Michelin-star food for the same price as frozen meals: Q&A with Northwell's Sven Gierlinger and chef Bruno Tison

Hospitals have a reputation for bland or unhealthy food, but New Hyde Park, N.Y.-based Northwell Health is flipping the script by hiring chefs from Michelin-star restaurants.

"We did all this without increasing food costs," Sven Gierlinger, chief experience officer at Northwell Health, recently told Becker's. "We've utilized our purchasing power as a larger organization. It doesn't cost more to cook fresh food if you have the right talent because buying processed food is actually pretty expensive."

"We have a team of talented chefs that honestly I can say some hotels and restaurants would envy," chef Bruno Tison said, in a simultaneous interview. Mr. Tison served as executive chef at New York's Plaza Hotel for 30 years and earned a Michelin star at California's Sonoma Mission Inn.

Editor's note: responses have been edited for clarity and length.

Question: Hospitals have a reputation for bland or unhealthy food, so what happened that made you say, "no more, we need a change"?

Sven Gierlinger: We've known that our patients were very dissatisfied with the food. Patients have very low expectations when it comes to that and even with those low expectations, we were at the bottom. We were somewhere in the 9th percentile for the quality of foods. We did deep dive interviews with patients and what we found was that in many cases, patients were very happy with the experience and with the care that they received from the doctors and nurses and the outcomes, but when we measured the likelihood to recommend us they didn't give us a "definitely recommend." In many cases it was because of the food. To know you do all this great work and then you get downgraded because of the food is just crazy to think about. So we started a journey to not just transform the food for our patients, but also to think of food as health.

Q: What was the process to bring Chef Tison on and how long has this initiative been running for?

SG: We are probably a year into it now. At the beginning, we put together a steering committee of high-level individuals to identify strategies around improving our food. What we realized is that we didn't have a leader that was overseeing food. We put a job description together, but let's just say we weren't very excited with the candidates. Most were coming from institutional food service and that's not what we wanted for the position. We realized the problem was the kitchen and we needed somebody with a chef's background to handle that. When we interviewed with chefs, I realized there's a whole different level of passion for food. And that passion started to permeate throughout the organization. It was a game changer for us.

Q: How did you go about rolling this out systemwide?

SG: It started with the steering committee that I mentioned, then we started setting standards for overall food and nutrition commitment for the health system. That became a strategic initiative for the system supported by our CEO, Michael Dowling. That was our guiding light that helped us through the process as we worked with each facility to improve their food. We eliminated all fryers and dramatically reduced sugar beverages. We changed the process for how food is delivered and served and created recipes that taste great. We have seen a sharp increase in our food quality since starting this process. Today we're around the 80th percentile, and some of our facilities are in the high 90s.

Q: What benefits have patients and the health system seen from this new program? 

SG: Now the patients are writing letters solely about how incredible food is and how it made them forget that they're in the hospital or forget the pain they were in. They were looking forward to ordering and they couldn't decide what to order. They have room service so they can eat what they want, when they want and order from an order taker from our beautiful menus. That's what they're talking about now: how their experience is more dignified as a patient and it helped them in their healing journey. So it's unbelievable the feedback we're getting now. And the chefs are now sort of celebrities in the hospital. This week our chefs were showing some executives around to explain the food journey and the patients would say, "You're the guy from the back of the menu. Oh my gosh, you're the chef!" and they high-five them. That excitement doesn't happen in hospitals anywhere but now it's happening in our hospitals. Chef Bruno always says, "It's like we're bringing the restaurant to them." And it really is a dining experience. 

Q: Mr. Tison, what about this opportunity made you want to leave restaurants and work for a hospital system?

Bruno Tison: By pure coincidence, I was meeting a friend of mine who was the food and beverage director at the Plaza Hotel in the early 2000s. We met for dinner and from the beginning he asked me, would you be interested in this program at this hospital in New York? So I told my friend, "Yeah, I would love to hear more about it." And the more I listened, the more I thought it was interesting. After Googling Northwell, I decided to interview. We connected very well and honestly I was scared. I said, "Boy, I don't know anything about healthcare. Am I going to be a disadvantage, and am I going to succeed?" I spent my career cooking very expensive meals with no second thought about the price but never thought about impacting humanity and the people who couldn't afford it. I like to help people and I saw this as an opportunity for me to put my talent, knowledge and years of experience at the service of people that needed it most during a difficult time in their lives. I was convinced this was my destiny, to help people in a different way.

Q: Where did you start with making such major changes to the food quality?

BT: To begin, we have to understand that it's our fault, and I mean the healthcare system, for not focusing on food and nutrition, for not seeing it as an asset but rather a disadvantage or a cost. When it's not prioritized, it has a snowball effect. If you don't care about food or nutrition, you don't hire talented, qualified people. Those people hire people like them. If you're not a good chef, if you don't care about good food, you don't care about the cleanliness of the kitchen or uniforms. You don't train your chefs and the food gets worse and worse.

The first thing I did was bring on talented, qualified chefs. I saw that what I was afraid would be a disadvantage, knowing nothing about healthcare, became an advantage. I wanted chefs who also knew nothing about healthcare. I wanted them to learn as they go, but bring the hotel restaurant experience to our patients. I found 15 highly talented executive chefs with some amazing backgrounds. We have a team of chefs that honestly I can say some hotels and restaurants would envy. After that we had to bring on better product. When I came in, everything was frozen or ready to be reheated; there was no actual cooking going on. We selected local fish, bread, and produce vendors for the best quality ingredients. After that, we worked in converting our freezers into refrigerators. We organized a kitchen cleaning schedule, which didn't exist before. Then we got a committee together and redesigned the uniforms for chefs and front of house. And suddenly the chefs and the staff started to really be proud of what they're doing.

We created diner-style menus that are easy to read and don't have any medical or clinical terms. I suggested we put the therapeutic diets and explanations in the arrival packages for patients. I wanted our dietary services to be involved. Instead of patients reading their dietary requirements off a paper, I wanted them to have human contact with their specialists.

I could go on for hours. It's constant small changes, day after day, week after week. I think about the next step, what I can improve. All those small details make a big difference in the end.

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