Hospital Food Goes Healthy and Local

Michelle Martinez
Crain's Detroit

For decades, the food that hospitals served their patients and visitors was a practice in irony. Hospitals advised patients to change their diet to help treat chronic illnesses such as diabetes, hypertension and heart disease, but served up bland, salt- and fat-laden foods bedside or in their cafeterias.

But new food programs are allowing hospitals to practice what they preach, serving fresh, healthy and — increasingly — locally sourced foods to patients, visitors and even staff.

The change is a chance for hospitals and Michigan communities to get “multiple outcomes,” said Michael Hamm, a professor of sustainable agriculture at Michigan State University, “a public-health impact, an economic impact and a land-preservation impact.”

Hamm in March co-wrote an article in the Journal of Hunger and Environmental Nutrition that estimated if Michigan residents ate the recommended amounts of fruits and vegetables and bought them from local, seasonal sources, it could add nearly 2,000 jobs and $200 million to the state's economy.

Henry Ford West Bloomfield Executive Chef Frank Turner puts it another way: If more residents were to spend “just $10 a week on locally grown food,” tens of millions of dollars would be put back into the state's economy, he said.

“We want to set the example for the community,” he said.

Henry Ford Health System isn't the only one. Locally, Warren-based St. John Health, Detroit-based Detroit Medical Center and Royal Oak-based William

Beaumont Hospitals are all finding new ways to offer healthy choices to everyone who passes through their doors. The Michigan Health & Hospitals Association last November started a campaign to get hospitals to eliminate trans fats from their vending machines, cafeterias and patient menus by January.

Nationally, Arlington, Va.-based Health Care Without Harm, a global coalition of health care providers, labor unions and environmental groups challenged hospitals to overhaul their food systems to healthier and locally sourced models.

That group in June hosted its FoodMed conference in Detroit, addressing strategies and benefits of instituting a healthy, sustainable food plan in health care settings.

More than 250 hospitals nationwide have signed that organization's pledge, Henry Ford West Bloomfield and Chelsea Community Hospital among them.

The practices are more important to recession-worn residents, who may want to support Michigan economies, and to those more interested in where their food comes from in light of recent peanut butter, spinach and meat recalls, said Elaine Brown, executive director of Michigan Food and Farming Systems, a nonprofit that promotes sustainable agriculture.

In 2003, there were 90 farmers markets statewide, she said. Today, there are 200 — including weekly markets at Henry Ford West Bloomfield, Beaumont Hospitals and St. John Health.

Henry Ford West Bloomfield President and CEO Gerard van Grinsven sees it, too.

The healthy and sustainable communities concept is “the whole theme behind what we're doing,” he said.

Van Grinsven in 2006 was hired to head Henry Ford's new West Bloomfield hospital from his post as vice president and area general manager of the Chevy Chase, Md.-based Ritz Carlton Co. The hospital has become a lab for the seven-hospital system, where holistic health care and fresh, local food preparation are tested for systemwide viability.

Van Grinsven tapped Matt Prentice, the chef behind such restaurants as Coach Insignia and Shiraz, and Prentice's executive chef, Frank Turner, to develop menus that included fresh local foods. Instead of institutional food workers, the pair hired 20 chefs, half of them culinary students, to serve about 800 meals a day in the hospital.

West Bloomfield cooks patient meals on demand from a large menu. It has no deep fryers or freezers. Its projected $100,000 annual food spending goes mainly to regional farms and vendors such as Maple Creek Farms, a community-supported organic farm in Yale, in the Thumb; or Chef's Garden, an organic farm in Huron, Ohio.

A demonstration kitchen is on hand for healthy-cooking classes, drawing residents each week for classes such as vegetarian cuisine or healthy tailgate food, featuring Michelle Bommarito, a TV chef who has appeared on TV with Martha Stewart and on the Food Network.

Henry's, the hospital café, serves up dishes such as carrot bisque and salmon burgers to about 200 people a day who show up at the hospital for no other reason than to eat, van Grinsven said.

Two months ago, a farmers market was added, drawing another 200 to 300 people to the hospital every Wednesday.

Not everyone is throwing out their fryers, but other local hospitals are moving toward more healthy offerings.

Beaumont Hospitals has been free of trans fats since May, said Maureen Husek, director of nutrition and retail services. The three-hospital system's “My Healthier Choice” program labels cafeteria items that meet American Heart Association guidelines, Husek said.

