Hospital Food--not as bad as I thought...

[M.X.Hassett]

Obviously there are cost factors involved but would it not make sense that the body and mind would heal faster if people where being served nutritious edible food?

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But who will pay for it?

SB

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In "Super Size Me" there is a school lunch program mentioned that manages to prepare freshly made food at the same cost as regular school lunch programs. Obviously this may not work on a massive scale as easily but I am sure some small improvements could be made. I think the biggest hurdle is made of red tape.

[Milagai]

Great topic. I 've wondered about this myself.

Re payment: who pays for the food under the

current system and how hard can it be to

incorporate positive changes (OK - realize the naivete

as I was typing that, but will let it stand).

In many developing countries for anyone being

hospitalized, it's become essential for other family/friends

to remain in close attendance and bring them food and

take care of other necessities that the system finds

it hard to provide.....

Milagai

[Fat Guy]

When I was doing the research for Turning the Tables, I wanted to include institutional food service. In the end, the material didn't fit in, but I visited a few operations. Among others, I spent a day with the "Chowboss" aboard the U.S.S. John F. Kennedy (an aircraft carrier), toured the kitchens on a Crystal cruise ship, and spent time with the executive chef at the CaroMont Gaston Memorial Hospital in Gastonia, North Carolina.

Hospital food is a complex issue. The elephant in the living room is the homeless problem, i.e., homeless people trying to get admitted to hospitals so they can get a bed and good meals. To some extent, especially in the major urban areas (less so in Gastonia), the food at many hospitals is designed to provide sustenance but not pleasure. Only on the "executive" floors of many hospitals -- where you pay a cash premium of a few hundred (or thousand) dollars a night for a more hotel-like room (and a better standard of care, though no hospital will admit to that part of it) -- can you get actual good food from the hospital's caterer.

There are other issues as well. The available foods are limited, because a lot of allergies and conditions have to be ruled out. Packaged products are preferred because they're prepared in industrial HAACP facilities and therefore run less of a risk of bacterial contamination. Food for hundreds of patients needs to be prepared at the same time, placed on carts, held at temperature and rolled around to the rooms -- this also limits what can be done. Another unspoken assumption is that a lot of patients have their families bring them food, even if it's just from the hospital cafeteria.

The cafeteria food in hospitals, for its part, is always a hundred times better than the patient food and is occasionally good on an objective scale too. The remarkable thing about Gaston Memorial was that the cafeteria food -- the food the doctors and families of patients eat -- was as good as at a white shoe law firm cafeteria here in New York City. The executive chef was Johnson & Wales trained, followed a lot of classic recipes from scratch, used a variety of suppliers and cared about the quality of food. He was media savvy so wouldn't come right out and say it, but I think he was frustrated at the limitations that make it so difficult to provide decent food to the patients.

[srhcb]

I think the biggest hurdle is made of red tape.

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ie: Medicaid

SB (wonders how the food is in Canadian hospitals)

[jsolomon]

Hospital food is a complex issue. The elephant in the living room is the homeless problem, i.e., homeless people trying to get admitted to hospitals so they can get a bed and good meals. To some extent, especially in the major urban areas (less so in Gastonia), the food at many hospitals is designed to provide sustenance but not pleasure.

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It is a complex issue, because in places (like Broken Bow, Nebraska) there isn't a homeless problem. But, the hospital food there still sucks.

So, I don' think the homeless issue is all to blame. It simply doesn't affect all hospitals the same, so calling it the root issue doesn't seem to pass the sniff test. There must be some other nefarious plot at the root of it.

[Holly Moore]

For someone of my ilk, at least, good food makes me happy, horribly prepared food can depress me. I remember my first meal in a week, following surgary that required a gastro-tube pumping away for that week - I was looking forward to it. Scrambled eggs. They were indeed horrible. Fried hard, no flavor, no moisture. Sawdust.

I'd think hospitals would realize the impact food has on a patient's spirits and that the mind does play a major role in the process of healing.

If budget is the issue - just like I have to pay an extra fee for phone and TV, I'd gladly pay $20 or $30 a day for decent food.

[jsolomon]

Actually that does segue into something that I want to write a grant for once I get finished with med school.

I wonder if Medicaid, or whichever pays for things like occupational therapy, would pay for the occupational therapy to be in the scullery of a hospital. There would certainly be lots of things necessary to iron out of such a plan, but I think from a life skills standpoint, the patients would do better, and also from a social standpoint, I think it could be beneficial for all parties involved. Plus, the hospital would then get a renewable resource of cheap(er) labor which could be carried back into lower bills for the hospital (or eaten up by executive pay raises in the modern era).

[M.X.Hassett]

I'd think hospitals would realize the impact food has on a patient's spirits and that the mind does play a major role in the process of healing.

