Let's Talk Solutions: Exceptional Food Service with Dirk Noteboom

Amy and Jon chat with Dirk Noteboom, President of Culinary in Healthcare and Senior Living for HHS, and discuss hospital food service, the patient ambassador program, and how to incorporate restaurant-style dining into a healthcare facility.

Intro...

Amy Fritzer

Well, hello, everyone, welcome to this week's episode of Let's Talk Solutions: Candid Conversations with Healthcare Leaders. I'm Amy Fritzer.

Jon Amos

And I'm Jon Amos. And this week we've got a really great guest joining us in Dirk Noteboom.

We're going to discuss with him about all that goes into food service at a hospital, specifically the patient ambassador program and how that brings a restaurant resort style service experience to patients, his background in 30 years in healthcare and the evolution of that. And it's a really exciting conversation. Really glad he’s joined us.

Amy Fritzer

OK, thanks so much for joining us today, Dirk. We really appreciate it. And just to kick things off and first things first, could you tell us a little bit about your background and expertise and how you got into the food nutrition services side of healthcare?

Dirk Noteboom

Yeah, sure. I started in this business back in 1987, by getting into dietetics at school. I had gone to college to become a biomedical engineer, but I didn't like that. Went into accounting, liked that even less and got into dietetics. I was into nutrition and fitness and stuff like that. 

And actually, through a fluke of the phone system, I had asked my mom to call around hospitals in Memphis, Tennessee, where they had just moved to, to see if they had a summer internship program that I could get some experience in dietetics and understand a little bit more about it in real world application. And again, through the fluke of the phone system, she ended up talking to Keith O'Neil directly, which never happened in this hospital. And he said, I have a job for him and the rest is kind of history. That's how I got into dietetics and management of food and nutrition services. And then kind of grew from there into the role I'm at today.

Amy Fritzer

Wow, so you knew Keith all the way back then, huh?

Dirk Noteboom

Yeah, I've known Keith for 35 years.

Amy Fritzer

Oh, small world. I didn't know that. That's interesting.

Dirk Noteboom

So that was fun. And of course, I did a couple of internships for Keith, and when I graduated from college I went to work for Baptist Hospital that Keith was running at the time. And shortly thereafter, he formed his own company and left that role. And I joined him in his new venture, and the rest is history, as they say.

On the evolution of food service...

Jon Amos

That's awesome. So as someone who's been kind of in the field for a long time as a registered dietitian, but also now, you know, a leader and executive, obviously going back for 30 years. Can you kind of walk us through just how it's changed and the evolution especially of just, you know, how food is presented and delivered to patients?

Dirk Noteboom

Yeah. When I first started, it was very different than food service is today. When I started directors and managers really didn't go visit patients. We didn't really have patient satisfaction in the form it is today. If you didn't get a complaint, you were crushing it. It was kind of the rule of the day and that started changing in the early 90s as the Joint Commission and as CMS started putting quality measures in place regarding almost every aspect of the hospital experience.

So we had a lot of very extensive training with the Studer Group and Gallup and Press Ganey and all sorts of survey tools to understand that we needed to get up on the floors, we needed to talk to patients, we needed to really market ourselves to patients, nursing staff, and everybody in the community as a very high end food service operation organization. 

And through that, there's been a lot of trips and stumbles and falls in terms of what works and what doesn't work and and getting to the point of more customized service, bedside service, if you will, for example, with our ambassadors. In the past, patients would fill out a paper menu or maybe not get a menu at all. They'd get served and the host or hostess, the ambassador was in and out of the room and really didn't have a whole lot of interaction.

Today, that's changed, and it's more of a full service type of an operation where we're taking menu orders at the bedside, either manually or through a computer application. And we follow up with the service delivery of the meal, we pick the meal up and have interaction with the patient. Then we come back and take the next meal order. So it's pretty labor intensive. But we get immediate feedback and we track that on a meal by meal.

