In this webinar, Alluserv presents two guest speakers who explain how the “food as medicine” movement is being adopted within healthcare facilities. Topics include: new relevant terminology, developing action plans, and determining who leads, executes and adopts these plans. Speakers include Aatul Jain, Sr. Executive Chef at St. Peter’s University Hospital in New Brunswick, NJ; Dr. Veronica McLymont, Director of Food and Nutrition Services at Memorial Sloan Kettering Cancer Center, New York, NY.
The culinary world is forever changing, as new technology and scientific evidence shapes how people perceive food, health and the overall dining experience. It seems that people are trying to get back to basics - attempting to form better relationships with their food and understanding where it comes from. We are starting to become more aware of what we’re eating and what is going on our plates. In 2018, we can expect to see an increase in seasonal cooking and more plant-based diets. As our knowledge of certain foods and their health benefits increases, we are now becoming alert to things like gut health and how fermented foods can help with our digestion and overall health.
This year, we can expect to see the comeback of quite a few “old-age” themes with food and the actual dining experience. There has already been an increase of zero waste bulk-buy stores as people are becoming more aware of the amount of waste they produce, and that trend does not seem to be slowing down anytime soon. These stores also tend to sell organic and sustainable foods and honestly make the grocery shopping fun! Another comeback we can expect to see is the experience of dining as a social event, not just sitting and eating food like it’s a chore. Some restaurants have already started introducing ‘communal dining’, where people can sit down with friends, family or complete strangers which can enhance your dining experience...well, depending on who is sitting at the table with you.
However, sustainability is an issue that food manufacturers, scientists and food engineers need to overcome due to the growing population and the depleted resources that we will face in the not-so-distant future. Finding sustainable methods of food production is going to be the main goal over the next few years, kicking off in 2018. Waste production is going to be a major focus this year, as breakthroughs in nano-packaging and 3D printing will change the way foods are not only packaged, but also cooked and stored. Nano-packaging has already shown to give foods a much longer shelf life, without the use of preservatives. As people become more conscious of what food they are consuming, information platforms will become readily available to help educate people on waste production all the way to the chemical compositions of foods.
Overall, the entire world of food and hospitality is going to change in 2018. From the change in diets, what foods are available and how we consume them to how foods are grown, produced and packaged. It’s going to be a long year ahead, but remember:
One cannot think well, love well, sleep well, if one has not dined well.- Virginia Woolf
How a food looks tell the patient a lot about the food and the foodservice team accountability and experience. People use the way a food looks to judge the food for freshness and quality. When the food is visually appealing to a patient, you accomplish your mission of providing nourishment for the recovery and healing of your patients.
COLOR, SHAPE, SIZE AND POSITION OF FOOD MATTERS IN VISUAL APPEAL
COLOR: The most impactful eye appeal
- Break up the colors
- Enhance the colors
- Make it “glisten”
- Keep the colors natural
- Vary the cuts of ingredients
- Add textures to the dish
STYLE: Arranging ingredients, plating
- Traditional – The Y style of plating
- Modern plating
- Include variety
- Add flavor to comfort food
- Herbs add color, taste and smell
- Cooking techniques can enhance aroma and experience
- Be aware of visual placement on the tray, temperature awareness, less is more, easy to handle and maneuver on tray space
For more on this topic, click here to watch Alluserv's last webinar!
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Ergonomics is an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely — also called biotechnology, human engineering, or human factors. Ergonomics affects all ages, all professions and all aspects of daily living.
Consider these conditions/requirements when evaluating equipment:
The goal is to monitor all work activities that permit the worker to adopt several different, but equally healthy and safe postures. Identify where muscular force has to be exerted, localize it to the largest appropriate muscle groups available. Where motion is performed, target the joints at about mid-point of their range of movement, particularly for the head, trunk, and upper limbs.
Lost or Found $$$
When making a decision to select equipment, one key objective is; get most done in the shortest amount of time in the most efficient manner. There are many nuances that may attribute to a lower price for a piece of equipment however, these attributes may in fact result in a higher Total Cost of Ownership (TCO). Will this specific product increase or decrease:
- Injuries/Call Offs
- Cleaning Times
If any result in an increase, “Houston, we may have a problem.”
Time is money! Distance is time!
If the equipment happens to be “X” millimeters wider/longer/taller/shorter, and, this results in an increase or decrease by “Y” milliseconds to complete a task, what is that cost or gain to the operation?
