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Overhauling hospital chow - From Chez Panisse to an institutional kitchen

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In the San Francisco Bay Area, there seems to be a movement to make hospital food worth living for.

Are any other hospitals in the country (or elsewhere) doing similar things?

Hey, if I get sick while traveling, have to know the most chow-worthy hospitals.

Alison Negrin who started in the kitchen if Chez Panisse is working to revamp the food at John Muir Medical Center hospital in Walnut Creek.

Kaiser Permanente has a program to source local produce.

Executive chef Lorenzo Wimmer at Marin General buys his produce from the Marin Farmer's Market

Chef Deane Bussière at Santa Cruz's Dominican Hospital put chicken mole on the cafeteria menu.

Do you know the pedgriee of your hospital chef?

There's an excellent article by the East Bay Expresse's restaurant critic, John Birdsdall about the challenges that Negrin and other chefs.
http://www.eastbayexpress.com/2007-02...

Have any chowhounds worked in hospital kitchens? What were the culinary challenges?

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  1. I don't work for a hospital, but I am new to my position as Food Services Director at an retirement home here in Toronto. I was hired specifically to change my department's approach from a healthcare model to a service model.

    I am reducing the pre--packaged, pre-made, portioned and processed foods that have been used in the past. Now, we will be offering less choice on the menu but are using local butchers and a quality fish monger, buying local produce and baking our own bread and desserts when possible. Moreover, we are increasing the variety of foods served to accomodate our resident's diverse tastes. Many of our new menu items are GI and diabetic-friendly, while still remaining delicious for everybody. We are also supporting The Seafood Choices Alliance and working to introduce more environmentally friendly packaging wherever possible.

    I think that as the average age of our population gets older, baby boomers retire and people live longer, this type of thing will become an even greater priority.

    The greatest challenges are changing the healthcare mindset of the longtime cooks as well as managing staff that are often heavily unionized and/or not as well paid as their industry counterparts in hotels and restaurants.

    1 Reply
    1. re: bogie

      Yes that was one of the challenges that Negrin seems to be facing, a union threatening to strike and long-time workers who don't want the job to be more than chopping and warming food ... not embracing the creative opportunity.

      Good luck to you. There's an organization mentioned in the article called FoodMed that seems to be trying to nationally start a movement for change.

    2. yay
      i'm tired of catering lunch to family members in hospital bc hospital food is unhealthy & inedible.

      1. Years ago, I worked at a hospital that was the testing ground for a local culinary school. The food in the cafeteria was great for the workers but, as a patient there, I didn't get the same food. It was worst than airline food.

        1. At one hospital where the census was largely elderly - 90% of the patients were 60 years old+, we instituted a restaurant menu in lieu of the typical hospital menu. We used the menu items which people generally liked and added a few daily specials.

          It made planning a lot easier as we were producing the same items almost daily and significantly improved the patient surveys.

          Do realize that unless you are in a long-term care facility or program, you spend very little time in-patient. And generally, when you are in the hospital, you are pretty doped up most of the time (or in my case, on a liquid diet) and can't taste as well as usual.

          1 Reply
          1. re: jlawrence01

            Yep, I've spent 20 resentful years in and out of every Bay Area hospital taking care of my mom and personally have had back surgery.

            This is a stupid thing, but I got into making my own jello this year which really involves using fresh juice and unflavored gelatin and is actually easiery to make than the sugary packaged stuff. It made me wonder why hospitals couldn't do healthier things like that instead of using the artifical packaged sugary stuff.

          2. I work in a hospital, and while I think they try to provide healthy choices, they are a long way from being healthy. Just recently, they have started putting the breakdown of calories, fat, fiber, sat fat, etc, on a placard next ot he items. I thought this is/was a great idea, until I saw that the Rueben sandwich they featured one day had 960 calories, and a whooping 64 grams of fat! On the other hand, they always have a salad bar available. I'd like them to always have more healthy choices available. I've always thought that the hospital cafeteria has the hospitals best interest in min, i.e. the more unhealthy the food the higher the probablility of them being patients one day. <-- I say that jokingly , of course.

            If I was entrepenurial, I would forge an alliance with a local culinary school and have them design the menu and have the students there to supervise, cook, and design the menus. I would have them procure their products from local organic vendors and prepare most if not all items with health, calories, fat, and taste in mind.

            Wow, that was a nice dream, now I'd better get back to the real world....

            6 Replies
            1. re: bluesman13

              When I was running hospital cafeterias, we would get the typical comment on our surveys that we should "serve more healthy food." We went through the menu and where we served fried food, we added a similar lower fat alternative. After these changes, the most popular entrees were, you guessed it , batter fried fish and fried chicken.

              Personally, I think people have free agency and should have teh opportunity to choose what they wish to eat. Hospitals should provide a wide variety of foods that allow people to tailor their food to their personal needs,

              Lately, I have had a great experiences at the local hospital which has basically stated that they are adopting the same hospitality standards as the Ritz Carlton. And I have had some very poor food at another area hospital.

