Client Success Story - Duke University Medical Center
Duke University Medical Center, in Durham, North Carolina, is consistently rated among the top hospitals in the country by U.S. News & World Report. The youngest of the nation's leading medical centers, Duke University Medical Center operates one of the country's largest clinical and biomedical research enterprises, and quickly translates advances in technology and medical knowledge into improved patient care. It is the leading medical center in the Southeast, with a medical school ranked among the top three in the nation.
An Efficient Diet Office
When this story began in 1994, Duke had eight successful years using CBORD's diet office software. Duke's trayline staff was beating the national average: they were producing six-and-ahalf trays per minute, compared to the two-and-a-half trays per minute assembled by food service departments with a manual diet office. "With CBORD's system we organize the tickets however we want, so our stations are very efficient," Connie Uhrick, Associate Director of Patient Food Service in the Food Services Department, explained. "The CBORD® program makes our staff so much more efficient and so much more accurate."
With the department running this well, why would the team at Duke consider making a change? The ability to bring even better service to patients was a strong motivating factor. When bundled menus came along as an option, it was worth looking into!
Bundled Benefits
Bundled menus, the plan in which Uhrick and her team became interested, ensure that patients get well-balanced meals. In a bundled menu system, the patient chooses an entrée, and the starch and vegetable that go well with that main dish are selected automatically. This ensures both good plate coverage— an important issue in a large retherm facility such as Duke— and nutritionally sound meals for each patient.
Another benefit is the quality of the food. "This food gets rave reviews from patients," said Uhrick. "It's also very colorful, which is great because retherm trays can't be garnished."
Unfortunately, there seemed to be no way to implement bundled menus in the automated diet office environment Duke had constructed. As much as the bundled menu approach would benefit their operation, Uhrick couldn't imagine reverting to a manual diet office to implement it: "We did not want to lose the CBORD program or the tray tickets." Uhrick also had staffing concerns. Duke, a large facility with 1,100 beds, just doesn't have the number of staff needed for a manual diet office. "We don't have the labor in this day and age. Even if we had the budget, we couldn't find the people to do it," she said.
A Team Effort
Uhrick and her team met with CBORD to find a way to make the CBORD systems work with a bundled menu. The result of that collaboration was the first database for a bundled menu. "CBORD was willing to think outside the box," said Uhrick. "This database is significant because it means the difference between keeping our computers or not."
Uhrick was also excited because the bundled menu concept works well with CBORD's Bedside Menu Entry (BME) system and a spoken menu. "We know from research that the one kind of menu really driving patient satisfaction scores is the spoken menu," said Uhrick. "So we really wanted to do that." They had been using a menu and collection method, getting patient orders up to two days in advance. BME, which runs on Palm handheld devices, allows the staff to visit with each patient every day to discuss his or her meal options. The selections are taken closer to meal times, which is key in today's healthcare environment where patient visits are sometimes very short.
A Great Diagnosis!
The breakthrough database has been beneficial for all parties. Uhrick has received calls and visits from facilities all over the country interested in adopting this innovative program.
The new menu is also a hit with patients. In addition to offering more wholesome foods, the database includes an all-time-favorites menu, which is great for long-term patients, and kid-friendly choices such as pizza and chicken nuggets. Special menus with Latin, kosher, and Muslim choices are also available.
Duke saw great results almost immediately. Using Press Ganey as a benchmarking tool, its overall patient satisfaction score went up nine points after one month with the new system. This represents a huge success since Press Ganey considers a move of two points in patient satisfaction scores a significant change.
Duke is enjoying the best of both worlds. It is continuing its success with CBORD's automated diet office, and it's now using it with its patient-friendly bundled menu.
