Hospital Food Getting Easier to Stomach

It’s the food everyone loves to hate.

Especially if their hospital stay is longer than a day or two.

Even pollsters in the business of improving patient satisfaction expect complaints about hospital fare.

“Traditionally, food is one of the things that least satisfies patients,” says Mary Malone, spokeswoman for Press, Ganey Associates, a South Bend, Ind., firm that measures the satisfaction of hospitalized consumers.

In its latest survey, patients gave meals 77 points of a possible 100. That doesn’t sound too bad, until Malone mentions that it was the rock bottom score, with patients evaluating everything else about their hospitalization more positively.

The good news? Hospital food is getting better, say Malone and others who work in the industry. “In the past, a lot of what you heard was probably correct,” says Steven Eisner, administrative director of food and nutrition services for UniHealth America, a network that includes 10 Los Angeles-area hospitals, “but we are working hard to change that perception.”

Spurred by competition, new federal regulations (aimed at improving the overall quality of life at hospitals) and a desire to make hospital cooking taste more like home, hospitals are overhauling their menus and listening to patients more. The improvements sometimes demand more ingenuity than money.

Thick Crust or Thin?

Lloyd Delaney got weary of watching visitors to Glendale Memorial Hospital walk across the street to Pizza Hut and return bearing the telltale square boxes. Why not save them the trip? asked Delaney, director of food and nutrition services for the hospital, a facility of UniHealth. Eisner of UniHealth agreed.

Last November, the pizza chain and the health network began a pilot program at Glendale Memorial, and now all 10 hospitals offer it to patients whose doctors don’t object. (Pepperoni, vegetarian, supreme and cheese are most popular.)

Other hospitals do likewise, offering homemade or big name pizza.

Looks Are Everything

How a food looks is especially important for patients whose sickness has dulled their appetites. So the fine art of “plate presentation” has assumed major importance in hospital kitchens. At Long Beach Memorial Medical Center, for instance, a standard ham, broccoli and mashed yam meal is dressed up, says Carrie Hornby, director of food and nutrition services. “You eat a lot with your eyes,” she says, “so the ham is garnished with fresh pineapple and a cherry tomato. The yams are put in a casserole dish with a little crumb topping or in a patty form.”

‘Re-Formed’ Food

A buzzword in hospital kitchens, this food is ground up into consistencies needed by stroke patients and others who might have difficulty swallowing, and then reshaped into its original state. “The biggest challenge here is meats,” says Hornby of Long Beach Memorial Hospital. But she sometimes even adds grill marks to make re-formed pork chops and other meats appear charbroiled.

Ethnic Sensitivity

There is a new sensitivity to the value of ethnic specialties as comfort foods. “We have steamed rice and warm tortillas and salsa at all three meals now,” says Hornby of Long Beach Memorial Hospital, whose patient population includes many Asians and Latinos.

Special Needs

Alternative menus for patients with special needs are yet another trend. Jeffrey Nelken, director of food and nutrition services at Encino-Tarzana Regional Medical Center, worked under the direction of Dr. Avrum Bluming, a hospital oncologist, to develop a special menu for cancer patients receiving chemotherapy, which often robs appetite and nauseates patients.

First, Nelken created a pictorial menu with the 21 meal options illustrated in full color to whet the appetite. He also put the food on smaller plates because a large, full plate “can look overwhelming.” He is careful to rinse and cook foods to eliminate odors, such as fish smells, that can make patients queasy. He picks high-calorie, high-protein foods so patients can get adequate nutrients from smaller portions.

Putting On the Ritz

To attract patients, some hospitals are taking a cue from tablecloth-type restaurants and nice hotels. At San Gabriel Valley Medical Center, for instance, patients are offered a second cup of coffee after meals. At Long Beach Memorial, patients admitted between mealtimes can request a special sandwich plate.

Most Like It Hot

Even the tastiest, best-looking food tastes terrible if served at the wrong temperature. To eliminate the chance, new, smarter delivery systems are in place. At Childrens Hospital Los Angeles (which, incidentally, has an on-site McDonald’s), a new system reduces the chance that milk will be warm and hot entrees cold, says Linda Brown, manager of food and nutrition services. Foods are prepared ahead of time, then rapidly chilled and assembled on special compartmentalized trays that separate foods to be served warm and foods to be served cold.

“Everything stays cold until it’s time to heat,” explains Al Prillaman, spokesman for Aladdin Synergetics, the manufacturer. As the food to be heated warms up, the cold food comes up to serving temperature--all within 36 minutes.

Some hospitals have abandoned the concept of a central kitchen in favor of placing cooking units on individual floors. Such is the case at Cedars-Sinai Medical Center, says Jerry Berkman, director of food and nutrition services. He compares the traditional kitchen concept to “throwing a dinner party at home, cooking in the basement and serving in the attic.”

The Belly-Aching Factor

No matter how mouth-watering hospital food becomes, patients probably will never mention it in the same breath as Mom’s home cooking or gourmet restaurants, says Malone, the expert who measures patient satisfaction. And that’s fine by her, because she says belly-aching about hospital food serves an important function.

“It’s like people on the outside talking about the weather,” she says. Most patients find it much easier to strike up a conversation with an unfamiliar roommate by talking about soggy French toast or a tough steak than by asking questions about their surgery or prognosis.

Editor’s Note: A future Fitness column will look at walking. Please let us know the location of your favorite strolling spot. Send to Walking, Los Angeles Times, View Section, Times Mirror Square, Los Angeles, Calif. 90053.

A Matter of Taste

What did patients recently hospitalized in Los Angeles think of the food? The envelopes please . . .

* “They did have the greatest red Jell-O on the face of the Earth--I’m not sure if it was cherry or strawberry--but their culinary capabilities ended there. The oatmeal and Cream of Wheat were awful; so were the pressed turkey with what was supposed to be gravy and the fish that didn’t smell good.

“My hospital bill should have been credited because my husband ended up getting my food from the hospital (employee) cafeteria, which tasted much better.”

--Moe Bryant, Los Angeles business manager

* “Overall, it’s pretty good here. There are stuffed shells in marinara sauce. The sandwiches are good, particularly the turkey and avocado with sprouts. There is a good selection. That’s important when you’ve been here five weeks, as I have.”

--Michelle Wilson, Chino Hills, who was preparing to give birth to twins

* “In my opinion it was completely tasteless. The problem was the lack of seasoning or real flavor in any food I ate. The menu included margarines, syrups and other heavily processed foods that I never eat. There were sauces on my meats that were absolutely vile.

“The people who served it were awfully nice, though, and I couldn’t rave any more about the medical care.”

--Marian Gellich, Van Nuys public relations and marketing communications specialist