Hunger pains

We are all familiar with the stereotypes about hospital food.

When Jessica Smith was a patient at the Ottawa Civic Hospital, for example, she requested a vegetarian meal and got nothing but a peanut butter sandwich.

“Then there was their version of ‘soup’ that was literally hot water with three slices of carrot,” Smith says.

Bob Copeland, who stayed at St. John’s Rehabilitation Centre following a hip replacement surgery in Toronto, says that portion sizes were unappetizingly huge.

“There was just so bloody much of it," he recalls. "When you were doing nothing but lying in bed all day, you couldn’t eat it all.”

But now imagine you have the option of sweet and sour chicken, Jamaican pork or pasta primavera. Imagine you ate vegan or halal or kosher and there was a menu tailored to those restrictions. And imagine your meal was delivered to you on proper china within an hour of ordering it.

A sample of the food HFS supplies to hospitals.

For Brad McKay, CEO of healthcare food supplier HFS, this is how he sees the future of food in Canadian hospitals.

We need to serve (our patients) food that is not only nutritious, but also encourages eating. — Brad McKay

“We need to serve (our patients) food that is not only nutritious, but also encourages eating," he said during the Future of Food in Healthcare Conference, hosted by HFS in Ottawa on Oct. 15.

HFS provides food to hundreds of healthcare facilities across Canada. Its mandate is to create food that is both nutritious and appetizing.

“It’s often seen as a non-medical part of operations,” McKay tells Capital News via email. “But many would argue convincingly that (food is) just as integral to recovery as the rest of the healthcare process.”

A new alternative

Some institutions have already made the transition from cold, prepackaged food to a more varied menu for their patients.

At Toronto’s Humber River Regional Hospital, current patient Andrea Meadowcroft enjoys meals that feature Italian wedding soup and roast turkey.

“The food is really good,” says Meadowcroft. “And I like being able to give my order as though I’m at a restaurant and not in a hospital.”

In October 2009, the Queensway Carleton Hospital in Ottawa worked with HFS to pilot a similar model. 

The Simply Outstanding Hospital Food Initiative operated out of a renovated kitchen space in the rehabilitation unit of the Queensway Hospital. Meals were served hot and in smaller, more nutritionally-dense portions — which greatly reduced the amount and cost of waste from the typical plastic packaging and leftovers.

Carlalan Dams, food services manager at QCH, says the hospital was receiving poor responses on patient feedback forms, so she pushed for a more varied menu.

“Hospitals are starting to look at quality indicators and the overall satisfaction of the patients,” says Dams. “And our results (before SOHFi) showed that overall mealtime satisfaction was reaching a peak of just 57 per cent.”

When the core demographic of healthcare patients today are between 70 and 80 years old, McKay says getting them the proper nutrition is already a challenge even when they do eat everything on their plate.

Moreover, according to Ottawa Hospital dietician Sylvie Bedard, Canadians on the whole are becoming more informed about health food trends — such as Health Canada's push for lower sodium and reduced fat intake.

“They are aware of new healthcare policies… and they are very much aware of what nutrition there needs to be at home,” says Bedard. “They expect the principles they follow at home to be found in hospitals, too.”

After SOHFi, Dams says she and her colleagues were overwhelmed to see that mealtime satisfaction among their patients increased to nearly 100 per cent and says she hopes to get the capital needed to fund the program hospital-wide in the next 18 months.

"Ideally, in ten years, I'd like to see similar models in place throughout the region," she says.

Budget realities

But in an era of tighter healthcare budgets, the service, quality and presentation of food is often far from a priority.

Until 30 years ago, meals were made from scratch in a kitchen within all hospitals. But this method was inefficient for several reasons.

Brad McKay speaks at the Future of Food Conference.

According to McKay, it was expensive to stock a kitchen for so many and it was difficult to attract trained chefs who would maintain the quality of the food.

"The food could be good one day or bad one day and if the chef didn’t show up then who took care of things?” he says. “There was a lot of variability.”

So in a cost-effective move, hospitals started buying what McKay calls “convenience food”: food that was prepared and packaged at a centralized location before being distributed to hospitals throughout the region. The food was both highly processed and lacking in taste.

But today, McKay says HFS is able to capture both the reduced cost of the convenience method as well as the homier taste from when meals were cooked onsite.

Though HFS is also a centralized supplier, and as such is able to purchase large amounts of ingredients at a relatively low cost, it also focuses on developing simple, from-scratch recipes.

The institutions the company supplies are also outfitted with larger kitchen spaces to better reheat the meals and then serve them as individual dishes.

Still, it costs the Queensway Hospital more than $60,000 to renovate the space needed for just one 40-patient unit.

"[This] might be a barrier for many hospitals — especially ones who don't have enough space already," notes Bedard.

She adds that the pressure for more beds might be seen as a more pressing budget demand for most institutions.

However, if other regional hospitals follow the example set by the Queensway Carleton, this will be one step closer to a national standard and what McKay calls the "recognition of the vital role that food plays in helping patients to recover."