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EXACTLY

[Shaya]

I think the biggest hurdle is made of red tape.

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ie: Medicaid

SB (wonders how the food is in Canadian hospitals)

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It's just as awful in Canada. When a family member was ill for an extended period of time I could not believe how unhealthy the food all seemed. The cooked food had virtually no energy to it, and would certainly do nothing to help the body heal after the shock of illness or surgery. And the packaged food was loaded with artificial colors and flavors, just all-around depressing.

Also, after I gave birth to my children I could not even bear to see what was underneath the lid on that food tray, let alone smell it. I subsisted on bagels from the cafeteria and could not wait to get home to be able to eat again.

[Tess]

I seem to remember another discussion on here where it was suggested that hospitals don't figure on the average person being around long enough for the food to matter much. Or at least that that has been given as an excuse.

I was unbelievably frustrated when a family member was being treated for cancer in various hospitals and was told to gain weight. He was a fairly big guy and I couldn't imagine him gaining a pound on the stuff they were feeding him. He had a refrigerator full of Ensure in his room but that is really gross, especially if you have to drink a lot of it. I started bringing in a meal a day from restaurants. Nice if you can afford it, or if you have a kitchen nearby and can cook.

When I shared the hospital meals, I really noticed a lack of salt although we had not ordered a sodium-restricted diet. I'll definitely be bringing my own salt to any further hospital stays, although sprinkling it on is no substitute for cooking with it.

[srhcb]

I think the biggest hurdle is made of red tape.

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ie: Medicaid

SB (wonders how the food is in Canadian hospitals)

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It's just as awful in Canada.

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As I suspected. Because the ultimate payer (the government) is so far removed from the end user (the patient) a universal blandness is almost predictable.

And, at least in this Country, any innovative or experimental programs would run the risk of incurring legal liability.

So, I guess that unless we're fortunate enough to afford private care hospital food will hold true to it's reputation. It will keep you alive until you are released.

SB

[markabauman]

My mother had occasion to be admitted to the Mayo Clinic in Scottsdale a couple of times this past year. I must say, both the food in the room and the cafeteria was quite decent. Since my mother was on a low-fat diet, the dietician told her that they had to "hold the Mayo". Must be some sort of standing joke there.

[Sneakeater]

I recently had major abdominal surgery. I couldn't eat solid food for days.

Finally, the day came when I could solid food again. I was hungry. I was bored with jello. I was excited.

They brought me this salsbury steak in this brown sauce. It was much too salty. It tasted like tar. And it was COLD. I mean, like, chilled. Generally speaking, it was disgusting.

I had about three bites and left it.

The next meal -- highly processed "chicken" breast in some kind of repulsive mucky mustard sause -- was no better.

What a major disappointment! I couldn't wait to get out.

Edited June 24, 2006 by Sneakeater (log)

[snowangel]

So, my dad had quintuple bypass surgery. The first meal they fed him was some damned broccoli, rice and cheese casserole topped with FRITOS. Then, they put one of those covers on it so the Fritos were all soggy. Regardless. Fritos for someone who has just had quintuple bypass surgery?

Bless my Thai friend who brought me larb and som tam within two hours of the birth of my youngest. Sure beat the some sort of meat product on squishy white bread with a tube of white crap (aka condiment) on the side.

[srhcb]

Then again, the quality of food served in hospitals compares quite favorably to the level of medical attention available in most restaurants.

SB

[markabauman]

There used to be this great little bar/restaurant on the upper East Side of NY called The Recovery Room, popular with the doctors from the nearby hospital. May be the only place where the food matched the level of potential medical attention.

[srhcb]

the food matched the level of potential medical attention.

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My Sister hosts an Iron Chef style Wild Game Feed every year, where attendees are expected to sample all the offerings, which usually tend to be quite "creative".

On the invitations, to assuage any guests' trepidation, she advertises that my Cousin Mike, an MD, and his GF, a Head Nurse, will be in attendance.

SB (she pointedly doesn't mention the fact that Dr Mike is also the County Coroner)

[Pookie]

I think the biggest hurdle is made of red tape.

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ie: Medicaid

SB (wonders how the food is in Canadian hospitals)

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It's just as awful in Canada.

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As I suspected. Because the ultimate payer (the government) is so far removed from the end user (the patient) a universal blandness is almost predictable.

And, at least in this Country, any innovative or experimental programs would run the risk of incurring legal liability.

SB

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We do our best, Really! But yes, money is the biggest factor in making the food choices.

Plus we have the challenges of trying to predict how many patients we will have on any diet at any one time. With the speed that people are shuttled in and out of hospitals here we never can tell from one hour to the next how many low fat (for example) meals we will need. Once we have opened and used a portion of food we have to throw the rest out due to cross contamination issues.