Although a few mm or ms may appear insignificant initially, an increase, positive or negative, by example, reduce or add 400 milliseconds to complete a task (the time it takes to blink), repeated say, 1,000 times per meal period, that’s 400k milliseconds for the meal period, about 6.7 minutes. 6.7 minutes, no big deal, right? Then, multiply this by three meal periods and that’s 20 minutes per day. Still not a lot of time but you could get quite a bit done with 20 minutes of “found time” each day.
Let’s take this example a bit further. 20 minutes a day translates to 7,300 minutes per year, 122 hours. Over a seven year life-span for the piece of equipment, that totals 850 hours +/-. If the average wage is $15/hr, that’s $12,750. You can add or subtract this from your TCO to help make your decision.
Considering this one example, multiplied by each work station, for multiple tasks per station, and suddenly, you have good reason to look very closely into the ergonomic impact of every piece of equipment.
Use these findings to reduce FTE’s or repurpose work assignments. Either way, you have a “win.”
By The Way
Also, imagine if you could reduce one call-off per year per FTE due to reduction in back injuries, that’s another 56 hours added to your bottom line.
How about one less “call back tray or courtesy tray” per meal period? … that’s $15/day, $450/month, $5,475/year in direct cost savings.
There are solutions, the Alexander Technique, a training program to help individuals to better understand how their bodies react to work/stress and how to avoid habits that negatively impact their well-being.
The right meal assembly set up can reduce minutes and increase time to get meals to patients. Modifiable equipment that works with your people. No one size fits all. Alluserv’s is ready to help! Modifiable tray starter stations, heights and widths for meal delivery carts, tray lines, etc...
A garnish is an item or substance used as a decoration or embellishment accompanying a prepared food dish or drink. In many cases, it may give added or contrasting flavor or texture. Some garnishes are selected mainly to augment the visual impact of the plate, while others are selected specifically for the flavor they may impart This is in contrast to a condiment, a prepared sauce added to another food item primarily for its flavor. A food item which is served with garnish may be described as being Garni, the French term for 'garnished.' Many garnishes in the past were not intended to be eaten but today is a different culinary playground.
I went to some of the foodservice culinarian leaders and asked them these questions:
- Can the food be the garnish?
- Or are traditional garnishes still mode of operation?
- What does a garnish do for the experience?
Here are their insights:
“In my opinion food should be the garnish in its own edible form. The old form of garnishes are out of trend. You might say, Elvis Parsley is no longer king or has left the restaurant! I prefer to see the plate like an artist palate. For example, a beet carpaccio with fanned out sliced beets with a dollop of goat cheese is eye catching and makes the food more appealing. Customers eat with their eyes and this is precisely why you see so many customers taking food selfies. The top restaurateurs understand "the art of food is from their palate to your palate."
“Food garnishes in their traditional forms are edible, however does a person dining actually eat a piece of parsley on a prepared dish? Not to say that they can’t but most don’t eat the garnish as it hasn’t been appealing or appetizing. If the garnish becomes part of the dish and is the right component of the dish it can enhance the flavor or texture profile when consumed with the dish. For example, I make a braised boneless beef short ribs sliders with garnish of caramelized onions. It can be actually the best dining experiences are when the garnish becomes part of the embellishment of a dish to enhance the customers palate.”
An herb’s blossom tastes like the herb itself. So, thyme blossoms are subtly thyme-flavored; arugula blossoms taste like arugula, with a hint of honeysuckle. In season, look for blossoming herbs at the farmers’ market — or in the vegetable garden. Notice how an ordinary bunch of rosemary or sage is flecked with delicate, perfumed flowers.
Of course, there are other beautiful edible flowers to consider, like calendula and nasturtium and borage and marigold, ready to sprinkle, like fairy dust, as a garnish, or to make your food even more colorful.
Today’s culinary playground is fierce as foodservice venues and chefs try to compete with each other for dining clients and loyalty.
Variety and purpose of garnishes are being reimagined. It needs to become an important component of sustainability as in the past, the garnish in a traditional sense was added as eye appeal then discarded by the customer and not consumed. Waste!! However, if a chef creates a garnish that can be consumed and enhances the customer dining experience, the garnish becomes that add flavor or texture that separates recipes from competitors’ recipes. See pictures slideshow of other ideas to incorporate into your flavor, taste and sight experience. Use your imagination and reach beyond. We eat with our eyes and if it looks and tastes better we can get better nutrition too!
Written by Marsha Diamond, MA, RDN
10. Raise Awareness – Heightened awareness is critical to the welfare of this population so that they can be served safely by knowledgeable staff and facilities. We are very passionate about this cause and try to spread the word as much as possible.
