The Menu Madness Quality Action Team (QAT) of Emanuel Medical Center was originated to design a new ethnically diverse patient menu which replaced the old “meats and potatoes” menu of 3 years. The team consisted of 11 Nutritional Services employees which included cooks, cold food preparation, stock clerk, and Registered Dietitians. The Menu Madness QAT determined during the Focus phase that the current patient menu system leads to inefficient food preparation methods and does not meet customer needs, which include ethnic choices and healthy lifestyles. During the Analyze phase of the process, the team developed and conducted a patient questionnaire. Each team member was responsible for obtaining and recording information from at least 10 patients, who were selected randomly over a 2 week period. A summary of the results revealed that 40% of the patients prefer the largest meal during lunch, 73% prefer hot meals at lunch, 68% prefer hot meals at dinner. Out of all the ethnic choices, 71% reported they prefer Mexican Cuisine. During the Analyze phase, the team members prepared and submitted family recipes for consideration and taste tested a wide variety of entree options in designing the new menu. As part of the Development phase, a new five-entree menu was created. It included four choices (two hot, two cold) which are the same daily and a fifth which is a “Signature Item”. Utilizing this information, the QAT members successfully designed and implemented the new patient menu. The total process took eight months. A follow up patient questionnaire was conducted and the results revealed that patient satisfaction has improved. Not only are the patients satisfied, but the employees have benefited as well. Cafeteria sales have significantly increased since the new menu items are being offered to the employees as well. By utilizing the Continuous Quality Improvement (CQI) process, the team was made more aware of the patients' expectations and could therefore, serve them better.