ODETTE PERRIEL: So currently, I'm the Director of Environmental Services at Hackensack University Medical Center, which is a part of the Hackensack Meridian Health family. But before that, I was actually at New York Presbyterian Hospital, where I was the Director of Support Services at the Lower Manhattan campus. So I'm just going to give you one of the examples from the Lower Manhattan campus and kind of set the scene for you.
I came over to health care from the hospitality industry. I'd spent over 13 years with the Ritz-Carlton Hotel Company. And my first job in health care was at Lower Manhattan, and that was in 2013.
Is anyone in here familiar with Lower Manhattan, New York Presbyterian Lower Manhattan? Yes? New York Presbyterian Lower Manhattan. Maybe if I said, have you heard of the downtown hospital? So let me tell you where it's located.
So that hospital is located at the lower end of Manhattan. It's pretty much one quick walk away from Wall Street. It's right next to Pace University, so it's all the way south, right, just about to step into where the both rivers meet. So that's where the hospital is located.
And for me, it was my first hospital experience so, yeah, excited, coming out of Puerto Rico, just opened Dorado Beach, which is an extension of the Ritz-Carlton. And you know, I felt, OK, I can take on health care, so I arrive there. New York Presbyterian had just bought out the downtown hospital, which was about to collapse. It was about to go under because of financial reasons. And they took over in July of 2013, and I arrived in August.
So the first thing was, OK, great, you have support services, turn this around. Now when it was downtown, people had different expectations. But the name New York Presbyterian came with a whole other set of expectations, right? So now they expected the same experience, the same service as a Weill Cornell campus, the Columbia campus, because it was New York Presbyterian, and that was what people were coming for.
So the food services course, when you looked on the quality of the food, they were in the dismal 40th percentile. Nobody found, it wasn't anything exciting. And as we all could agree, going to a hospital, you don't go say, god, I can't wait for the food to be served. Or well, I can't wait to get those towels, you know. It's such a good thing for me to do.
So looking at what we were faced with and also just knowing a little bit more about our customer base, 70% of the customers were from the Chinatown area. So that was also the demographics that we were dealing with. So I remembered when I was with Ritz-Carlton, and we used to have our surveys, our Gallup surveys, you know, the Asian market always had the one thing that we couldn't use in the Americas, which was traditionally Asians polled way lower, way lower than Americans would.
So if you expect to get an 80% satisfaction from an American, an Asian isn't going to give you more than 30%, and that for them is exceptional. So their scores would always look lower. So I said, how am I going to be successful in this market?
You know, I'm already starting at a disadvantage. And you know, I thought, my VP, he was from the Ritz-Carlton background, too. And I said, well, Allen, you know, this isn't going to work. And he says, figure it out.
So we worked with it. I brought the team together. And we said, OK, we have to figure out, how can we make an impact quickly.
There isn't a lot of money. We don't have $100,000 to invest. But let's figure out what are some quick wins that we can do.
So I gathered a team, and it was a cross-sectional team. We looked on everyone from the person cooking in the kitchen, the person serving, the one stocking and taking in all the goods coming in. We put the team together, and we came up, and we started brainstorming and saying what exactly can we do immediately that could be a big win as it related to the food service?
So everybody started talking, and we said, you know, what do we want to achieve? Our ultimate goal was to create a dining experience. So we said, what does a dining experience look like?
Let's face it. When you go to a restaurant, what's that experience like? You get greeted by a hostess. They seat you. Then your server comes over.
What's the first thing they offer you? A beverage, right? So they start with the beverage service. They're going to probably tell you all the menu options, what's the special for the evening, and they take it through.
So we said, what if we just disrupted our entire meal service and started treating it like a dining experience? What if we were to pull that apart and offer that to our patients? So we figured out, then everybody looked and said, could we do it? But we always serve everything on one tray.
And we're, like, probably we could. Let's see what that looks like. So that's what we started. And we figured out that if we could break things apart, if we could also look at our demographics and figure out what is it that they liked and what they were interested in having, or is there anything different in terms of when you're sick in your community, are you served something different from in another community?
And we realized, because our director, actually our Manager of Food and Nutrition Services, she was also from that community. And one of the things she brought out in this session was, she says, you know, I never quite got why we always offered everybody coffee. And she says, as Asians, you know, when we're sick, the one thing you want is warm milk. Shocking, right? Warm milk? Yeah.
And she says, that's a huge thing because, you know, growing up, everybody offers you warm milk. Or you get hot water, and that's what we drink when we're sick. Coffee isn't something we like. You know, we will have tea, but warm milk is the most, the one thing that goes over well. OK, so why were we always serving coffee? No wonder we were getting these scores.
So we figured out, how could we make these changes? So it was things like that that we did. And we listened to people who were from the community and understood what it took to be able to create that type of experience in the community so that they could feel valued, and they could feel as though their choices were taken into consideration. So we rolled out what we called our version of the dining experience at Lower Manhattan.
