Keeping things cooking at the Island hospital
Low-fat, no sugar, gluten-free, vegetarian - if fixing a family dinner that pleases everyone seems difficult, Chris Porterfield's job makes it sound like a piece of cake.
As the director of food and nutrition at Martha's Vineyard Hospital, every day he and his staff plan, prepare, and serve more than 550 meals that must accommodate every type of dietary restriction - and taste good, too.
"It's an interesting department, because we facilitate both Windemere Nursing and Rehabilitation Center and Martha's Vineyard Hospital - so our area's a little challenging," Mr. Porterfield said in a recent interview in the hospital cafeteria.
In addition to preparing about 100 meals three times a day for those two facilities, the department serves about 150 breakfasts and lunches in the cafeteria and makes another 110 Meals on Wheels for the Island's senior centers and elderly residents in their homes.
Feeding the masses
The 26 people who work in the food and nutrition department, a mix of full- and part-time employees, are its most important asset, Mr. Porterfield emphasized. "It's very humbling to talk about what I do, because we've got so many great people who work hard in this department," he said. "We're very lucky to have the amount of people we do who are committed and dedicated to do something that's very difficult to do - it's very physical, it's tough, and it's three times a day."
They also must adhere to strict state Department of Public Health regulations. Meals must be spaced a certain number of hours apart - breakfast preparation begins at 7:20 am, lunch at 11:20 am, and dinner at 4:20 pm - and delivered to the various hospital areas and Windemere units within a 10-minute window at the same time every day.
Offering a tour of the kitchen during his interview, Mr. Porterfield started in the cold food preparation area where technician Beverly Tucker has worked behind the scenes for 41 years. "I'm here for the patients - that's what I like," she explained, while preparing three frappes for patients' lunches. Nearby her co-worker of 10 years, Edna Koch, put together delicious-looking fruit plates.
Around the corner, Sharon Araujo, a hospital chef for 31 years, added pesto to a huge vat of pasta primavera. Mr. Porterfield introduced Chef Paul Donnelly, who formerly worked at the Harbor View and Black Dog restaurants for several years, as someone who "is very committed to trying to make an improvement in what we're doing here - he's a good fit."
Later in the day Chef Christopher Belain, the pm cook, would arrive to prepare dinners for Windemere residents and hospital patients. He also makes pizzas and burgers for the cafeteria and prepares Meals on Wheels.
"We've got chefs with backgrounds in fine dining to institutional - it's a good blend," Mr. Porterfield said. Unfortunately, however, he must compete for them in the job market with other food establishments. Recently Chef Mark Brasefield, an employee for three and a half years, left for another job that Mr. Porterfield said was a wonderful opportunity for him.
The chefs collaborate on the weekly cafeteria menus, which gives them a chance to experiment and also to make their specialties. Mr. Porterfield said no one can make a meatloaf as good as Ms. Araujo's.
Out front, cafeteria attendants include Melissa Courneyer, and 10-year veteran Tamma Willoughby. Meals, including an entrée, two side dishes, and a medium drink, average about $5.50. Sample entrees from recent menus included chicken Oscar with crabmeat and asparagus topped with hollandaise, barbequed baby back ribs, and mustard crusted salmon.
Many locals frequent the cafeteria, including construction workers and Steamship Authority employees. "When Linda Jean's closes for a few weeks in the winter, we notice an upswing," Mr. Porterfield said.
Working with a streamlined staff in a small facility means that Mr. Porterfield wears many hats. "We were short a cook one Saturday, so I was a cook that day, whereas in a large facility, you would never see the director of food and nutrition in a position like that," he said with a laugh. "But if you're afraid to wash the dishes, you shouldn't be in the kitchen. I think you learn a lot from that." He also serves as the hospital's security officer and as the default vending machine specialist.
Another key player is Mary Gross, the hospital's dietician for 21 years. She meets with hospital patients and Windemere residents to plan their meals, and provides dietary and nutrition counseling in-house and on an outpatient basis.
Diet aides Jennifer Rapuano and Lucy Menton, also called hostess/technicians, assist her in making sure food trays contain the right items before delivering them to patients. In addition to helping patients fill out their menu selections and providing general diet information, they add special touches, such as delivering coffee and a newspaper with breakfast, and afternoon snacks.
Mr. Porterfield said some healthcare facilities have switched to a "room service" program where patients phone in their menu selections. "We could order the technology, which is expensive, but I think it's better to have somebody to work with patients one-on-one," he said.
The extra touches
The food and nutrition department also provides convenience meals for family members of surgical, emergency department, acute care, and obstetrical patients.
"It's nice if you have patients with loved ones that we feed them as well, too, because it encourages the patients to eat - we're trying to give them the normalcy of home," Mr. Porterfield said. "It also encourages people with eating disorders or problems eating to eat with somebody."
The new hospital will have kitchens on each floor and places where people can dine together as a family if they choose to, Mr. Porterfield said. However, the food and nutrition department will stay right where it is.
The food and nutrition department also caters the hospital's and Windemere's extracurricular and special events. "We just finished a golf tournament, for which we catered a cocktail party the night before at Farm Neck, and then we catered meals for all the players and volunteers on the day of the event," Mr. Porterfield said. "There are numerous outside events and functions for different areas."
His department kicks off the summer with a barbeque for all hospital campus employees, and ends the season with a clambake. In the meantime, there are special meals for various staff appreciation days, luncheons for administration or physicians' interviews, and unit barbeques, garden parties, birthday parties, and celebrations for Windemere residents.
A work in progress
Mr. Porterfield said the hospital formerly contracted food services from the Marriott Corporation and Aramark, and hired him in 2001 with a goal to save money by running the department in-house.
It worked, Mr. Porterfield said, and as the hospital achieved a better financial position overall, he expanded his efforts to improve quality by assuming more control of the food, from preparation to delivery.
"Quality comes with having a little money to make those improvements and having the staffing to do it," he said. "Our original focus was on saving money, and now it's a balance of being efficient and providing a good service, too."
Food quality has improved as well, Mr. Porterfield said. Results of confidential surveys conducted by an independent agency show a rise in patient satisfaction since he started. "We've come a long way. Are we perfect?" he reflected. "No - but we're working on improving, and that's what we should be doing, trying to make things better."
The food and nutrition department's operating budget is about $1 million a year, Mr. Porterfield said, out of a total of $43,858,793 in expenses for the hospital. Sharing food services works out very well for Windemere and the hospital, especially in terms of being cost-effective, he said.
Very few of the department's expenses are offset by reimbursements, however. Although the cafeteria produces some revenue, food prices are kept low and profits go toward labor costs.
The department does receive reimbursement for Meals on Wheels, a state program run by Elder Services for the Cape and Islands that receives federal funding, as well. "We're required to use a percentage of government commodities in the meals, which they give us a list of a month ahead," Mr. Porterfield noted. Elder Services asks clients to donate $2 towards the $6 cost of each meal.
Before moving to the Vineyard, Mr. Porterfield, who has a bachelor of science degree in hotel, restaurant, and institutional food service and culinary arts, worked four years as a food service director at Boston's Fleet Center. He said he finds his job at the hospital much more satisfying because, "Here, food service is beneficial to the community and to the people that need it and appreciate it - they don't take it for granted."
Mr. Porterfield grew up in Santa Fe, N.M. His wife Stacey is the granddaughter of Robbie Cronig, the butcher at Cronig's Market when it was on Main Street in Vineyard Haven. "She convinced me to move here, and it's a great place for our kids," he said, speaking of Owen, 7, Nate, 5, and Charlie, 2.