9. Fulfill the Need - As demonstrated by the trends and facts, this topic requires greater awareness to meet the needs of the patients, residents and patrons.
8. Ease Your Worries – Putting a formal program into your facility will ease your worries that people can dine safely and have their needs met. No one wants to see people get sick.
7. Take Pride – This is a wonderful opportunity to provide a work environment that is topnotch and demonstrates caring and that you have taken the extra step to do the right thing!
6. Instill Confidence – The most important aspect of providing a formal program is that you will instill confidence with the patients, residents and patrons that you know what you are doing and that they should not fear that they will get sick. In addition, the staff will have a renewed sense of confidence as they have been given the knowledge to do the right thing.
4. Regulatory Compliance – From the start, develop the program so that it will be compliant with the FDA Labeling Laws and other regulatory body standards - federal, state, local, Joint Commission.
3. Well Educated Staff – Knowledge is power which will increase confidence in the patients, residents and patrons, and your staff. This new program needs to be comprehensive so that it covers all facets including clinical and practical aspects.
2. Change Agent- Start a movement and be a best practice facility for your peers to look up to. It will be great publicity for your institution
1. Patient/Patron Safety and Satisfaction!!!!! – Ultimate Goal which can be accomplished with the implementation of a formal gluten/allergen-free food service program following the guidelines presented today.
Eating food from a bowl is comforting and wholesome. Foodservice facilities have come to realize that bowls are a wonderful vessel for more than just soups or cereal. Health care facilities and restaurants alike are utilizing bowls to create portable, comforting meals. Plus, bowls can also provide your customers with a sense of independence. Both from flavor, taste, and even to better person centric care for the physically challenged feeder.
The catchword, "local" has become a symbol of trust. As a result of the internet and social media, consumers are more likely to trust their small local farmer who offers healthy, seasonal foods. Often, food service operators use the names of these local farms in menu marketing.
Consumers are not the only ones trusting in local food, physicians recognize the preventative health benefits of sustainable food systems. Now, a number of hospitals are using their massive food purchases, which feed both patients and staff, to support local food. Hospitals have a huge purchasing power and by supporting local food, the local economy is strengthened and healthier options are available at the hospital’s food service facility. “Hospitals hope that by modeling good eating habits and supporting local food systems, patients will take good eating habits home and communities will have greater access to fresher, whole foods.”
Hospital food is turning gourmet! Many medical centers have hired executive chefs to upgrade their food service menus, types of foods utilized and preparation techniques.
Hospitals also hope these higher patient satisfaction rates will influence potential healthcare customers, like those looking for a place to have a baby or get elective surgery. Not only does chef-driven food at hospitals attract these new consumers, but there might be more at stake for hospitals than simply attracting new consumers. Under the Affordable Care Act, federal reimbursement is being linked more and more to patient satisfaction scores.
Condiments from Scratch
By creating condiments and specialties from scratch, healthcare food service facilities gain a reputation for offering fresh, wholesome food for their patients, plus cultural diversity and ethnic flavorings. Consumers demand authenticity and this trend of making condiments from scratch can have a positive impact on their perception. Plus, the great thing about offering homemade condiments and specialty items is that the production may take place during off hours or may be done off-premise, thus the foodservice operation's workflow is not altered.
Healthcare food service facilities are shifting to a more individualistic food service delivery model. The industry is seeing dining trends that are based on providing freshly prepared items, which are driving hospital foodservice operations to migrate from more batch-style cooking to models such as room service. Thus, patients are now given the opportunity to order what they would like to eat, when they are ready to eat. In turn, the shift to individualistic food service delivery has greatly increased the quality and freshness of hospital food. Another wonderful benefit of offering patients’ individualistic food service delivery is that facilities are now able to closely monitor patients with special nutritional requirements or allergies.
Many healthcare foodservice facilities are offering ‘a la carte’ options. Special diets with a simple philosophy: “fresh, homemade selections minimizing the use of fat and sodium.” They want patients to taste the food, with most menu items being made to order to optimize freshness and minimize waste.
Senior dining is focusing on individualized approaches too their person centric care approach. Giving each individual what they want from food, flavor, location and timing is being addressed for today’s customers.
Have you ever been to a nice restaurant and the food is almost too beautiful to eat? Well, there is psychology behind your salad that looks like a Picasso painting!
