Everybody Eats - New Cafeteria

Everybody Eats!

From patients to visitors to staff, Mary Greeley satisfies diverse appetites and health needs … and a refreshed cafeteria is adding to the experience. 

BY STEVE SULLIVAN

Hungry patients start calling in their lunch  requests around 11:30 a.m.

Melanie Reisinger, a Dietetic Services staff member, fields calls at her desk in Mary Greeley’s diet office. A new father on the Birthways unit orders food for him and his wife: mac and cheese, a burger, a salad, a fruit cup, broccoli, apple pie and two strawberry milk shakes, please. The order is promptly entered into the system and sent to the prep line.

Another call. This time a patient on the 4th floor of the west patient tower orders a hot beef sandwich, carrot cake and a milk. There’s a snag, though. Records indicate the patient is NPO, which means “nothing by mouth.” Reisinger makes a quick call to a nurse to be sure that the patient is still under this designation, which is often doctor-ordered following a surgery. The patient is indeed NPO, which means the order can’t be filled. The nurse will explain everything to the patient.

And so it goes. One order coming in after another, each request verified against medical orders to ensure each patient is getting a meal that is appropriate for their given condition.

Patient Care Team Members

Dietetic Services oversees all meal services in the hospital. It’s one of Mary Greeley’s busiest departments because it is serving patients, visitors and staff. Even members of the public who have no other reason to be at the hospital will come to the cafeteria, drawn by the selection and affordability.

This isn’t just a hash-slinging operation, however. It is a central component of Mary Greeley’s patient care, and a significant contributor to the experience people have here. Also, to paraphrase a line from that car commercial, this isn’t your father’s hospital food that’s being served.

“Just because you’re in the hospital, doesn’t mean you should have to eat hospital food,” says Kris Van Houten, Mary Greeley’s executive chef who oversees development of patient menus and the day-to-day offerings in the hospitals’ cafeteria. “For many patients and visitors, the best part of their day here is when they eat. We get a lot of great feedback, a lot of comments about our food being so much better than other hospital’s. We feel good about that. It says we’re doing things right.”

Mary Greeley’s food service defies the stereotype of hospital grub. Yes, if you’re a patient you may find the food shy on salt and spice. That comes with the territory. Mary Greeley’s regular patient menu, however, provides a variety of options, from Angus sirloin to blackened shrimp with remoulade sauce, whole grain salad to grilled portabella mushroom with pasta. Meals are made to order and nothing is deep fried.

Patient orders are entered into a system called CBORD, which “talks” to Epic, the hospital’s electronic medical record. Epic will recognize the patient room and alert cafeteria staff if someone is ordering food that goes against what has been prescribed by a physician.

“A diet order is ordered by a physician. It’s really a form of a prescription,” says Matt Hart, director of Dietetic Services. “We ensure that the prescription is followed, and that’s what makes us part of a patient’s care team.”

Dietitians

Dietetic Services works closely with the hospital’s dietitians to develop menu items and address individual patient needs. 

“We see to the nutritional welfare of our patients,” says Jolene Wolf, RD, Mary Greeley dietitian. “If we keep a patient well-nourished, their length of stay may be reduced.”

Dietitians will be called in if there is concern about malnutrition, or to advise if a patient has recently been diagnosed with diabetes or any condition requiring a special diet. They will also work with a patient and family members to help ensure that proper nutrition is being followed after discharge. Dietitians are members of the interdisciplinary transition team, which encourages patients to ask about any nutrition concerns they may have prior to discharging home.

Maintaining a proper diet while in the hospital is important to the healing process. Dietetic Services runs a “missed meal” report after each meal time to determine if a patient has had the opportunity to eat. These situations are promptly reported to a nurse on the patient’s floor.

Dietetic Services maintains nine different menus to ensure every patient condition is being addressed. There is a regular menu, of course, as well as menus for liquid-only diets, heart healthy, diabetic diets, gluten free and low-fiber. Some patients might be in the hospital for a stretch of time and get tired of a menu. Patients can also order the entrée specials from the \cafeteria menu, which changes from day to day.