It was the lowest budget project that ever rolled out because we didn't have much money. But what we had was spirit, and what we had was a team that wanted to make a change. So we spent just a couple of hundred dollars to buy new carts.
We figured that we would start with beverage service, so we bought some carafes so that we could have what? Warm milk. We could have hot water. And we could give them the options that they liked. Yes, coffee was still on there because we were trying to cater to everyone, not just our Asian population, but that was important.
So all we had to add was just a couple of things to the beverage. So we started off first by doing the beverage selection. And we went around the units, and we only had three inpatient units that we had to serve.
So we went around. We offered beverage service first. And then after beverage service was finished, then we came through, and we started offering our main course. And we did that for all meal service. And we kind of just deconstructed and pulled it apart.
And, yes, we could serve things at different times. We didn't have to bring everything on the tray because it was never set in stone. It was just the way things were done. And it didn't mean that it always had to be done that way, or it was the most efficient, or that gave people the most satisfaction.
So we blew that apart. And what we realized is in a space of one month, we saw our scores immediately start going from the 40th percentile, went up to the 80th. Then we started going to the 90th, and we were able to consistently maintain that for a long period, you know, for several months.
Not only did we pull apart our meal service and we did that in that way, but we also, as we said, we included, we always had Asian options on our menu. So we never made any changes in the menu. The only change was to add, like, the warm milk to the beverage service.
So without changing our menu, they were eating the same food. It was all about the presentation, and it was all about our team members and how they impacted it. So the other thing that we implemented was, you know, I remembered from the hotel services, we did what we call line-ups, so we implemented line-ups.
So at the beginning of every shift, every team member, we went through lineup. We focused on it. But also in this particular area, what we implemented was something that happens in a lot of kitchens in restaurants across the US and across the world really, is that the chef would talk about a special for the day.
So we would choose one item off the menu. Everybody had to taste it. We talked about three things, what the item was, the benefit to the person, so is this going to help you to get healthier bones.
So these were talking points that the team members then went out and felt comfortable to engage with the patients and say, you know, today you're going to be having chicken because, you know, like, we have the chicken Marsala today. It is rich in, you know, iron and protein because we want to make sure you have healthy bones. You're able to heal better.
So they were talking to them about something that they knew and they understood. So it wasn't an awkward experience when they went up onto the unit to serve the meal. They had something to talk about. So those were things that we focused on.
In our line-ups, we called them huddles there, and they were prepared. We made sure that we focused on training as well. So we scripted them. We gave them some things because not everybody is comfortable to just go out and have great engaging conversations, right?
So we had to help them in terms of making that transition as well. So we knew we needed to do that, and I focused a lot on doing that training and really saying things like, our chef has specially prepared this meal for you. It makes it sound, it's a whole lot more appetizing and welcoming than saying here is your food, enjoy, bye.
So they would say things like that, and we'd talk about, I also appreciated what Jill said where we also invited units down to do tastings in the kitchen, so that they could be our best promoters on the unit. So they said, oh, my gosh, I hope you had the fish today because that fish is so delicious. And having the patients hear a team member say that they ate the food, now says to them, well, if you're eating it, this must be really good because, you know, there is an old saying in Jamaica that says a fisherman won't say his fish is smelly, that's what I would say. So you're always going to promote your own things. So if you're promoting it, and you believe in it, people will actually buy into it as well.
So those were some things that we did. And it yielded for us really great results. The cost was very low in terms of implementing it. But we got a really big impact and a big result from doing that.
We also offered beverage services outside of the mealtimes, so we had snack. We had mid-morning snacks that we offered them. We also offered them late afternoon snacks. And we offered them late evening snacks because what we found is that patients outside of the traditional mealtimes, there was nothing else for them to eat.
And so, therefore, people, they do want something. So whether it's a fruit in the morning or, you know, just again warm tea, warm milk, or something like that to offer them, that made a big difference to them. And that created that dining experience that they were looking for in a setting such as a hospital. And that really had a big impact on the overall experience that they had.
So that's one of the innovations that we created there. We also did some other things, such as we also implemented, we talked about the huddles, the afternoon snacks, the ethnic preferences. And during traditional celebrations, such as the Chinese New Year, Lunar New Year, we would give a mandarin.
So we'd have that served on the tray for all our patients. We would do these things that were ethnically appropriate but also really falling in line with traditions. And we didn't only just stick with Asians. We did for just about any type of celebrations that we thought was appropriate, that we celebrated as a community and as a hospital.
We really made sure that people understood that they were valued, and we wanted them to feel like family. Because that's what you do when you know when you have family come to visit, you try to give them all the things that you know that they love, right? You don't just say, well, I'm going to give you this because it's what I like. You try to really cater to them. So we really wanted that to be the feeling that they experienced.
And you know, I think about years ago, my first experience, when I opened a Ritz-Carlton [INAUDIBLE], was the spearhead behind the Ritz-Carlton Hotel Company. And every time he went to an opening, he would say this. He would say, we have the finest china, the best building. We have the best product we could offer our guest.