We also operate under the assumption that most people spend at most 2 or 3 days in hospital and as long as we can manage an adequate level of nutrition then they can go home.

We do have the homeless problem reported above as well. Many come into the emergency room and threaten to kill them selves just to be admitted. This happens most when we get a large storm being forcast.

And dont forget, hospitals have to keep foods appropriate for low fat, high fat, low fibre, high fibre, diabetic, peadiatric, puree, ground, vegetarian, vegan, high protein, low protein, liquid diets, high fluid, low fluid, clear fluid, full fluid clients as well as being able to provide allergen free meals at any time of day or night.

Sure you can make better food. But we are doing our best.

(and a hint - if you are in Hospital in Canada for an extended stay, ask to speak to a Food Service Supervisor - explain your situation and we can usually finagle you some better grub or at least a voucher for the cafeteria so your family can pick you up something that might suit your tastes better.)

[dliu]

Since I'm entering the medical profession, I'm sure that I'll have a thing to two to say about the food offered in hospitals. Don't know if there are any studies out there, but I suspect that better food = faster recoveries, like having pets and visitors. (maybe an area for future research?) Plus, all the careful nutrition in the world won't help if the food is so awful that patients won't eat it.

[Kris]

I've been hospitalized a few times for various surgeries, but my most unpleasant stay was when I was hospitalized for a staph infection 8 years ago.

At first, I didn't have much of an appetite. I guess that was a result of the infection. But the meals certainly didn't help, particularly the breakfasts (which they never got right regardless of my choices indicated on the menu card). The scrambled eggs were of the powdered variety and were usually tepid. I would stick to the fruit juice and fruit cup.

I don't remember exactly the types of food I would have for lunch and dinner, but they must have been very underwhelming. I do remember that the chicken and beef dishes were bland. And I usually didn't eat the veggies since they looked like they were from a can.

It was rather pitiful that I would start looking forward to the post-dinner snack of pudding and jello as the highlight of my culinary day.

When I started getting my appetite back, I began craving a Big Mac. So I had my then-friend/now-husband smuggle in some McDonalds for me. And sure enough, I got busted by one of the nurses who scolded me to no end.

I'm a big woman and I love to eat. But I lost 20 pounds in 12 days in the hospital.

[mizducky]

Well, it's come to be my turn to have an up-close and personal experience with hospital food, as I check into the local Kaiser Permanente establishment this coming Monday for a 4 to 5 day stay. I already have volunteers lined up to smuggle in sushi, pho, and fruit smoothies. I'll be sure to report back on my experiences with hospital "cuisine" as soon as I'm together enough to sit up at a keyboard and type (which might be up to a week or more after I get home ... hard to tell these things in advance ... )

What I've found challenging in its own way is trying to anticipate what kinds of foods to have waiting for me at home once I'm discharged. Again, I've got friends lined up to help me out with grocery shopping and food prep ... but that means coming up with really simple stuff to tell folks to get for me, when I'm bound and determined (with my doctors' blessing) to keep up my healthy eating regimen. That means the usual mainstays of visitors feeding convalescents, i.e. casseroles heavy in cream sauces and white-flour noodles, are kind of OUT. Maybe I can get somebody to make me a nice pot of chicken soup ...

I've loaded up the freezer with frozen vegetables and boneless/skinless chicken thighs (easy to throw on the Foreman Grill), and bought a bunch of canned lowfat chicken broth and pineapple in its own juice (the only canned fruit I really care for). And I've emailed a list of my food preferences/needs to the church staffer who's playing point-person for me while I'm out of it. Heh. I never used to think of myself as a picky eater, but when I wrote those food preferences up, I realize that's just what I've become.

Finally, the instructions the docs have given me for my food intake, or lack of same, for the 24 hours before my operation are kind of, erm, *special* in their own right. I haven't made jello in so many years, the last time I did try I actually managed to screw it up!

[azlee]

Hospital food is a complex issue. The elephant in the living room is the homeless problem, i.e., homeless people trying to get admitted to hospitals so they can get a bed and good meals. To some extent, especially in the major urban areas (less so in Gastonia), the food at many hospitals is designed to provide sustenance but not pleasure.

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It is a complex issue, because in places (like Broken Bow, Nebraska) there isn't a homeless problem. But, the hospital food there still sucks.

So, I don' think the homeless issue is all to blame. It simply doesn't affect all hospitals the same, so calling it the root issue doesn't seem to pass the sniff test. There must be some other nefarious plot at the root of it.

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I agree that it is not the homeless problem that is primarily to blame. There are a number of issues at play (including the limitations inherent in creating a nutritious but limited daily set menu (3-4 meal choices) that take into account the dietary requirements and food sensitivities of numerous patients).