“We start with the regular menu and then work with the hospital’s dietitians to determine which items can be included on specialized menus,” says Van Houten. “It really is a team effort to ensure that patients are getting what they need.”

Recently a nurse called to order a birthday cake for a patient. One problem: The patient was on a doctor-ordered cardiac diet, which means food high in saturated fats needed to be avoided. Wolf provided a solution, recommending angel food cake.

Prompt Delivery

A typical order takes about 22 minutes from when the order ticket is printed to delivery to the patient room. When the order is made, a ticket is issued at the prep line. One side of the line does hot foods, while the other takes care of cold foods, drinks and condiments. When a tray is ready, it is placed inside a cart, which a Dietetic Services staff member will then deliver to the patient’s room.

Upon entering a room, the Dietetic Service employee follows the same process as any member of a patient care team. The employee will first “foam in” with a stop at the hand sanitizer dispenser, and then introduces themselves to the patient, and explains why they are there. They set-up the patient with their meal, and then “foam out” as they exit the room.

In some cases a ticket might be stamped with a particular color, indicating that the there is a special patient need. For example, a pink stamp indicates that the patient is diabetic, which means whomever is delivering the meal needs to make sure that the patient’s blood sugar has recently been checked.

Patients can order food anytime they want between 7 a.m. and 8 p.m. The busiest times are breakfast from 7:30 to 8:30 a.m.; lunch from 11:30 am to 12:30 p.m.; and dinner from 5:30 to 6:30 p.m. There are snacks and drinks available on each patient floor to satisfy any cravings that arise after 8 p.m. Patient meals are part of their stay at the hospital. Guests can order from room service for a $7 a meal charge.

Follow that Tray video preview

Follow That Tray

Watch the patient meal process, from the order being made to the meal being delivered to the patient

Tasty Remodel

One half of the Dietetic Services kitchen is dedicated to preparing patient meals, while the other focuses on the cafeteria’s daily fare. The food service area of Mary Greeley’s cafeteria was recently remodeled. Food stations now include made-to-order sandwiches, a pizza oven, an entrée station, grill station, a soup and salad bar, and an Action Station, where Van Houten displays his skills. This is a cafeteria where you will find dishes like mushroom risotto, gnocchi, chicken-pesto pizza, Vietnamese pho bowls and bananas Foster. Yes, there are items that are sure to meet the comfort food needs of anyone, including mac and cheese, chicken  strips, and an unusual but popular sandwich made with bacon and cheese between two waffles. (Don’t tell your cardiologist.)

“We work hard to make sure everyone is happy – patients, visitors, staff, really anyone who joins us for a meal,” says Hart. “We offer a variety of healthy options, as well as those guilty pleasures that everyone loves. Many people walk through Mary Greeley’s doors every day – individuals with different tastes and needs. We put a lot of effort into and take a lot of pride in giving each  of them a great experience.”

The design of the new cafeteria is intended to get cooks out front, where customers can watch them prepare fresh meals. You can see cafeteria staff putting together pizzas or wraps, or Van Houten whipping up made-to-order omelets.

There is one drawback to the remodel: The changes have made it difficult to immediately decide what you are going to eat. Mary Greeley staff routinely have to walk around the cafeteria a couple of times to take in all the options before landing on a final dining decision.

Patient care is a 24-7 responsibility, which means having staff immediately available to provide care or respond to an emergency. It is important that staff have a quick, affordable option for meals. During lunch you will see groups of employees from various departments eating together. This camaraderie-supporting convenience is a real plus for quality patient care, says Hart.

With the support of hospital’s administration, Van Houten has been allowed to experiment with patient menu and cafeteria offerings. The response has been positive, especially
at Van Houten’s action station. Still, a chef never rests and Van Houten’s already dreaming up his next mouth-watering move.

“I’d love to have a sushi bar,” he says.