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Hospital food, long the target of criticism and jokes, is getting an overhaul.

Charcoal-broiled chicken, fancy salads and salmon with dill sauce, among other new dishes, are replacing cold meat loaf, lime Jell-O and soggy vegetables.

In a turnaround in philosophy, a few hospitals here have begun to join a growing trend of offering meals hotel-style -- ordered and then delivered hot when patients want them and not reheated and served on the facility's schedule.

It turns out, to no one's surprise, that patients eat more, waste less and come away more satisfied with their hospital stay when the food tastes good and is what they like.

"Patients want more control and selection. They know what they like and don't like," said Michael Glose, director of food and nutrition for the Catholic Health System's Northtowns hospitals.

The Catholic Health System recently introduced hotel-style room service at St. Joseph Hospital in Cheektowaga. Plans are to add the service at Kenmore Mercy Hospital in the Town of Tonawanda later this year and Sisters Hospital in Buffalo in the future.

Patients now can choose meals from a large restaurant menu specific to their dietary needs, including low-sodium, low-fat and low-fiber foods. The emphasis is on variety, everything from create-your-own omelets for breakfast to an assortment of pastas with different sauces for dinner.

Patients have more say over portion sizes and can make substitutions.

The change is a recognition that meals in a hospital can serve as defining moments, helping shape the perceptions patients and their families form about the quality of care.

But it's not solely about image. The thinking goes that if patients like what's prepared, they will eat more, aiding their recovery.

Patients notice the change.

"You don't feel like you're eating hospital food," said Jacqueline Jachim, a pneumonia patient at St. Joseph Hospital, who ordered chicken with fresh herbs for dinner one day during a recent stay. "You can fit the meals around tests and visits so the food isn't sitting around getting cold."

"A halo effect"

A recent survey by the National Society for Healthcare Food Service Management found that 26 percent of its 4,253 members in North America are offering room service and 42 percent plan to do so soon.

Swedish Medical Center in Seattle, one of the leaders in moving to room service operations, is also known for using creative plate presentations, distinctive china, place mats and napkin rings.

"Food has the ability to create a halo effect over everything else that you do," said Michael Giuffrida, chief executive officer of the Washington, D.C.,-based society.

It's not just a matter of patient satisfaction. For some hospitals, food service is viewed as a potential profit center and morale booster instead of a necessary cost.

In addition to room service for patients, many facilities across the country today pay much more attention to the quality of food and service in their employee cafeterias.

Moreover, it's not unusual anymore for visitors and nearby residents to buy their meals in the hospital.

Nationwide, 68 percent of all meals served in hospitals are eaten by nonpatients, according to Giuffrida, compared with 25 percent about a decade ago.

"If employees feel good about the food, their positive attitude gets passed on to patients," he said.

In the Buffalo-Niagara region, room service for patients is the major innovation so far to be introduced at a few institutions.

Patients have reacted favorably to one other program started in late 2002 at Lockport Memorial and Newfane Inter-Community hospitals, where charcoal-broiled chicken salad has become a patient favorite.

"People are able to tailor meals to their own tastes," said Susan Wendler, director of development and community relations.

Nurses approve

Nurses like room service, too, although it can take time to adjust to the new system. They're freed from having to deliver food trays, and they less frequently interrupt meals.

"You see much less plate waste, and meals can be ordered around tests," Kim Rodriguez, a registered nurse at St. Joseph, said recently while assisting a patient, Hildegarde Domrus.

Domrus said she was pleased to find her scrambled eggs and toast were warm.

One of the most common food problems in hospitals is that patients often are sleeping, surrounded by staff or not in their rooms when meals are delivered. When they awaken, finish with the medical care or return to their beds, the food is unappealing and cold.

Room service solves that problem, say its advocates.

By moving to hotel-style food ordering, patients can also control portion size.

"We learned that the old system overwhelmed many patients with portions that were too large," said Nancy Marinelli, lead clinical dietitian at St. Joseph Hospital. "If people only want a little soup and a sandwich, they will eat more of it than if they're given a big portion of something that they don't want."

Room service costs more. But the extra staffing and equipment are offset somewhat by the fact that the hospital is preparing only what it needs, Glose said.

"We no longer have to deliver late trays. We no longer see a lot of wasted food," he said.

At St. Joseph Hospital, a professionally dressed food service "ambassador" visits patients after they are admitted and explains the restaurant-style menus. To get a meal, patients call the kitchen, where their requests are placed into a computerized order-entry system by a receptionist.

Like most hospital food-service departments, the kitchen was built to produce hundreds of meals in bulk. To operate more like a restaurant, the hospital hired a chef with restaurant experience, added a grill and moved toward on-demand meal preparation in which hot and cold foods are prepared in separate locations and then assembled on the plate.

Once about 10 meals are ready -- the kitchen produces 240 meals a day on average -- an ambassador delivers them in a food cart. The goal is to have a hot meal in a patient's hands no more than 45 minutes after it is ordered.

"The new system gives us total control of the process," said Marinelli. "It's our priority and not nursing's problem."


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