Volume 2 | Issue 2 | Year 2006

Consider the following menu served to you in bed shortly after you ordered it:

Roasted chicken broth accented with fresh mint and lemon

Pan Seared Scottish Salmon sprinkled with Mandarin Caper Relish

Steamed Texmati Rice

Bounty of Garden-fresh Vegetables

Possibly the only items missing are the glass of wine and the ambiance of a fine restaurant.

Yes, hospital food service has “come a long way, baby!”

Health care executives realize the importance of emphasizing the “hospitality” component of hospitals. As a result, patient satisfaction has become a major outcome measurement for all hospital departments. And, food service, one of the few activities over which hospitalized patients have some control, is an extremely important event in the day of a patient. Patients may not know if the surgery was outstanding, but, they do know if food service was good.

As a result, today’s health care food and nutrition services directors are continually seeking more effective and efficient food service delivery systems for patients, in order to exceed their expectations and generate high satisfaction scores. Twenty years ago, patients were offered menus today for tomorrow.Do you know what you want for lunch tomorrow? Add to that dilemma, your changing health status.If you don’t feel well, what would whet your appetite in 24 hours?. Difficult question to answer, even for healthy folks.

The spoken menu

Over 10 years ago, Mary Spicer, Director of Food and Nutrition Services at Presbyterian Hospital, Plano, Texas, translated the restaurant model (wait-staff describing the menu specials at table-side) to what she called “spoken menu” in hospitals. Her “spoken menu” model required a representative from her department to visit each patient immediately prior to each meal period, describe the menu and take the patient’s order. Her system enhanced her patients’ satisfaction, and many of her colleagues across the country began to incorporate the concept in their hospitals.

Around the same time, Allen Caudle, then Director at Swedish Medical Center in Seattle took the “spoken menu” concept a step further and developed a system for room service for patients. Just like hotels! Patients call a number to place their meal orders. At the designated time of service, a smartly uniformed foodservice employee arrives with the patient’s meal tray, places it on the over-bed table for the patient and assures that the order meets the patient’s needs before leaving the room. With this model, the patient foodservice satisfaction scores at Swedish spiked to the top of the rankings!

Today, according to The National Society for Healthcare Foodservice Management (HFM), the preeminent healthcare foodservice organization of over 2,000 healthcare food and nutrition professionals, about 22 percent of HFM members report using room service or some variation of the model, and an additional 17 percent report that they are considering implementing the concept.

Joyce Scott Smith, Director Food & Nutrition, Dietetic Services at University of Pittsburgh Medical Center, Presbyterian Shadyside Hospital, recently reported the results of implementing a “Liberalized Patient Diets” program. Traditionally, modifying recipes to meet nutrient parameters for patients with chronic diseases such as diabetes, renal, cardiovascular, etc. resulted in products that may or may not meet the “sensory expectations” of the patient. Even when registered dietitians team with trained chefs to develop those modified recipes, the resulting products don’t always excite the consumer.

Scott-Smith and her team decided to develop a system to teach patients how to follow a modified diet by judiciously selecting foods from the regular menu. By giving control to the patient and providing bedside nutrition education, she and her team increased patient satisfaction scores significantly. An interesting follow-up study might be to determine how many of those patients who participated in the “liberalized diet” concept were compliant with their diet restrictions after discharge. Logically, one would believe there would be a high degree of compliance.

Today, many directors of health care food and nutrition services employ trained culinarians to assure the quality and aesthetic presentation of food to patients. During the 2005 HFM National Training Conference, the professional society began a culinary competition to showcase the culinary talent found in health care today.

Linda Lafferty, PhD, RD is president of The National Society for Healthcare Foodservice Management, which represents more than 2,000 on-staff food service professionals at acute, extended and long-term care facilities and suppliers in the United States and Canada. Visit: www.hfm.org.

Bruce Thomas, MBA is treasurer, The National Society for Healthcare Foodservice Management and associate vice president, Guest Services, at Geisinger Health System, Danville, Pa.

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