Jon Amos

So you mentioned that a lot of that change came sort of like through regulatory bodies. But was that the main driver of the change or what sparked that shift?

Dirk Noteboom

Yeah, I think the main driver of that was two-fold. Part of it was regulatory as the government went to what they call diagnostic related groups to reimburse hospitals for services. Subsequently, insurance companies went that route as well. And so they put a great deal of emphasis on quality. 

And by way of example, you know, back in the 70s, the doctor may put you in a hospital for a week to get rest like a little mini vacay at a hospital resort, if you will, and that's ceased. The government stopped paying those kinds of bills and reimbursing hospitals for that. Now, for example, you have a hip replacement surgery you're in and out of the hospital in one day today for a hip replacement. If that patient stays for five days, the hospital gets reimbursed for one day. So they're very motivated to get you in and get you out on time so that they can make money in the process.

Subsequently, those types of issues led to quality enhancements, led to the driver of

what we have as patient satisfaction today because regulatory kind of pushed it. And then it's a competitive advantage in the marketplace. If you can say our patient satisfaction score is in the 95th percentile of all hospitals, we have the best food based on our patient feedback. And so there are a couple of drivers regulatory and then and then market driven outcomes in terms of getting market share.

On changing expectations...

Jon Amos

So the patients, in terms of their expectation of what the food is going to be like at the hospital, with the experience with food was going to be like, was it something you discovered kind of after the fact when these changes to start happening, you started measuring, then you started realizing, Oh, there's actually a lot of expectation around here. And you kind of mentioned needing to tweak things and testing and failing.

Dirk Noteboom

Yeah, I think that's a good question, Jon, because in the past, we didn't get a lot of feedback in regards to food. And, you know, the old joke around hospital food being so bad and was out there for years and decades. And that's changed a lot. We offer very high quality food. We have chefs in all of our units. We have very trained production staff and teams that produce the food that we deliver to patients.

And it's good. I'd put our guys up against anybody, but the expectation has definitely changed. I think our population here in the United States is much more food savvy these days. Everybody has a food show, so they understand what a braise is. They understand what a light sauce is. They're like, Well, I got the chicken and it just wasn't sauteed properly. 

So I think people have a much higher expectation when they're paying their dollars for service, even at a hospital. And I think the expectation is that we provide a solid restaurant experience to the patients, even in the hospital and particularly on the various diets that we have.

We have 14 based diets that our cooks produce every day and then we have the myriad of other specialty diets that doctors ask us to produce or that patients may ask us to produce based on their preferences or their lifestyle. And so our cooks may be producing up to 20 different meals each meal period for these things, and the expectation is the quality of those meals is on par with any restaurant out there every time.

And so, yeah, I think we have a much more savvy clientele. I think that the expectations are very high even with them being on specific diets.

On marketing food service...

Amy Fritzer

Like you said, the clientele is much more savvy because these days, I mean, health care has become almost like a hospitality service and where people, you know, they get second and third opinions, or they check out, you know, quality measures at this facility over that facility.

And, you know, in many cases they can determine where they go to get their care. So obviously, the food is driving that decision as well. How do hospitals, I guess, market to potential patients for the food service? Do they do that as well?

Dirk Noteboom

Yeah, I think that marketing of food is something that specific specialty hospitals will do. Like if you have a back and spine clinic or surgical hospital, where somebody is getting mostly knees and hips replaced, they're absolutely going to market the food experience to those patients.

If you're in a hospital in a downtown setting that is mainly treating patients from the neighborhoods and the surrounding area, they may not be marketing food, they may be marketing that they're a trauma center or things like that based on the need of the area. So I think the marketing piece surrounding food is very specific to the type of hospital and location that it's at. Some hospitals don't market it at all. 

Some hospitals are kind of low key when it comes to marketing and what they can do affordability around what they're doing in the services they provide. Safety net hospitals come to mind. They get a little bit higher reimbursement because they're the only medical facility in a large area and so they're less concerned with marketing of food or some of these ancillary services and really more talking about their medical programs and the service lines. Cardiac lung cancer specialties, things like that that patients are looking for.

