H1N1 Battles

As fears about the spread of H1N1 in hospitals heated up last fall, several hospitals across the country put restrictions in place for both visitors and staff. These restrictions have affected foodservice departments by decreasing sales and leaving staffs shorthanded.
In some hospitals, visitors are being restricted from the grounds, including the cafeteria.

Last fall at 211-bed BroMenn Medical Center in Normal, Ill., the community was told not to come to the hospital unless necessary. “Originally there were cases of H1N1 and it was huge,” said Karen Mellon, hospitality manager. “I think the cases have diminished and so has the excitement, but in the spring the flu season hits and I’m sure it will be back again.”

Mellon said since the hospital’s administration put out the word to stay away except under certain circumstances, people have listened. “For a few weeks the extra traffic through the hospital was kept to a minimum,” Mellon said. “I think that people did heed the warning. If you had a husband, wife or child in the hospital you were here, but if you were coming to visit an aunt or uncle I think it restricted those people. I think that at that point people hadn’t had the H1N1 vaccination and I think they were all scared of that. The elderly folks just avoided coming here as much as possible.”

Cafeteria sales dropped during the weeks when the restrictions were in place. “There wasn’t much that we could do,” Mellon said. “We had to understand that there was a reason for the restrictions and hope that they were temporary. The flu thing could have gone both ways. It could have gotten worse, but it’s leveled off, at least for right now.”

Other hospitals are banning visitors under the age of 18. Mary Washington Hospital and Stafford Hospital Center in Fredericksburg, Va., are two hospitals in the state that restrict visitation, according to an article in The Free Lance-Star. In late October, the hospitals, along with others in the state, adopted a color-coded policy of whom would be allowed to visit the hospitals. According to the paper, the hospitals were placed under the yellow code, meaning visitors under the age of 18 were not permitted.

“My friend said she was aware of the new visitation policy but didn’t realize it applied to nonpatient areas as well,” the article said about a woman whose 16-year-old son was refused access to the cafeteria at Mary Washington. “’It never crossed my mind that we would be refused entry to the basement cafeteria,’” the woman said.

At 550-bed University of California San Francisco Medical Center, visitors under the age of 16 were not allowed on patient floors, but the children were permitted in the cafeteria. Dan Henroid, director of nutrition and food services, said he is offering gift cards to the hospital’s cafeteria for those who cannot visit patient floors. “We get a lot of people who have traveled from significant distances to visit patients and they are forced to hang out in the café. One parent will stay in the café with the child while the other parent goes up to the patient floor.”

Henroid said he wanted to be able to give those visitors affected by the age restrictions a break while they waited, so he started offering the gift cards. He has given out 150 since the beginning of November.

For Walter Thurnhofer, assistant administrator of support services at the 450-bed University of Washington Medical Center in Seattle, H1N1 restrictions have hit closer to home. Any employee who exhibits flu-like symptoms cannot come to work.

“We had a meeting with all staff in the hospital and told them every day you need to self-screen and if you have any of the following symptoms—fever, cough, sore throat, runny nose or nasal congestion—you need to stay home,” Thurnhofer said. Employees are not allowed to return to work until 24 hours after their symptoms have resolved. “That’s probably good practice any time, but with H1N1 it’s made everybody more aware of what’s going on. We have trained our supervisors to essentially check employees as they come to work every day to look for these symptoms.”

Thurnhofer said the department has been affected. “Out of a staff of about 200 employees, we’ve probably had about 20 to 25 who have shown some kind of these symptoms and been restricted from work—either self-restricted or we have sent them home. This is definitely above average. You are always going to have one or two people here and there who call in sick, but we have made people so aware and we are checking so closely that that number is probably well more than double the usual amount.”

A hospital-wide system has been put in place to cover sick employees. If a department is short on staff, employees from other departments will help out. Thurnhofer said he can’t have non-foodservice employees help with cooking, but he said other hospital employees can help with tasks such as tray delivery if the need should arise.

Another byproduct of H1N1 is fear of spreading the virus in the cafeteria. “We have customers who have been concerned with self-service and the spread of pathogens and we’ve had concerns ourselves,” Thurnhofer said. “These buffets, self-service, all-day operations are problematic. We can screen people at the door and put out hand sanitizer, but the fact is that some people are going to come through who didn’t wash their hands in the bathrooms or have flu or cold issues and have been touching their nose or eyes and then handle utensils. Then the next person comes along and it’s transmitted.”

In response to these fears, Thurnhofer said the department is moving away from all self-service aspects. The make-your-own sandwich bar has been removed. He has requested money to replace the self-serve salad bar. “We are going to expand our made-to-order sandwich operation and put in a display cooking station. People like to make their own stuff, but many people understand the risk you incur that is just inherent in these open food bars. We want to give customers something back so they feel like they haven’t lost anything but have gained something.”

Thurhofer is also hoping to change the way utensils are distributed. Right now customers take whatever utensils they need from a self-serve area. Soon, flatwear will be distributed from single-serve dispensers.