Depending on where your foodservice operation is located, your clientele may have different nutritional needs that you should keep in mind when developing menus and plating food. For instance, as adults age, many changes influence their eating. Medications and physical, sensory and cognitive impairments can interfere with older adults’ enjoyment and physical ability to eat. Eating difficulties can lead to serious consequences like dehydration, malnutrition, weight loss and more. Thus, foodservice operators should understand the psychology behind food plating to ensure their customer is receiving the best that is possible.
When plating is artistic, people enjoy food more than, if the same ingredients were randomly placed on the plate. Hence why you would rather eat a salad plated to resemble a painting. One way for children to have a more enjoyable experience with their food is to place ingredients in the shape of a face - like a broccoli floret for a nose, cucumber slices for eyes and red bell peppers to form a mouth. People have even become Instagram famous for their beautiful food art!
Ida Skivenes (www.idafrosk.com) is a famous artist from Norway who creates (and eats!) food art. She is crafted food to look like the Eiffel Tower, a hot air balloon, a bumblebee and more. You do not have to get this creative, however, it is important to keep in mind who you are serving and that the food looks thoughtful on the plate.
Along with artistic food, the shape and color of the dinnerware can also affect taste. Round, white plates enhance sweet flavors in food, whereas black, angular plates bring out flavors that are more savory. Serving food on a red plate tends to reduce the amount diners eat. Also, keep in mind “The Large Plate Mistake,” especially if your clientele will be serving themselves during mealtimes. Research has proven that diners will eat more food when using a larger plate. So, if your foodservice operation cannot change the color of your dinnerware, change the size. Using smaller plates ultimately leads to clientele choosing smaller portions.
Foodservice operators can change dishware to better accommodate the dining needs of clientele. If your clientele needs to eat less, select plates that have high color contrast with the food that is being served. For instance, if your clientele needs to eat more greens, serve them on a green plate. Another idea is to use table clothes too. Foodservice operators can select a tablecloth with a low-contrast to the dinnerware to lower the likelihood of over-serving or stimulate the eating.
Color, size, shape, material of small wares and plating play a role in elevating the dining experience. Keep the food psychology in mind with the selection of smallwares to affect positive nutrition and hydration.
For patients in a hospital or healthcare facility, food is one of the only things they can control. Healthcare foodservice facilities can create a comforting environment for patients based around food.
With the cooler months ahead and temperatures dropping, it's natural for patients to crave foods that hit close to home. Comfort foods promote warmth and familiarity, but the downside is that they are usually high in calories and fat. There's a healthy side to comfort food, and we're here to give your healthcare foodservice facility some new ideas so that patients can still enjoy their favorite foods.
Instead of completely changing foods to something unfamiliar, healthcare foodservice facilities can "makeover" patients' favorite recipes so the foods remain familiar to patients. Comfort makeovers include multiple recipe tweaks like using meats and cheeses lower in fat, shrinking portion sizes, and adding vegetables and fruits.
Southwestern Vermont Medical Center’s foodservice operation (link: www.foodservicedirector.com/menu-development/creating-healthier-menus/articles/comfort-s-healthy-side) had to rethink a customer favorite: cheesy, crispy quesadillas. The original recipe was high in fat and calories, so the foodservice operation needed to trim down the popular snack. The team first shrank the tortilla from 10 inches to six, which decreased all of the fillings like low-fat mozzarella and shredded chicken. Plus, there was also less avocado and low-fat sour cream piled on top. The new quesadilla now comes in at 330 calories and 17 grams of fat, while the old, larger version had 880 calories and 43 grams of fat. This is a great example of a healthcare foodservice operation decreasing portion size and using meats and cheese that are lower in fat.
Another popular comfort food for patients in healthcare facilities is mashed potatoes. Instead of using whole milk and topping the mashed potatoes with thick gravy, the University of Rochester has a healthy version of this crowd favorite. The mashed potatoes are dairy-free and come with low-fat gravy made from mushroom broth, miso paste and cornstarch. This is a prime example of adding vegetables to a class recipe to make it healthier for patients.
Healthcare foodservice facilities can also lighten up classic comforting desserts like fudge brownies, cookies and cinnamon buns. For instance, try making this recipe for black bean brownies. That’s right – this recipe from the Food Network (www.foodnetwork.com/recipes/melissa-darabian/black-bean-brownies-recipe.html) uses black beans to create even fudgier brownies. It’s easy to add fruits and vegetables to these desserts without sacrificing texture and flavor.
What are some comfort foods that your healthcare foodservice facility is providing, and how can you make them healthier? Comment and let us know some of your ideas.