“Farm to Bed”

Northwell Health has transformed its foodservice program over the last seven years.

Northwell Health hired Michelin Star Chef Bruno Tison — the legendary Executive Chef of the Plaza Hotel when he was 30, among other accolades and accomplishments – to be its Assistant Vice President of Food Services and Corporate Executive Chef at the end of 2017. The health system was the first in the country to hire a Michelin Star chef. In the seven years since he began reinvigorating hospital food, lots of changes have occurred.

For one, Chef Tison is far from the only Michelin Star chef at Northwell now. “Most of our chefs, now all our chefs, come from the hotel restaurant background,” Chef Tison said. “We have five chefs that I’ve worked in Michelin star restaurants [with].”

Among the reasons Northwell can attract such talent, apart from Chef Tison’s reputation, is that it raised the wages of its chefs to reach what Chef Tison considers “a proper salary.”

Additionally, Northwell has vastly increased its usage of fresh produce and high-quality ingredients. It brings in fresh, artisanal bread from two of the best locations in New York State. Before Chef Tison signed on, Northwell used about 90 percent of its refrigerated space for frozen food. Today, that percentage has been flipped to 10 percent and the little that is frozen are stocks and sauces that are made at each facility. Chef Tison considers Northwell’s cuisine now “farm to bed” based on its fresh, high-quality ingredients.

Hospital menus have also been redesigned. Gone are the Northwell logos and photos of the front of the hospital.

“Quite honestly, the last thing I need to remind you when you’re in bed suffering is that you’re in a hospital; you know you’re in a hospital,” Chef Tison said. “For 10 minutes, when the patients are reading the menu, you transport them to another world, to the world of food… and they start salivating and they start thinking about what they’re going to get. [When patients are eating, it] gives them a small moment of pleasure and the time to forget about why they are in the hospital.”

Northwell is investing in its food quality for several reasons, including strategic business ones. Given that Northwell is situated among several of the top hospitals and health systems in the country, it’s in a competitive market.

But, as Chef Tison explains, “if you get great care, a clean room, good attention, a smile from the person who served your food and great food that smells and tastes good, where are you going to go?”

When Chef Tison first joined Northwell, the institution’s Press Ganey scores (a marker of how facilities are performing in various patient care metrics) were in the ninth percentile in the area of food quality. When he joined, Chef Tison joked with Northwell’s Chief Experience Officer Sven Gierlinger that he would like to get those scores to be at the 90th percentile – just adding a zero. Seven years later, Northwell is pretty darn close.

During an interview in March, Chef Tison shared that Northwell in aggregate is at the 84th percentile, with eight hospitals, including a tertiary, achieving above the 94th percentile. Chef Tison is hopeful that all the health system’s facilities when combined will reach the 87th percentile by the end of the year. And given the health system’s start to the year, that looks promising.

“[The industry] served pretty bad food for such a long time that we still have people coming to some of our hospitals thinking they’re going to get bad food,” Chef Tison noted. “But it takes time to change people’s perception because, again, the stigma of bad food in healthcare in a hospital is still there for what we’ve done for the past 50 years.”

Among the areas that Chef Tison would like to continue to improve is how the food is delivered.

“I’ve realized that there is no difference between the hospital patient and a hotel customer,” Chef Tison said. “The food you provide them needs to be done with the same attention, same style, the same refinement that you would do in a hotel.”

So, if you watch a Northwell food and nutrition person delivering a patient’s food, you should notice their crisp, clean uniforms and friendly and welcoming demeanor. Chef Tison is working toward having all hospital food delivered by food and nutrition personnel rather than a member of the nursing staff.

“We still have a lot of hospitals where our food is being served by nursing services,” Chef Tison said. “And there is a big debate about, it should not be their work and they should not be handling the food… At the end of the day, when you look at the job of a nurse, if he/she has an emergency and needs to give some care to a patient, if the food is being delivered, how has it been delivered? The food is going to wait. You know, the patient’s life or care is more important than the food. And that’s why I would like to transfer all the food to be served by food and nutrition, not by assistant nurses.”

Chef Tison is certainly going to be busy in the coming months. In addition to his efforts to help Northwell achieve the 90th percentile, the health system just merged with Nuvance Health, adding seven more hospitals to Northwell’s growing healthcare empire. That group of hospitals outsourced its food preparation.

Between its 80,000 staff and 5,000 beds across its hospitals – and that’s not counting the Nuvance addition — Northwell is serving more than 10 million meals a year.

“We purchase $55 million of food every year,” Chef Tison explained. “If we would be a hotel company purchasing $55 million of food per year at a 25% food cost, we would be a $220 million business.”

Northwell is changing the perception of hospital food one step at a time and making a sizable impact on patients all the while.