St. Charles Health System adapts to COVID—and preps for the future

Many foodservice organizations spent the spring of 2020 scrambling to keep up with the dizzying changes brought about by COVID-19. But at St. Charles Health System in Bend, Oregon, Food Services Manager Thom Pastor was taking a proactive approach to ensure his hospitals’ meal programs could continue running as smoothly as possible.

“We were looking at Italy and New York when they were getting overrun. We didn’t think we’d have any reason to avoid that scenario, where we were many times over our capacity and wouldn’t be able to serve normally,” Pastor explains. “We started to make a lot of changes.”

That started with making sure Pastor and the other leaders of the healthcare system’s foodservice team were never working in the same location at the same time. Even if one hospital experienced and outbreak and one of the leaders got sick, all of the leaders wouldn’t end up out of commission at the same time. “Three of us could operate our four hospitals reasonably well,” he explains. “We always wanted to make sure we had somebody available to lead our teams.”

Pastor and his team also developed serving plans that could be implemented in the event that the hospital was over capacity and was short on staff. In normal times, St. Charles Health System offers menus for hundreds of special patient diets. But the emergency plan would mean moving to non-select tray service, with just a few limited exceptions. “Working with our dieticians, we determined that diabetes, the top eight food allergens, and texture-modified diets were the only special diets we would acknowledge in our disaster plan,” says Pastor. “That would allow us to not have to modify as many meals, and we’d be able to serve a lot more people than normal with fewer qualified staff.”

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The plan also included the option to shift to block-style service to ensure every patient would receive every meal. “We divided each hospital into different zones. The largest hospital had nine zones, for instance, and we’d deliver meals to the zones in order. Right after zone nine got lunch, zone one would be getting their dinner delivered,” Pastor explains. A test run with 50 patient rooms proved successful. “Nursing was involved to make sure they understood the process. We wanted to make sure the timing was really right. And it was a really good test,” Pastor says.

Thankfully, none of the foodservice leaders got sick and the disaster plan never had to be implemented. But COVID has brought about opportunities for other changes that have been put into play—and will likely persist beyond the pandemic. Early on when the virus’s surface spread wasn’t well understood, Pastor opted to move to a cashless payment system. “We learned that our cashiers loved it. They always felt kind of icky handling cash, like their hands weren’t clean,” he says.

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There turned out to be other benefits too. “We reduced the risk of cash loss through theft and were able to repurpose multiple hours of labor every day that were previously spent on cash management tasks,” Pastor explains. Occasionally there’ll be a customer who can’t pay without cash. “We keep quiet about it, but it’s a lot cheaper to comp them. We don’t see any reason to bring cash back in the foreseeable future,” says Pastor.

Pastor and his team also started placing 5x7 acrylic sign holders on dining tables that listed the table’s seating capacity, with instructions for diners to knock the sign over when they were finished eating. “It allows our cashiers and attendants to scan dining areas and go directly to the dirty tables and not worry about the tables that are clean,” Pastor explains. “That reduced their busy work and ensures tables are clean for customers. It’s been a big win.”

Overall, the pandemic has taught Pastor about what it means to be truly prepared for an emergency. While his team had always had disaster plans in place, he now knows those pre-COVID plans weren’t enough. “Stuff could go wrong at a large level,” he says. Today, the team’s pandemic-inspired disaster plan is built on flexibility. “We can stand it up or shut it down quickly. We can operate it at one or all four hospitals. We can continue to reduce our offerings and be able to flex into an unqualified staff,” he explains. In short, they didn’t have a plan that could meet the massive-scale challenges of a crisis like COVID. “But now we do,” he says.