              1. re: jlawrence01

                reminds me of one of our local hospitals that has a mcdonalds inside the hospital. when the hospital was going to not renew their lease in an effort to get more healthy food available, the STAFF (mds and crns) of the hospital practically rioted. they want their fries & 99cent menu i guess. i would rather pluck the blades of grass from the roadside & eat them than be transported into hospital-foodland. interestingly, i don't have health insurance, like most food pros who work outside of institutional settings. food pros who work in hospitals, jails, & schools are generally unionized, recieve benefits, and serve lousy food that is planned with a canopener heat & serve mentality, using as few fresh foods a possible in order to keep overhead low. many institutional kitchens don't even have knives or veggie peelers, or staples such as flour. then we wonder why kids, poor folks, etc don't eat vegetables or other healthy foods and have corresponding health problems that land them--back in the hospital with more of the same institutional food that got them there in the 1st place!

                all ranting aside it is heartening that some hospitals are trying new approaches. in my exp. progress has been snail-slow too.

                1. re: soupkitten

                  First, most hospital food service workers are NON-union and are generally paid no better or worse than any other food service workers. The one GOOD thing about working in a hospital food service is that generally (but not always) are the health insurance and wellness benefits are better. And in many cases that I have seen in certain cities, the unionized employees in the food service are often paid less than their non-union counterparts.

                  Second, I was never in a hospital that did not have vegetable peelers or serve fresh vegetables.

                  Personally I don't understand the hostility of your post.

                  1. re: jlawrence01

                    i apologise-- i did not mean to seem hostile to you personally, my problem is with the institutional food model.
                    in my experience, locally to me, there has been a lot of resistance from unionized hospital labor groups with regards to getting fresh local foods because there would have to be increased training in order to do the job-- i.e. learning how to chop and prepare fresh vegetables. i think that the quality of institutional food is by and large determined by issues of labor and overhead as opposed to nutritional profile or even sometimes edibility, let alone appearence. these issues are the same whether you work in a hospital, school or jail. my point was that if the institutions would look at some of the same factors that drive consumers, or that foster good health in general, that everyone might benefit. my other point is exactly as you pointed out: that institutional food workers are given //health insurance and wellness benefits-- while food workers outside of institutions by and large don't recieve any of these at all, nada--- this leads to a weird vortex in which food pros that are committed to healthier foods don't elect to work in institutions that could probably really use their perspective, and food pros who want to hold on to their benefits don't get any outside experience with people eating real food outside of the walls of the institution. this situation really frustrates me, and i think it's going to take a lot of time and trial and error before perspectives between institutions and the people they serve food to are evened out.

                  2. re: soupkitten

                    Interestingly enough there was a study or article written about serving children in hospitals McD's and the psychological benefits. The gist of it was that a Happy Meal does more good then harm to seriously ill kids. You know it's something they look forward to and will willingly eat. I buy the concept and I say if it helps why not? Sorry don't have the link but I think it was done at Stanford's Children hospital.

                    1. re: ML8000

                      And the favorite entree at the children's hospital that I worked at was ... Spaghettio's. With help of the head dietitian, tried to replace it with pasta and sauce that contained less sodium and had more flavor. The children would not eat it. In all honesty, we decided it was better to serve food that would be eaten rather than what theoretically is more helpful.

                      Ditto for terminal patients. Give the people whatever they can put down and will eat. I had my grandfather drinking a fortified 16 oz milkshake EVERYDAY so that we could keep his weight up in the last months of his life.

              2. What do you consider healthy? I'm afraid that the hospital that served me an inedible powered eggwhite omlette with rock-hard out of season fruit considered the breakfast good for me, though it was horrible.

                1. "And generally, when you are in the hospital, you are pretty doped up most of the time (or in my case, on a liquid diet) and can't taste as well as usual."

                  Knock on wood, I haven't been a patient in a hospital since I was 4 (and from what I've seen with relatives, would almost rather bleed to death on the street). The patient food has invariably been worse than the worst school cafeteria food I was ever served in 20 years of schooling....

                  1. This is taken very seriously in Britain, and there is a lot of progress being made.

                    You can see small (4-6 portion) recipes at http://195.92.246.148/nhsestates/bett...

                    Seasonal recipes at http://195.92.246.148/nhsestates/bett...

                    An astonishing recommended menu at http://195.92.246.148/nhsestates/bett...

                    Policies and other discussion at http://195.92.246.148/nhsestates/bett...

                    1. Many years ago, I had back surgery at Monterey Peninsula Hospital. The food was wonderful! They even had a wine list for those patients who could have alcohol. I remember, with particular fondness, a cheese souffle w/ crab sauce - not one's typical institutional offering.

                      The ninth floor of UCLA's hospital has a private chef who cooks to order in addition to offering "elevenses" and a lovely afternoon tea for patients and their visitors. The rest of the floors offer typical hospital slop.

                      1. My dad was in the Arizona Heart Hospital for a bypass, and the food they served was appalling -- greasy, salty, exactly what heart patients shouldn't be eating. This is a hospital that specializes in heart patients. What a total disconnect. The food in the cafeteria for visitors was marginally better, but still heavily salted. I hope the reformers make a difference!