And then the other piece on the CMS website and I believe the Joint Commission website as well, people can go and look at that hospital's most current ratings and scores based on patient satisfaction surveys so they can go to any individual hospital and look up; How good is their cancer care? How good is their cardiac care? What is their food service score? What does their EV's score?

And so if somebody has that level of interest in going and seeing what their medical facility is actually doing from a quality perspective based on consumer feedback, they have easy access to it. And so that goes along with what we were just discussing in terms of a more educated consumer, a more savvy consumer, I think, in all aspects of health care delivery.

On the patient ambassador program...

Jon Amos

So then in terms of, you know, we've obviously been talking about quality of food, but in terms of the quality of service you mentioned, you know, we've already discussed that the patient ambassador approach, but that shift to having a dedicated, you know, patient ambassador who's focused on delivering great customer service. What have been the one of the benefits of that model? And how does it differ, maybe from a resort or a hotel?

Dirk Noteboom

Yeah, so the ambassador model that we've been working with now for ten, ten years, going on eleven years, I think is transformative in the service that we provide to patients. It gives somebody a patient that one on one experience, somebody who starts to learn you very quickly in your preferences.

Our ambassadors work a twelve hour shift and we do that. Not so. We're not so we're extending the Ambassadors day, if you will, but we're doing it for continuity of service. So that patient sees the same individual three times a day breakfast, lunch and dinner. And generally with the length of stay of about 3.4 days, that ambassador may be the only food representative outside of a manager that this patient sees for their stay.

Which is great. It provides a lot of continuity of care in terms of what we provide and that patient gets to know, our ambassador, that ambassador gets to know our patients and and just provides a better level of service through ownership of that relationship.

And so I think we've seen great results from patient satisfaction. I think our ambassadors, as well as our whole teams, do just an outstanding job of delivering that care. And it's not uncommon for us to get letters or comments from patients regarding specific ambassadors and the care that they'd given them. Our ambassadors frequently go above and beyond, bringing flowers or making small talk or cracking jokes or whatever the case may be. And I just think that human connection in a hospital is so, so critically important to the care and the healing of the patients because you're in such a clinical atmosphere and you're having all sorts of stuff done to you that you maybe don't really understand and you do understand food.

You might not know if it's prepared properly, you might not know really, if it's good or not, but you certainly know whether you like it, and that patient ambassador helps enhance that experience all the way around. So they are the front line of what we do in the face of what we do on the patient services side.

Jon Amos

Does that also help with service recovery? And I'm thinking outside, I used to manage a Chick-Fil-A, actually. And you know, one of the things we trained our team members on was, Hey, there's going to be times where we mess up an order and a customer comes and says, ‘Hey, I asked for no pickles on the sandwich and there's pickles on it’. And that's actually an opportunity. You know, we train to actually go above and beyond and satisfy that person because we'll just give them another sandwich. That's right. You know, say, we're sorry, give them the right thing and recover. 

You own that mistake and actually enhance the experience. Is that something that the patient ambassador does and have you seen it be effective?

Dirk Noteboom

Yeah, I think the patient ambassador absolutely does service recovery. And that's part of being up there and having between nine and twelve touches a day with that patient. The other piece of the service recovery is it's very easy for our managers on a service recovery to go up and say, How is your ambassador? How is Maggie doing today for you? And almost always 99.9% of the time they're going to say, Oh, Maggie is fantastic. I don't know what I would do without her serving my food to me. But you got a problem in the kitchen with your people plating this stuff up.

But on our patient satisfaction scores, the highest scores that we always get are around our people and our ambassadors. So from a service recovery standpoint, again, the ambassador is our first line of service recovery and managers are kind of the second piece of that service recovery.