But we're not a Ritz-Carlton until we have the heart and soul come into the building. And the heart and soul is in our team members, right? And if we can just remember that they're the heart and soul, and if we can find ways to make them a part of the operation and really feel that they're valued and they can contribute, they, too, will make sure because they're the ones touching our patients or guests. They're the ones at the front line, so it's really creating that culture that allows us to be able to have those results.
So a couple other things I wanted to share because I do work for Hackensack. So although that was great to talk about my New York Presbyterian experience, I'm going to just share some of the things that we're doing at Hackensack right now. And though my role is a little bit different, you know, I just wanted to do a cross-walk of what are some things that have changed, like we've implemented from the hotel that's brought over to the hospital, that's given us some really good results?
I don't think this quite came out well, but you'll probably be able to follow. So in hotels, we have what we call turndown service. At Hackensack, we have second service. So we do a second refresh in the afternoon that's really focused on that bathroom, the question on HCAT.
So sometimes you have to study to the test, right? The question is, how often was your room and bathroom kept clean? So of course, we will focus on what is on that. So we go through, and we make sure that we refresh the bathrooms.
We talk with the patients to just check in, to see if there's any other service that we can do for them. And that has really created and, again, an experience that they find to be very welcoming, and they appreciate. Because the majority of the patients that come to us are the same people who go to hotels. So they've had these experiences, and they're trying to, they want to align their hospital experience with what they consider to be great customer service, which has been traditionally what they've experienced in hospitality.
We also at Hackensack, we have room service as well. And it is offered throughout the entire hospital. We have an 800-bed hospital there, so we're able to do that.
And, yes, investing in a point of sale is important. Having a great clinical dietician team is great. But the room service option of giving patients the option to call and order their meals whenever they want has been a huge success.
Also we have concierge service as well that we offer. Line-ups, we have them there. It's Take 5. It's a huge part of our culture.
It sets the tone for our team members. Every shift, we start off with Take 5 with our huddles because it's important that we set the tone for our team members and really give them something to go out with so that they're able to engage in a positive way with our patients. Because we can't impact the experiences they had before they came into work, but we certainly have an impact over what happens when they're in that building. So that's the way we are able to do that.
We do the Room of the Day program as well. And that's where Environmental Services, along with Plant Operations, Engineering, and our Capacity Management team will work to make sure we have a couple of rooms every day that we take out of operation to do small touch-ups in whether it's painting, detail cleaning, making sure that we're constantly maintaining those rooms so our patients are coming into rooms that have been maintained so that they can have really great experiences while there. We also have what we call our discharge calls, that we call patients after they've been discharged.
In the hotel setting, that would have been what we used to call departure calls. So you know, just before Gallup can make that call to you to see how your service was, we want to be able to get to you right before that. So we still have one last shot. It's not over. The game isn't over yet until we're able to do that one final call and really make sure that we can touch them and make any changes necessary.
And in order to do all of this, it starts with the ladies and gentlemen, the team members that we have, because it's so important. And I know, Cheryl was asking me, do you have trouble recruiting? The answer is yes. Who doesn't have trouble recruiting?
Did you see the numbers for unemployment that just came out? It's getting more and more difficult to recruit, right? So one of our things that we found to be very successful for us is using Talent Plus. Talent Plus is an assessment that we use to help us identify the right talent for the right job.
Because if you don't have the right talent in the right job, no matter how much you train, it's not going to give you the end result that you want. The motto has always been, "hire friendly, train technical." Making sure that you have the right talent for the right job is critical for us. So those are just some of the things.
We can talk also, we have a command center as well that we use at Hackensack. And that model is really based under what happens in hotels, where everything falls under one division, Rooms Division. And Rooms Division really controls that whole guest flow in a hotel, right?
So you're checked in by Rooms Division. You're checked out by Rooms Division. The bellman that goes up to you all under Rooms Division.
But then you go to a hospital, and capacity belongs to nursing. Then EVS belongs to Hospitality Service or something. And you have all these different departments, right, but yet still we want to know, why is it patient flow is still a problem?
Creating one model where they all sit under and, you know, that really came out from our Chief Nursing Officer and Patient Experience at our hospital, Diane Aroh. Her team developed the Command Center model, where everything sits under one umbrella. So we're all getting the information.
And everybody has to have a stake in the game of getting that patient through the hospital has really improved our turnaround time for our patients and really helped us with our throughput. So those are just a couple of things I wanted to share. I really did take Brooke's suggestion to only do two slides literally, so I gave you two slides. Thank you.
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Odette Perriel, Director of Environmental Services, Hackensack Meridian Health, Hackensack University Medical Center, speaks about lessons learned from applying her professional experience in the hospitality industry, to the healthcare industry in a leadership role in a large medical organization. The talk was part of the Healthy Futures Roundtable held on October 10th, 2018.