to the table in a restaurant style, but it is the experience. We are a 24/7 business, and we want to make sure that staff, patients and visitors can get what they want to eat when they want to eat it.”

Nowicki says she jokes with her staff about how “I don’t want our customers to feel like they have to go on a commute to the cafeteria to get their food because a lot of them only have 30 minutes for breaks.”

She cites one of her staff members who tracked the time from her office to the cafeteria and back at 23 minutes. “That’s why I get really passionate about the technology side of the world and how it can bring food closer to guests and patients. You want people to enjoy it when and where they want to.”