Room Service Interview
From: M. D. Anderson Department of Performance Improvement
Date; January 15, 2008

Duke: Now one of my earlier projects was working with room service. We came in and were doing staffing study on how, how well they were keeping their service promise. And during that study, one of the most intriguing things, I could sit there and speak with any one of the room service staff, and I was just blown away of how service oriented they were. How they felt impressed to stay in line with the patient, and take care of their patients, that kind of stuff. So, I thought I'd come in to find out how do you develop a culture where the entire staff is like that. So, Mohammad...

Mohammad : Well, how you do?

Duke: How are you doing?

Mohammad: How are you? Good to see you again.

Duke: Good, good. This is Mohammad Tekrouri. He is the Manager of Room Service and first of all, how did all this get started?

Mohammad: Well, before room service, Carol Frankman, the Director of Clinical Nutrition with the VP clinic, his name was John Crosely, they were having a meal together and he ordered a meal from Nutrition at that time and he received a piece of chicken that really looked like a chicken that wanted to fly, and he was just not pleased with the food at that time and he asked my boss, Carol Frankman, to start looking at other ways of serving patients.

So Carol Frankman with a focus group that have people from like nursing, other departments were involved and they did the pilot program where they ran room service on two nursing units, and it was supposed to last for three months but people liked it so much it lasted one year. And on one unit they have the wait staff go into patient rooms and taking orders and the other units, they have patients calling down and placing their order. And really from the pilot program, that's where they make projections on what menu they need for room service, on staffing level for room service, so it was just meant to have some projections for the program if it was accepted to be live.

And sure enough, they also did (a) survey with patients, doctors and nurses. And everyone liked the program. Everyone was like, yes, let’s do room service.

Duke: Okay, being measurement oriented, what was the measure of success?

Mohammad: Why, it was a 100%. I mean everyone liked room service, everyone was cheering for room service. And I'll say like 60% from the staff and patients liked the traditional food program. But a 100% staff and patients want room service.

Duke: Okay. Now with the staff themselves, do you orient? How do you get them so engaged and wanting to make sure that the service is high?

Mohammad: Well Duke, after we implemented the room service, I mean, we made it clear to the staff that the institution has invested a lot of money in this program and they did it not to make money, but they did it to make patients happy. So, there was a lot of investment and interest in achieving high patient score. So when we bring wait staff, again we are the first hospital to implement room service. It was very hard for us to bring wait staff with the kind of experience we want. So when we bring staff they have to go to certain in-services like, you never go to a hotel or restaurant and you find the waiter that served the patient in an isolation control room. You don't find wait staff in the restaurant doing calorie counts, while our staff does those things. And so we do a lot of in-services where they attend classes we do also on-the-job training. Where they will work with the waiter for a while, and then we observe, give them quizzes and observe how they are doing their job and if they were able to do their job and we assess both by observation and by giving them written tests.

Duke: Okay.

Mohammad: And then we meet with wait staff daily in line up and we talk how it is very important to give the best service to our patients and our patients, I tell them, day in and day out, that those patients, it could be their last meal, those patients they are here, they are stuck with us, you know, while if you are in a restaurant or a hotel you have choices. I mean you choose where you want to go eat. Versus our patients they really don't have those choices and they are not here on a business trip or celebrating some big accomplishment. I mean they are sick, they are not feeling well. So the last thing we want to do is give them a bad food, meals experience. And the contrary we institution did the room service because they want patients to eat what they want to eat, when they want it and order whatever they want and we want to give them the best service. I mean we established fine hotel service tenders so the wait staff, before they go to a room, they make sure the order is accurate, they will check the name of the patient before going to a room to make sure they are serving the right patient, they use the ticket because it has the, the meal ticket has the medical record number on it and they will check it against the patient arm band to make sure they are serving the right patient. They ask the patient where they want to eat. They help them, you know, like if they have a beverage, they want it opened, or poured in their glass, they make, they offer those kinds of services, and they go over the order with the patient to make sure the patient, everything they order is there, or if the patient remember he want another glass of orange juice, then they will rush it for the patient. They will do whatever it takes to make sure before they leave the patient room everything the patient ask for is on the tray and then they will ask the patient if they need anything else and inform the patient that they will come back within 30 minutes and retrieve the dishes. Or unless the patient is a slow eater like me, and will say come back in an hour, so they will write that down and come back within an hour.

Duke: I think I've seen it one time where one of your captains was bringing a pickle that was left off the tray and he brought it up to the patient made a single trip just for that pickle for the patient and the patient was so, so amazed, because they didn't miss it but it was important to your staff.

Mohammad: Well, I mean that's part of the service, and one thing I tell my line employee, as well as my manager, we want to lead by example. If we tell my wait staff that they need to rush something within 5 minutes you know, then you know the managers need to do that too and show that they not just telling the wait staff to do one thing and to them it’s another thing. So, we are one team, and from the call center the people that take the orders to the cooks, to the transporters that transport food from the main kitchen to the nutrition center to the wait staff, we are all one team. We don't point the finger at each other but we just focus on serving the patient and giving the patient and their guest the best service we can.

Duke: Well looks like here at room services they just ingrain to their staff how important it is to put the patient first, so we're going to turn it back to the studio.