And I think as you said, your training program at Chick-Fil-A, you workshop those scenarios. We do that same thing, actually, our ambassador training is pretty extensive. We have 13 modules that they go through and it's ongoing training also with diets and things like that so that they can understand why somebody is on a specific diet. What that means to that individual patient and they have the ability to explain that at least on a certain level and then if we need to have more description or that patient needs to really understand a lot more, we're calling a dietitian.

Amy Fritzer

I was actually just going to ask that question if they do have any kind of, you know, clinician background or training in terms of should a patient ask, why am I on this specific diet or why can't I have this? Or, you know, and that it sounds like that they do.

Dirk Noteboom

They do have pretty extensive training on diets. Out of the 13 modules that we have, four or five of those modules are specific to diets and diet related issues. And then in our daily huddles, we always have a diet related item there. So we run through diets. We have 14 diets. We run those diets four times a year. And so it's a cycle of , you know. 16 weeks, 15 weeks, or whatever the case may be that we do some of that training in our daily huddles as well.

Jon Amos

So then kind of shifting gears here, I'm wondering if you mentioned paper menus that used to be or no menu at all and then the shift to using like an app. What's the technology that we're leveraging, is it synced up with the kitchen? What's that look like, I guess, in the role of the patient ambassador?

Dirk Noteboom

Yeah. So we utilize a proprietary program that's being built for us by third party fulcrum, and in our app it’s called Breadbox. We've been working on it for several years, and last year we started going live in units with the program. And generally, we can do this manually, where an ambassador will enter a patient name and the diet, or we can do it all automated.

We probably have them in 20 to 25% of our accounts at this point. And that automates the whole system for the ambassador, they basically get their list of patients, what diet they're on, and then the program itself understands those 14 different diets and how they may overlay.

And so they will give the ambassador what choices, what menu choices that patient has based on their diet prescription. So it's a pretty slick program.

And I mentioned it's kind of an app. So that's how it's set up on the iPad. And so our ambassadors really after about 15 or 20 minutes of training or whizzes at it, it's just so user friendly. We spend a lot of time building out the user component of it. It's really easy to use.

Amy Fritzer

So if we're talking about the patient ambassadors there and able to be next to the patient and, you know, obviously knows what diet that particular patient can or cannot have. 

Can it be so customized when they're actually ordering, like at a restaurant? Well, I'd like this salad, but I like the dressing on the side. Or, you know, like that scene of Meg Ryan in When Harry Met Sally comes to mind when she's so particular, you know, and she wants this on this side or two of this? Can they get that particular?

Dirk Noteboom

And that they can? Yeah, they can get that in particular. There are spaces on the order sheet, where they can free text so they can add patients like this this this, this, this. Choice of dressings, choice of beverages, things like that. So yeah, it's very customizable.

Jon Amos

So is this kind of program. I mean, I know we run it, you know, at our accounts here at HHS. But is there pretty much every hospital that has adopted this kind of program? Or are there still some that have nursing running this?

Dirk Noteboom

Yeah. So across the country, it's kind of all over the place. So yes, there are hospitals that run non select menus. Patients don't get a choice. The meal just shows up when it shows up. There are some that do a paper menu. There are some that do spoken menus. There are some that are automated. There are some that are manual.

Most of the big players have their own proprietary system. Many hospitals contract with Seaboard or top nutrition to Bolton, one of their add on menu programs. So there's a lot of different programs out there being run today.

We obviously think ours is the best and the easiest. You know, a lot of times clients will say, Well, I don't want you to bring in your proprietary stuff because when you leave, then all that information goes away and we don't have access to it. Well, our situation's a little bit unique because we will allow them to keep that system and operate it, continue to operate it. 

There's a licensing fee that they have to pay, but it's extremely small compared to what you pay for a keyboard or computation on an ongoing annualized basis. So we do offer something a little bit different out there and that alleviates some of the fear that clients may have.

On benefits of outsourcing food service...

