It’s no secret that foodservice departments and patient nutrition services operations throughout the country are being asked to do more, with less. Increasingly, we’re hearing stories about how several departments, from facilities management and transportation, to laundry and maintenance, all areas traditionally having little to do with foodservice, are being consolidated under the “Hospitality Services” umbrella. Have you ever wondered why all of this consolidation is taking place under the leadership of food and nutrition services? To me, the answer is quite clear, which is that Foodservice Directors and Clinical Nutrition Managers have always proven that they consistently thrive under pressure, perhaps because they don’t have an option not to. If a parking lot is full or there’s a spill on the ground, someone can put up a cautionary sign and provide an alternate route. However, if meals aren’t produced, patients starve. That outcome doesn’t really work so well.

Look at revenue generation in a different angle. Why not charge for room service, gourmet menus, and wellness care packages? These and other services could be potential revenue generators for you.

Multitasking and compliments aside, another challenge constantly presented to Patient Nutrition Services departments is to not only accomplish more with less, but to be profitable while doing so. There has no doubt been an increasing trend in healthcare foodservice operations of trying to identify new ways to generate revenue, either in promoting catering, adding new coffee or retail kiosks, or revamping dining outlets in healthcare campuses throughout the country. Personally, I see this as a huge win, in that healthcare foodservice teams are finally getting the respect they deserve and have worked so very hard for.

However, a pesky little challenge remains, which is that while patient nutrition services has improved by leaps and bounds over the past few decades, identifying ways to capitalize on these efforts have not. A conservative assumption is that at minimum, millions have been spent over the past few decades, investing in new methodologies in patient dining. The introduction of spoken menu, room service and TV/monitor ordering meal service approaches have all been a huge hit, increasing patient satisfaction scores and heightening the visibility and the impact patient feeding has on patients’ wellness and recovery. However, determining how to profit by the incredible level of service and quality provided to patients still appears to be a relatively new frontier.

This may seem a bit radical, or unorthodox at best, but could we perhaps compare the airline and healthcare industries for a moment? Up until the 80’s or early 90’s, the idea of not being accommodated on a flight, in terms of being served a meal, refreshments and beverages seemed a bit ludicrous. Flying was perceived to be a luxurious activity and the in-flight entertainment, meals and service provided were considered to be part of the entire travel experience; not just superfluous details surrounding the medium required to get from one destination to another. Then, as the cost of fuel and labor increased and profits dropped, major airlines began identifying ways they could shave costs from the transportation services they were providing. They went from serving meals to snacks, then snacks to generally nothing, ultimately seeing a tremendous revenue generation opportunity in terms of charging for the premium, yet ancillary services they once provided for free. Having a largely captive audience, people begrudgingly, yet willingly, allowed this shift to occur – as at the end of the day, they needed to get somewhere.

It may sound nuts, but hospitals may not, in actuality, differ that much. Now, I am not saying we should starve patients or that medical nutrition therapy is not vital to their recovery. What I am suggesting is that as an industry, we are spending all this money investigating ways to improve the patient experience, without evaluating how to benefit and capitalize from it. Why can’t we offer a non-select, or semi-select menu, then charge for the option of room service? Would people not go to your hospital, if you fed them three nutritious and delicious meals a day, but also promoted premium, heightened services or products for a fee?

Let’s play around with this concept to aggregate some tangible numbers for a moment. If a facility with an average census of 250 were to offer premium menu items to patients at $5.00 per patient day, with a profit margin of 50% and a participation rate of 65%, the annual net revenue would amount to $148, 281, or $228,125 with 100% participation. Alternatively, if a facility opted to promote an “anytime” menu, offering afternoon tea, or late night snacks to patients or their guests for a $1.75 daily surcharge or “service fee,” a 150 bed facility could rake in an extra $95,812 annually. It may not be the jackpot, but it’s certainly not a laughable amount either and one which could support the purchase of new equipment, introduction of a professional development program for staff, or more.

One could argue that this concept is no different than healthcare facilities that offer private rooms or preferred/VIP wings, at an increased cost to the recipient. Hospitals are required to provide safe, clean rooms to patients that have been admitted. They are not, on the other hand, required to provide Ritz-Carlton level service. To receive more personalized, luxurious accommodations, patients are expected to pay a premium. Why, on the other hand, are hospitals being charged with providing comparable food service to that of leading restaurants and hotels, yet expected to do so at a loss? What would happen if we applied the airlines’ profitability approach relative to ancillary, yet critical services? I have a pretty strong feeling that just as people didn’t stop flying, people also won’t stop patronizing healthcare facilities, as both are largely necessary.

What would occur, I would imagine, is that healthcare facilities would be given the opportunity to become more creative and competitive in terms of the premier products and services they could offer. Gourmet or farm-to-fork inspired menus, fresh sushi, or celebratory offerings such as birthday, anniversary or new arrival cakes and wellness care packages are just a few examples of items that could potentially make facilities tens of thousands of dollars a year, if not more. Why aren’t we allowed to think outside the box, identifying new ways to be recognized and budget conscious, but profitable as well?

While I am not presenting a strategic plan for shifting from cost-centric to profit-centric patient nutrition services, it is fair to say that the initiating the concept may have some merit. As more areas of responsibility are being consolidated within the loose framework of food and nutrition services, identifying methods to generate additional resources to support those efforts will become necessary. I’m not sure that it is fair to place the entire burden of the revenue generation that is expected from food and nutrition services on the staff and non-admitted visitors to a facility. Rather, spreading both the costs AND the opportunities for increased service and product quality to all recipients, including the patients, may be just what the doctor ordered.