Chief among those issues, its appears to be an insurance problem. Both private and public (medicare/medicaid) forms of insurance make great efforts to control costs associated with patient care. Food service (which is expensive and often comes with lots of waste) is an excellent place to cut costs (because oddly enough feeding the patients is not considered a core service of the hospital) and the provision of limited and uncomplex menu choices helps to limit the risk to patients (restricted diets, hidden ingredient allergies and sensitivities) of receiving food that may trigger other health issues, prolonging stays and raising costs to the insurers.

Having recently survived a short but very expensive hospital stay, I am more thankful, than ever, that I have excellent private insurance that afforded me the "executive level" of food choices and at the time I felt it was well worth paying the 20% of uncovered costs under my premium indemnity insurance plan to have both the premium care and food available to me. It also made me consider the plight of those who for any number of reasons do not have the same options for good and/or compassionate care.

[Kent D]

The hospital where I work has its food service managed by Aramark (previously it was Marriott), and while it's not "world-class" cuisine, it's for the most part both nutritious and palatable.

I know that the patients don't always receive "piping hot" food, because once it's loaded into a warming cabinet for transport to the floors, there are often delays in distribution due to patient tests, doctor rounds, visitors, floor activity, etc. And let's face it, when you're hospitalized and ill or being pumped full of chemicals, it's unlikely that your taster's fully functional.

I don't have any real reason to defend hospital cuisine, as I work in Medical Records, but the people in the kitchen ARE trained chefs (at least two are CIA grads), and the food they put out for the employee cafeteria and coffee shop is quite good. Our head of food service is from Lousiana and he really "kicks it up a notch" (to borrow a tired phrase) around Mardi Gras. It's just that they're limited by the restrictions imposed by the dietary requirements of the average patient. And most doctors look the other way if family members sneak the occasional "outside food" in for long-term patients, so long as they're not in an ICU. Nobody CHOOSES to go to the hospital to eat a meal.

[mizducky]

Well, the bad news WRT my hospital-food experience was that it was classic hospital food at its, well, whatever-est: lime Jello, bland boiled chicken, flavorless boiled vegetables, the whole magilla. The good news--besides the fact that the procedure I went in for was a 100% success--is that, when your stomach is upset from said procedures, jello and boiled chicken is actually not such a bad thing at all.

Oh yeah--one more good bit of news: I was let out early for good behavior, so to speak, and so did not have to confront the classic hospital-cuisine baked fish entree scheduled for that evening.

One other food vignette: my hospital roommate, when contemplating her dinner choices, was told by the aide that the stir-fry was really good. I had my doubts, but she ordered it anyway. Needless to say, it was not very good at all. "Not what I think of as a stir-fry," was my roommate's verdict.

[jsmeeker]

I just had my first experience with hospital food over the past few day. Certainly NOT a planned visit. 5 meals total during my stay. 2 Breakfast, 2 lunch, 1 dinner.

The first meal was breakfast on Monday AM. (I went to the ER Sunday night). The ticket said "Cardiac Diet". So, you can maybe imagine what that may be like. Eggs. Not sure if they were real. a soggy english muffin (the covers they put on there to keep the food warm ensures nothing will be crispy). Some kind of sausage. looked like it was steamed or something. No browning to be seen. Cup of canned pears (the tastiest thing on the tray), a cup of bad coffee, a carton of skim milk, and a container of corn flakes (not kelloggs). This was my least enjoyable meal.

On the tray was a menu for the next meal. I managed to save that.

Monday - Cardiac Lunch

Parmasean Roasted Cod

Steamed Red Potatoes

Green Beans

Light Cheesecake

Iced Tea

Alternate Lunch was offered by request.

Grilled chicken breast instead of fish

(everything else the same)

not great. veggies could have used salt, but I guess since it's "cardiac diet", they don't use any or much, and your condiment/silverware pack has a "salt substitute" That stuff was weird.. "Cheesecake" really wasn't, but it wasn't too bad.

I managed to snag and bring home the dinner menu for monday, too.

Monday - Cardiac Dinner

Mandarin Chicken Breast

Almond Couscous

Steamed Broccoli

Dinner Roll

Salad w/ diet dressing

Light Strawberry Mousse

Skim Milk

Alternate Dinner

Italian Chicken Salad

Dinner Roll

Light Strawberry Mousse

Skim Milk

this seemed to have some potential. But the couscous was weird tasting. Broccoli classic over steamed mushy broccoli. The dessert was the best thing on the tray.

The best thing I had the whole time was the banana pudding served with my lunch on Tuesday. I ate all of it. And all of the salisbury steak that was there, too.