Detroit Medical Center's Harper University Hospital labels each cafeteria item with its nutritional content and provides the Weight Watchers “point count” of certain items, said Thomas Malone, hospital president and CEO.

Signs posted around the hospital indicate calories burned by taking the stairs instead of the elevator, or walking around the DMC's Midtown “quad.”

St. John is trans-fat free and is revamping its cafeteria menu to be heart healthy, said Dina Ciaffone, a district manager with global food service company Sodexo Inc. posted at St. John and a former director of the system's Detroit Riverview hospital. The system has rewritten its patient menus along similar guidelines and alerts patients when they're butting up against dietary restrictions with each meal.

St. John has bought from local growers and vendors for the past 15 years, Ciaffone said, spending about $2.3 million a year for produce and dairy products alone to prepare nearly 4 million meals for patients and visitors a year.

“We really believe that the less distance food travels, the fresher it's going to be, and (it) cuts down on emissions,” she said.

The trend isn't happening only at hospitals. Skilled nursing homes are overhauling their food plans as well.

Nabil Hawatmeh, executive director of food and nutritional services at MediLodge of Sterling Heights, swapped the bland gravy-colored entrees being served several years ago for what he calls “upscale dining” options.

Now the residents are served from a colorful buffet that features five homemade entrees, healthy panini sandwiches, and fresh fruit and salads.

If they get hungry during the night, they can order room service from a 20-item menu, Hawatmeh said.

Medilodge relies on Medicare and Medicaid for the majority of its revenue, but Hawatmeh said the changes have made the Sterling Heights location a coveted place for prospective residents and drawn residents out of their rooms to socialize more.

The $1 to $2 in extra food costs per patient per day (the industry average is about $6 or $7, Hawatmeh said) is offset by creating efficiencies in other areas, or accepted by the administration because of the program's benefits.

“The No. 1 concern people have when they come here is the food,” he said.

Health care industry food giants are taking notice.

“We've definitely changed our buying patterns to accommodate (the increased demand),” said Diana Bott, senior director of multiunit and health care sales for Sysco Detroit, the local branch of Houston-based Sysco Corp., boosting local produce buys and increasing business with companies such as Cadillac Coffee and Achatz Handmade Pie Co.

But making paying cafeteria customers or wary patients warm up to healthier food choices has been a hurdle, Ciaffone said. DMC's Malone agrees.

Hospitals depend on revenue from cafeterias and retail food chains as part of their budget, Malone said. The biggest money producer on Wednesdays at Harper Hospital's cafeteria? Fried chicken wings.

Offsetting cost is another issue.

National healthy-food model Oakland, Calif.-based Kaiser Permanente started buying local and healthy foods for its hospitals in 2006 and saw an increase in its total food spending of about 1 percent, said Jan Sanders, director, national nutrition services procurement and supply. But it offset that cost with measures such as buying in-season produce, reducing the number of times high-cost items appear on hospital menus, or replacing beef or poultry with vegetarian options.

Preston Maring, the Kaiser Permanente physician who spearheaded the system's farmers markets and healthy-food programs, said most of its programs paid for themselves and did boost the amount of fresh fruits and veggies hospital visitors and staff ate, he said.

“It's difficult to say that someone healed a little bit faster because they had healthy food on their tray, but we do know that increasing overall consumption of fruit and vegetables is good for people and puts money into local farm economies.”

Van Grinsven said that a condition of West Bloomfield's radical approach was that it didn't cost more than conventional food service might.

The common-sense approach to serving patients food they want to eat when they want to eat has cut down on waste, Taylor said.

“You could feed a village from the amount of food hospitals throw away,” van Grinsven said.

Revenue from Henry's Café, cooking classes and the upcoming culinary institute will go to offset any increase from buying organic or local food, he said, but added that hard numbers on the cost of West Bloomfield's expansive food programs won't be tallied until the end of the year.

The hospital opened in March and has only 113 beds of its eventual 300 on line, with 192 scheduled to be available by the end of the year.

But early, small indicators are pointing in the right direction. Henry's Café is grossing $5,000 a day, matching early projections. They aim to double it when they expand their dinner service later this year, said Sven Gierlinger, hospitality services administrator at West Bloomfield.


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