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American Society for Healthcare Food Service Administrators

American Dietetic Association

Massachusetts
General Hospital

By Diane Sussman
May 15, 2000
Photos: Photodisc

Pan-seared chicken marsala with herbed rice. Pasta primavera tossed with garden vegetables. Honey-glazed tuna with garlic potato wedges. What ever happened to hospital standards such as watery Cream of Wheat, pureed mystery meat, and lime Jell-O, all left to grow cold on carts in the hallways?

"It's always been kind of a joke, hospital food," said Patrick Baldassaro, patient food services manager at Massachusetts General Hospital.

There is far less sniggering these days at the Boston hospital, where the food has improved so much that last year the Massachusetts Restaurant Association named the hospital's director of nutrition and food services Best Restaurateur of the Year. It was the first time a hospital had earned the honor, which usually goes to restaurants, Baldassaro said.

It's not just Massachusetts General that is hearing yummy noises for the first time. All over the country, hospital food, the gustatory appeal of which has traditionally ranked alongside lunch from the high school cafeteria, is undergoing substantial changes for the better. "There's definitely a national trend to get away from hospital food," Baldassaro said.

The trend is being driven by the same forces that have national chains such as McDonald's offering salad shakers and grilled chicken sandwiches: the growing sophistication of the American palate and an awareness of the relationship between nutrition and health. The changes also are being shaped by the idea that people who avail themselves of health services are no longer patients: They are consumers. And like consumers in other economic realms, they want their healthcare dollars to buy a few niceties along with their sutures and splints.

And the healthcare industry is responding, not just with better food but with services such as massage therapy, noontime concerts and anti-aging creams. "There has been a movement to provide more customer satisfaction," said registered dietitian Cindy Moore, MS, director of the Cleveland Clinic Foundation and spokeswoman for the American Dietetics Association.

Unquestionably, technology has helped as well, most notably in the form of microwave ovens, expanded use of refrigeration and new cooking techniques. "We're a cook-chill operation," Baldassaro said, meaning that the hospital cooks individual patient meals to 70 percent done, "blast-chills" them, and "rethermalizes" them in the microwave when the patient is ready to eat. "The food is always hot and fresh. There's no tray sitting around waiting while the patient is in the lab or having a test. It doesn't come out until the patient is ready to eat it."

But all the technology in the world can't make a silken pork roast out of a sow's ear-although Moore maintains there are fewer culinary sow's ears on the market. "The reason hospital food was given a bad rap had to do with the availability of good products," she said. "But a lot of that has changed. The food industry has introduced all kinds of low-fat, low-sodium foods that taste good."

While not exactly at hotel level, service is improving, too. At Massachusetts General, patients no longer eat at unnatural times to accommodate staff schedules. "We have tray service until 11:45 p.m.," Baldassaro said. And when the kitchen is closed, patients can order "emergency packs" of homemade soups and bread or fixings for sandwiches. "We're very patient oriented," he said.

And what's been good for the patients has been good for the staff as well. "I think it has been very refreshing for registered dietitians and nursing staff to be part of a system that provides good food to our patients," Moore said. "I think the test of a good program is the support of the nurses-and we have had tremendous support from the nurses."

But as nice as it is to cater to the national palate, some say, hospitals should not be looking toward spas or hotels for guidance on how to feed patients.

"I think we need to look at who is coming into hospitals these days," Moore said. "We know that 55 percent of patients are malnourished. And they are sicker. For that reason, I feel that our primary goal is to nourish them so they can develop the strength to get out of the hospital. Then afterward, if they want to take it to the next level, that's fine."

As much as the food at the Cleveland Clinic has improved, Moore is not quite ready to take a date. "The ambiance is still not there," she said.