Jon Amos

Yes, so what else? You know, if you're talking to an administrator and you know, they're worried about the costs, so you just mentioned are there, they've got concerns about switching to this, this style. What are the things that you talk them through about why it makes sense, why it's worth it? You know, what are the benefits? What are the things you're telling to an administrator about why it's worth it to go to this?

Dirk Noteboom

So one of the things that we talk to them about is whether you want this system or not. It's included for free to you. We don't charge clients for this program. It's an extremely cost effective program out there. So the benefit to them is they get the technology and the safety associated with using the program. The program has built in allergies and safety measures for patients that help us just maintain and enhance patient safety.

And again, it's at no cost to the client, so we have not really had any issues with clients. And oh no, no, don't do that. We've had a couple of clients that have said, well, our enterprise wide system is going to be this, but if this is no cost to us.

We'd like to run it as a trial. And in fact, I was just talking to a large hospital system yesterday that's bringing in competition, but they're allowing us to trial Breadbox at one of their hospitals, and we're in the process of getting that set up right now. And once we do that, they may come take a look at it. And actually, they committed to taking a look at it and seeing if that would work enterprise wide for them. And if it does, that may put us in a mix in a much larger and much larger position.

So I think technology does sell. I also think the ease of technology and having a manageable cost associated with it is a huge game changer in our business.

On a patient ambassador's typical day...

Jon Amos

Yeah. So then I'm kind of curious to go into the specific the actual patient ambassador who said they work twelve hour shifts and they're there for breakfast, lunch and dinner. And I'm kind of curious, in between those times, or just a day in the life of a patient ambassador. Yeah, you know, they're taking orders, they're getting into the kitchen, they're delivering meals and then breakfast time is over. What does that space in between look like? Are they following up with patients?

Dirk Noteboom

Yeah, so breakfast time is over. They go back, they pick up the trays, they bring the carts back down. Depending on the size of the unit and the load of patients that the ambassador is servicing. They might help scrap trays, help those trays run through the dish machine.

There's always silverware to roll, but usually after breakfast about 9:00, they're back up on the floors, taking lunch orders. And then they repeat the process. You know, they come back down to the kitchen. They help build the trays for their patients. They deliver those trays. Make sure everything's OK that the patient doesn't need anything additional. They'll do a round. And when one lunch is over, they will go back, pick up the trays, bring it down and start the process again. 

And then about 2:30 or so they will go back up and take dinner orders, and then breakfast for the next morning. Obviously, we don't want to be waking patients up at 4:30, asking them what they want for breakfast. so we do lunch before lunch, we do dinner before dinner and when we take the dinner menu, we take their breakfast order for the next morning.

Jon Amos

Gotcha. OK. And then how important is it in terms of, you know, those 12-hour shifts and integrating with actually the nursing and the clinician team, is that a relationship that gets built so that when a patient is talking about food, nursing knows you know who the patient ambassador is and there's that connection there and how does that get built over time?

Dirk Noteboom

Yeah. So that's a great question, and that's a critical component of an ambassador is building that relationship with nursing. And when you have ambassadors that are engaged and really doing a great job, nursing considers them a part of their nursing team. And when they're not on that floor, nursing will call down sometimes and say, ‘Hey, where's Maggie? She needs to be on this floor. She's our person.’ And so those relationships do get built over time. 

And really, we look to hire ambassadors that have personality, that have a smile, that are outgoing. Because we can train the actual jobs or the job task, what we can’t train is that inherent happiness, the want, and desire to serve people, and really have a personality that's outgoing, smiling, friendly. We can't really train that piece that you either kind of have that or you don't. 

But we can certainly train how to use the Breadbox application or how to build a tray or things like that. And so that personality that we look for in an ambassador is critical in building the nursing team relations and working with the dietitians and working with the managers in the department. So yeah, very, very critical.

