Confluence Health

Improves Patient Safety, Operational Efficiency with Move to CBORD
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Confluence Health

Confluence Health is an integrated healthcare delivery system in Central Washington, serving as the major medical provider for communities between Seattle and Spokane.

Over the years, Confluence Health has received recognition for its commitment to quality, safety, innovation, and excellence. The system earned DNV GL accreditation by demonstrating it meets or exceeds the patient safety standards set forth by the U.S. Centers for Medicare and Medicaid Services and by integrating the ISO 9001 Quality Management System into its clinical and financial processes.

Confluence Health, with two hospitals and more than 40 medical specialties, is committed to staying on the forefront of healthcare innovation for all aspects of care including food and nutrition services.


Facing ongoing barriers and challenges with the food management technology in place, the food and nutrition teams realized the existing system was not up to par in several key areas that impacted patient safety and operational efficiencies.

“From a technical standpoint, the integration with the electronic health record didn’t support multiple diet restrictions, and there was no integration with the recipe management and food production side of things,” said Garen Schroder, supervisor of dietitian informaticists at Confluence Health.

This lack of integration and dietary compliance put patient safety at risk with error-prone manual processes in their call center. “It wasn’t a very safe patient experience because we couldn’t track the allergens or nutritional restrictions for patients,” commented Michelle Harris, food service director at Confluence Health.

The system limitations weren’t the only challenges they were facing; the team was also dissatisfied with the vendor in general. “One of the biggest reasons why we chose not to rebuild our previous system was we were just really unhappy with the company overall and their level of customer service, flexibility, and willingness to work with us,” Harris noted. “The system was just not user friendly for our call center staff or back office to manage and maintain. It seemed very archaic and clunky.”


Having made the decision to transition away from their existing system, the Confluence Health team used their lean tools to identify the main challenges and created a list of items they wanted to solve. After considering several vendors and viewing in-depth demonstrations, the team turned to CBORD as the vendor of choice.“ CBORD was selected as the company that offered the most as far as flexibility, forward thinking, and growth opportunities for us,” Harris commented.

CBORD’s solutions offer the seamless integration and comprehensive features they were seeking. “From a foodservice perspective, CBORD offers what we wanted: a system that is all encompassing, where we can streamline ordering, manage recipes, and tie everything together,” explained Harris.

“From a nutrition or dietitian standpoint, we are able to better manage and personalize patient diets instead of the one-size-fits-all mentality of the past,” Harris said. “Now, we’re able to customize the process and educate patients more to look at those meal goals versus day goals and things like that. CBORD also offers a better end user experience for our employees, helping improve satisfaction and safety.”

From an IT perspective, CBORD makes it easier to keep the system updated. “We’re always on the latest and greatest version, whereas we were multiple versions behind with our previous vendor just because it was so cumbersome to update everything,” added Schroder.


Only a matter of months into using CBORD’s solutions, the Confluence Health team is already seeing improvements. “CBORD’s solutions are significantly improving efficiencies and outcomes,” Harris stated. “We’re able to have a better idea of our overall food costs and our patient safety has improved.”

Improved Patient Safety

The team appreciates the way CBORD makes it easier for staff to ensure patient meal accuracy. By carefully setting up and coding their data in the CBORD system, they can ensure orders adhere to limits and restrictions. “With CBORD, our staff is now able to follow the compliance that’s built into the system,” Harris noted.

One aspect of the CBORD solution that stands out as far as patient safety goes is the tray tracking capability. “A game changer for us was Tray Monitor,” said Harris. “It allows us to see when patients move rooms, if patients have diet order changes after the ticket is printed, if they go NPO. I can’t give you exact numbers, but for sure we’ve had a lot fewer events in our risk management software that we track as far as this patient got the wrong thing on their tray or whatever it might be.”

The flexibility of CBORD’s solutions gives them the agility they need in the current landscape. “We’re able to keep up with trends and the unexpected in foodservice,” Harris noted. “We have more flexibility from a disaster standpoint because, if we do need to modify menus on the fly or go to a house diet for all patients, it’s really easy to print tickets for the whole house.”

Better User Experience

With one of their main goals being to improve the user experience for their staff, CBORD has proven its value once again. “The system is more user friendly,” commented Schroder. “The web-based platform is lot more intuitive and accessible to users of different backgrounds; they just pull up a web browser for the most part.”

Harris is looking forward to having the improved user experience help indirectly with the current labor shortage. “Right now, we are struggling with staffing, so we’re trying to figure out ways to have some of our call center staff work from home to make the job more attractive,” commented Harris. “As soon as we get some internal IT setup resolved, the CBORD system is ready, and we can roll it out.”

Elevated Vendor Relationship

Harris and the team at Confluence Health appreciate the learning and networking opportunities CBORD offers, including informative webinars and the annual user conference, that were not available with their previous vendor.

“Garen and I went to the CBORD conference and found that extremely beneficial as far as networking and the information that was shared,” Harris said. “The webinars offered periodically provide ongoing learning so we can continue to optimize the software to help us be more efficient.”

The team at Confluence Health emphasized the importance of CBORD’s experienced, knowledgeable implementation and support teams to the success of their transition to CBORD. “The implementation representatives on our project made this project a success,” Harris said. “They were really great to allow us to think outside the box and figure out ways to meet our hospital’s needs and goals.”

“Related to ongoing support, we actually get to know these folks and they’re just super easy to connect with,” Schroder commented. “They have always been eager to help us address the more complex situations.”

Ready to read more? Click here to view the PDF and learn how switching to CBORD helped Confluence Health transform its food and nutrition operations.

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Confluence Health Case Study

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