Service Excellence was initiated at Howard County General Hospital in 1993. The goal of the hospital was to develop a process to improve customer service while maintaining a competitive advantage. Using the Deming philosophy, that 85% of the problems is system and 15% is people, the hospital embarked on a continuous improvement initiative. After assessing the organizational climate of the hospital, a multiple step process was recommended.The initial step was designed to set the culture and tone for team work and open communications. Senior management developed the Service Excellence Vision and Values. These values were discussed and encouraged as a guide of how work should be accomplished in the hospital Departments were asked to develop mission statements and goals to meet their mission. A major team work campaign was initiated m the spring of 1994.The second phase was the implementation of improvement teams. All department heads and managers participated in Team Leader training during the year. Interdepartmental teams were formed. The concept was expanded to develop the cross departmental indicators to meet the 1995 Joint Commission requirements through the product line approach that included nutrition.The final phase was initiated in January 1995. All hospital employees participated in a four hour training class to learn the principal elements of the process and tools for team success. Hospital wide the team spirit is blooming. Employees are suggesting opportunities for improvement and talking cross departmentally to solve problems. Morale has greatly improved.Teams have been able to implement changes which directly impact Food and Nutrition Services. A interdepartmental team analyzing discharges and transfers is presently implementing a computerized system that will conservatively save yearly $13,000 in wasted trays. A departmental team has analyzed the tray line system and implemented changes which has increased efficiency, eliminated of one full time equivalent and assisted with the development of a training plan for employees. Patient care teams have streamlined communications with physicians and enhanced the ability of the dietitian to better serve the patient.