Amy Fritzer

Yeah, and kind of to follow up on that, obviously it seems like someone to have to be bubbly, personality, very service oriented. And like Jon, I just asked about, you know, kind of integrating with the nursing staff and because they have such a high, you know, touch point with the patients. I would imagine that a lot of them can almost become like an extension of the family almost and aiding in the patient's healing. Or if you know what, patients in isolation, that might be the only person that, you know, the ambassador may be the only person that the patient has interaction with. Have you seen that too, Dirk? Just on a personal side with some of our patient ambassadors?

Dirk Noteboom

Yeah, definitely. It's not unusual for me to get stories or hear instances of ambassadors, you know, doing things like helping people get groceries after they leave the hospital or things like that.

I think particularly, if somebody is there for an extended stay, our teams get very close to those patients and their families and it is kind of a bigger family. And you know, that goes to another point too. We have patients that do pass away and that becomes very difficult for our team as well. While nurses are on the frontlines and doctors are on the frontlines, so are our teams, our ambassadors, our hourly team members, our managers, are all on the frontline. They know these patients and as they pass away, that's a big emotional blow that I think sometimes gets overlooked. But it's a reality of what we do. And so it can be very difficult and challenging at times due to the closeness that our teams get with the patients.

On predicted changes in hospital food service...

Jon Amos

So going forward, obviously, it's come a long way since, you know, the last 30 years in terms of, you know, how food is prepared and served to patients. But going forward in the next five, ten, the next 30 years, you know, how do you see, you know, the patient side of food, you know, changing in a hospital?

Dirk Noteboom

Yeah, you know, that's an interesting question. 30 years out is such a long time, especially with technology and medical advances and that kind of thing. We've been talking recently about, you know, with staff shortages, how can we help alleviate some of those issues? And we talk about, can robots serve trays and can they do this and that and the other? And the truth of the matter is I think there are some jobs, at least in the foreseeable future—the next five to ten years—that will always have a person there. And I think meal service is one of them. Simply because of that interaction that needs to happen and the unique challenges and issues that each patient has.

Amy Fritzer

Customized menus and things like that?

Dirk Noteboom

Yeah, selective menus and various disease states that require a little bit of finesse when you're getting an order from a patient, understanding what they need to do to help them heal. So I think that, probably over the next five or ten years, our goal will be to refine our training to help our team better be able to serve those patients' needs.

But another key piece of this is really getting hospitals to understand that while our department is considered entry level, that's not an eight dollar job anymore, you know, and the times are really going to have to change now and move forward. Otherwise, folks are going to choose a different career path and hospitals. Even though we provide education, we provide opportunities to get degrees and from various institutions to our team. It's going to take more than that, because if our team can't survive working a 40 hour job in the hospital, they're going to go somewhere else where they can. They can get paid for their work.

Amy Fritzer

Yeah. And Dirk, that kind of brings up a thought I just had is when you're talking to an administrator, you're talking about the food service program and costs associated. Obviously, labor is huge, right? You can't really cut labor, you need that. But what are other ways that a food service department could get creative in saving? Is it on a food cost side? You know, what are some ways that you've noticed or that we've even done for some of our clients, perhaps examples of how we've cut down on costs?

Dirk Noteboom

Yeah, I think I think that's a great question, and some of those ways absolutely revolve around food cost, getting the right product in for the right application, ordering the proper product at the proper time, and then the production of those products. And what I mean by that is, if we overproduce, let's say we're producing food for 100 patients, but we make enough for 150 and toss out 50 servings of everything that's a huge food waste. If we don't produce the product right, if we get a product in and prepared in a way that it's not meant to be prepared, then we waste a lot of food. So, it's looking at our menus, making sure that what we have on there is solid that we don't over menu items. And what I mean by that is we don't offer three different entrees. We offer one chef's special and then we all offer some alternatives that are always available. But those alternatives are always available in the retail space too. So it's really easy to get and we cross utilize.

So food cost, proper product at the proper time, and and avoiding food waste as much as possible is one way. Making sure we're ordering the right supplies. And one of our largest supplies in the kitchen is going to be paper products, whether that's disposable plates for the retail area, whether it's napkins, silverware, surprisingly, is one of the things that has a very high turnover rate. A lot of it gets thrown away or people keep it as a memorial to their hospital stay, you know, crazy things like that.

