Hospital food makes a recovery

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Hospital patients are becoming more empowered. They no longer will put up with Jell-O or mush."

Those words from a spokeswoman for Sodexho Inc., one of the country's largest institutional health care food-service providers, tells a great deal about what patients can expect from hospital menus these days. The fact that menus with choices exist at all is telling, but it isn't the whole story. While improvements have been made across the board in hospital fare, food purists wouldn't judge them as having gone far enough.

Imagine room service -- unheard of until several years ago -- provided at several local institutions, where it is possible to order by phone on just 45 minutes' notice. That is the case at George Washington University Hospital, where the standard menu lists a choice of 11 cereals, a wide range of lunch and dinner entrees, six kinds of milk, four kinds of bread, and both regular and low-fat mayonnaise.

Also, in what is a marketing ploy as well as nutritional bait, the hospital gives seniors 65 and older a slight upgrade -- a plant in the room and meal service on a silver tray with a slightly broader menu -- for a lifetime fee of $10. The hospital also has free guest-tray service for visiting family members and friends of all patients.

"I'm impressed. They have nice, healthy items," says Joan Lavella, 29, of the District's Glover Park, having lunch -- turkey sandwich, fruit salad, iced tea and chocolate pudding -- after giving birth at George Washington University Hospital to her first child, a son, Andrew. She had breakfast earlier that day in the delivery room.

"It's a fairly handsome menu," she says.

Government nutritional guidelines (MyPyramid.gov) are spelled out on the back of both the regular and vegetarian menus at Inova Fairfax Hospital, where choices are less elaborate than at GWU Hospital.both the regular and vegetarian menus at Inova Fairfax Hospital, where choices are less elaborate than at GWU Hospital. However, there is a room-service option at Fair Oaks and Mount Vernon, two of the five hospitals in the Inova system. Washington Hospital Center also tries to please by giving several options for each course and changing menus every four to six months; a "hostess" personally inquires of patients each morning about menu choices for the next day.

To date, none of these institutions goes as far as some hospital centers around the country that try to eliminate from their menus processed foods, chicken and beef raised with antibiotics in the feed, milk from cows fed synthetic hormones, and any non-organic fruits and vegetables. Even so, a May 2005 study by the Minneapolis-based Institute for Agriculture and Trade Policy, which promotes family farms, was optimistic about ongoing changes in food policies undertaken by administrators and nutrition directors at national hospital and health care facilities.

"Plenty of studies say if a person is well-nourished, he is bound to get better and leave the hospital sooner," says Dawn Jackson Blatner, spokeswoman for the American Dietetic Association, who works at Chicago's Northwestern Memorial Hospital Wellness Institute. She cites a need for a variety of foods "not only because of taste preferences, but because of different medical conditions." A patient's doctor always has the final say about a need for diet restrictions.

What has changed, too, is that patients are regarded as consumers in a competitive marketplace. Patients choose doctors, who in turn choose their hospital affiliations.

Better educated patients means higher expectations of service, suggests Mike Solomon, director of marketing for the health care division of Sodexho Inc., whose North American headquarters is in Gaithersburg. Sodexho is in charge of food service for patients and employees, as well as most public cafeterias, at the George Washington University Medical Center and Inova Fairfax Hospital. The health care food services division of Morrison Management Specialists, whose parent company is the Compass Group, handles the Washington Hospital Center.

"You can't judge the value of a future or how well your gall bladder was taken out, but you can tell how well you were treated during your stay," Mr. Solomon says. "The fact that people can go online to judge how hospitals rank in different categories means there is real urgency for hospitals who may deliver top-notch medical care but may fall short in other areas."

"The more patients, the more a hospital gets paid to serve them. A rising tide lifts all boats," agrees Jeremy Hough, Sodexho's food and nutrition manager at GWU Hospital, which has five registered dietitians on staff "to be sure nutritional needs are being met." Patients' food orders are taken daily on an electronic menu board. The only off-limits foods are raw sprouts -- because of the danger of bacteria -- and eggs in the shell. The latter is considered dangerous because of the possibility of choking problems, Mr. Hough says.

"We are looking at organic now," says Renee Landry, vice president in charge of support services at the Washington Hospital Center, which provides three meals a day to an average 850 patients. She also oversees a public cafeteria that has a Weight Watchers menu as well as smoothie and salad bars. There also is a Blimpie sandwich shop that stays open around the clock on a lease arrangement.

"We used to have Cinnabon but took it out," she says.

A decision was made a few months ago at Washington Hospital Center to use only trans-fat-free cooking oils when preparing patients' food.

Inova Fairfax Hospital is studying "moving to a hotel system," says Pamela MacChlerie, a registered dietitian who is employed by Sodexho to be that hospital's director of food and nutrition services. By "hotel system," she means expanding the emphasis on patients' physical comfort and emotional needs and offering room service throughout. Currently, menus change frequently -- a different one every day in a seven-day cycle -- and meals are delivered bedside in what is called a cook/chill system that finishes the cooking process inside the cart "to maintain the freshness of the product."

Already, she notes, a Dedicated Hostess Program serves in the high-risk pregnancy unit, where patients, many of them bedridden, may stay up to three months. She has two chef-managers on staff and 14 dietitians.

"Our primary food suppliers are under rigorous standards," she says. Local growers and vendors wishing to sell to the hospital "must work with experts at Sodexho. If their standards are consistent, they can be approved," she says. A local vendor supplies special foods, such as hummus and tabbouleh for Middle Eastern customers, and kosher meals are brought in "wrapped and sealed."