And then there's always a chance, especially as we get into an account and start operating it over the course of the first year, there is usually an opportunity to look at labor and understand since we've been operating it, how we can become more effective and more efficient. So, all three of those areas, there's always things that we can look at based on the experience of our operators to be able to help reduce costs.

Amy Fritzer

You were talking earlier about Breadbox, our proprietary software, and how it, you know, talks to the kitchen and things. Can they monitor inventory levels on product there as well when it, you know, integrates the recipe side and obviously the production side? Is that what clients utilize for, you know, purchasing products?

Dirk Noteboom

Yeah, so actually, our teams do all the purchasing of products. So our teams are monitoring all of that, what they need based on the menus for the retail and for the patient services. But yes, the inventory module will tell us what's in stock and we plug the menu into Breadbox, it'll tell us what we have in stock and what we need to order to complete that menu. So it becomes a very efficient cycle once all of those components are put in place.

Amy Fritzer

Helps cut down on waste is what it sounds like to me.

Dirk Noteboom

Yeah, definitely.

Amy Fritzer

And it’ll tell you exactly what you need and all that stuff?

Dirk Noteboom

Yep, it sure will.

Jon Amos

Well, obviously there's just a lot that goes into not only just the patient ambassador side of things, but just the overall food service, also. In summarizing this conversation, Dirk, I'm curious if you can just kind of cover some of the the biggest takeaways you think that you'd want to leave listeners with in terms of why the patient ambassador program is important and why food from a patient perspective is so critical for hospitals and for the patient experience.

Dirk Noteboom

Yeah, sure. I think the big takeaways for me regarding patient ambassadors is as a patient is lying there in bed and they're being poked and prodded and maybe they don't know what's going on, they absolutely love to see a smiling face and a bubbly personality come in their room, talk to them for a couple of minutes, and then deliver food that they've been waiting all day to eat.

A lot of times that's the only control patients have in the hospital, and so it's something they look forward to and it's really important to them — not only as a monotony breaker, but as a healing process as well. 

And so our ambassadors provide that to them. And I think they are very well respected and very highly thought of by our patients and nursing teams across our line of business.

My takeaway regarding food is that it’s critical for patients to be well nourished prior to being in the hospital, in the hospital, and when they leave.

The truth of the matter is what we do in food is critically important to that patient's successful healing process. 

You can have the best doctor in the world with the most advanced procedure, the most advanced gadget, and the best medicine — but if your body is not nourished properly, it cannot heal itself from any of the experts. So that proper nourishment that we provide really allows the technical expertise of doctors, nurses, pharmacists to be impacted in that person's healing process. 

So we have one of the most important jobs in the hospital, which is making sure that that our patients are being well fed and well nourished so that they can heal up. And without us, that doesn't happen. 

So the service we provide — while is many times considered entry level — is one of the most important jobs that anybody in that hospital has.

Amy Fritzer

It’s a lot of stuff you don't think about, you know? Everyone knows you go to a hospital to eat and that you're going to get fed in a hospital. But I don't think most people really think about what it actually brings to the patient.

Dirk Noteboom

Yeah, I think that's a fair statement. I also think that people have a very low expectation of hospital food. So when they walk in and they're a patient, and they get a cheeseburger and fries they’re like “Man, this is not bad. This is pretty good.”

Most people are really surprised to find out that we have chefs in the hospital that actually are very talented, passionate, foodie people. So that's another aspect. Maybe that's another show.

Jon Amos

Yeah, that’s great. Well, Dirk, I'm just so grateful that you gave us the time and provided a lot of insight here. I definitely learned a lot. So thanks for cutting time out of your day and doing this with us.

Dirk Noteboom

Awesome. Thank you, Jon. Thank you, Amy. I appreciate the time to talk about our ambassadors and our food program and look forward to being on another podcast.