To Glove or to wash; the debate and risks of using just one method in your kitchen
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- Serving: a reference amount of food as defined by Health Canada. Examples of what is a serving based on specific types of food can be found on Canada’s Food Guide (http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/basics-base/serving-portion-eng.php ).
- Portion: What you a put on your plate and intend to eat. A portion can be large or small, it is up to you!
- Use the measures above to help estimate servings and guide the portions you eat.
- Used the measures above and have food left over? Remember portion sizes served have increased over the years. Pack up the rest for leftovers.
- knocking before entering the patient’s room
- smiling
- being knowledgeable about the food being delivered
- positioning of the tray upon delivery
Food Labels: A Thing of the Future!
April 2nd, 2013Baby Boomer Generation
Baby Boomers are individuals ages 45-65. They have grown up in a different culture and have formed a unique set of values and ideas. Baby boomers overall are said to be very health conscious. With access to the internet, anything and everything can be “googled” making this group of individuals more educated on health matters when entering a hospital. Due to changing medical conditions, the most common being high blood pressure and diabetes, they focus more on nutrition. The Government of Alberta “Consumer Reports” publication reports that well over half of baby boomers check food labels as to avoid certain contents.
Wanting More…
With that being said there is a thought that baby boomers are not going to be as willing to listen to nutrition advice and it is questioned whether food labels will be in demand in healthcare foodservices. The thought is that they will want to read the food labels to ensure they are receiving healthy foods and avoiding the contents they avoid on a normal basis. I challenge if this is really necessary though in a hospital setting. Three things need to be considered: knowledge translation, feasibility, and patient satisfaction.
Knowledge translation
The Canadian Institutes of Health Research defines knowledge translation as a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system. In other words it is the process of putting knowledge into action.
What does this mean for the incorporation of food labels within hospital foodservice? By not understanding how the information from a food label translates into action means that more education is going to be required for these patients. Who would do the education? Ultimately the Registered Dietitian (or Dietitian Technician in some cases) should do it, but is there time for this to happen? There is also a question of time required to complete the education and what exactly would be taught off the label.
Feasibility
Anything is possible though. Incorporating food labels could definitely happen. However, the time it would take to translate food labels from the bulk products received in foodservice into food labels with individual food servings should only be done if it is deemed to be necessary. Aside from time, there are a variety of processes that must be reviewed to ensure flow of the information from the kitchen up to the patient. Many hospitals contract out their foodservice and thus a disconnect can occur between clinical nutrition (ie: the Dietitians) and foodservice operators. This may not be an easy hurdle to jump.
Feasible or not…
I argue that in hospital foodservice it will never be necessary. The act of reading a food label is done as to educate oneself about the nutritional quality of the food. Isn’t that already taken care of in a hospital? If there is a question about the quality of hospital food should it really be up to the patient to monitor it by requesting food labels? There is a reason why only Registered Dietitians are employed to review nutritional information in hospitals. They are accredited, respected, and trusted sources of nutritional information. A level of trust needs to occur between the patient and the hospital. That being said, you have to also question if it is really the role of an acute care setting. Would this type of education not be better suited in a continuing care facility or outpatient counseling center.
Patient Satisfaction
Patient satisfaction should always be at the centre of any hospital foodservice. If the stance was taken that patients should trust that hospitals are already providing them nutritionally sound food and really it is not the role of an acute care setting to provide food labels, one could argue that patient satisfaction will suffer in the future. Patients will be asking for food labels and we won’t be giving them.
No. It won’t. The reason why patient satisfaction will not decrease is because giving food labels does not solve the ultimate problem at hand the connection between the patient and foodservice. Giving food labels would create this connection by increasing the face time with the patient. More face time means more patient satisfaction. This has been shown time and time again.
Therefore, how do we convince the patient that the hospital food is of good nutritional quality thus them not requiring food labels? Take ownership of the food served. Read a previous post Gastronomy & Hospital Foodservice to see how this could be done.
By following the tips mentioned in that article face time will increase, confidence in the nutritional quality of the food will be achieved, patient satisfaction will increase, and food labels will not be necessary.
Big Picture
Absolutely we are going to see a generation that is more educated and more health conscious then we have ever seen before. However, we cannot forget who the experts are. Registered Dietitians and foodservice operators need to work together to provide quality food to the patients. With this being accomplished, the baby boomer generation can trust that in a hospital setting their health is the number one priority.
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Best Food Forward: Plan, Shop, Cook, Enjoy!
March 22nd, 2013March is Nutrition Month! The theme for this year is “Best Food Forward: Plan Shop Cook Enjoy!” The focus is on giving practical advice on navigating the grocery store, as healthy eating starts there.
Ever feel like you just don’t have the time to plan your meals and more importantly what you’re going to buy at the grocery store? You know you want to buy fresh, but the thought of figuring out what you are going to do with those fresh ingredients makes you cringe. It’s too much work! Don’t worry, you’re not alone!
Dietitians of Canada completed a poll in Spring 2012 where they found that 63% of Canadians struggle with making healthier food choices at least half the time they shop. Only 37% plan their meals in advance and 58% of Canadians reported they always or very often cook a balanced meal for themselves or family.
What can you do?
Plan: Before you head to the store think about what you or your family would want to eat for the week. Review what you already have in the kitchen and make a grocery list.
Shop: Shopping the outside perimeter of the grocery store is always best. Fill your cart with foods from all food groups focusing on fresh fruit and vegetables. Avoid highly processed foods that tend to be high in fat and salt. Read food labels and compare products when necessary.
Cook: Prepare your meals from scratch! Frozen fruits, ready-to-go salads and pre-chopped vegetables are nutritious short cuts to help you prepare a great healthy meal.
Here is a fact sheet with more information on including fresh foods in your grocery cart.
Also check out eatTipster at www.eatipster.com . Here you can download an app for your Ipad or Iphone to get healthy eating tips from Registered Dietitians every day!
Happy Nutrition Month!
Portion Distortion
March 8th, 2013Lunch time may be a time to get out of the office or socialize with co-workers. Eating out is common because of these reasons or simply because you didn’t pack one. Whatever the reason may be, making healthy lunch choices when eating out isn’t always easy.
There is no doubt that there are a variety of options available around the office. The problem isn’t necessarily what you’re going to eat though, it is how much you eat or the portion.
“Serving” and “portion” are words used interchangeably. What do they mean?
Portion sizes served in restaurants have changed over the years though and the gap between a portion and a serving has grown. Below is a chart that shows the changes seen in some common foods/meals over the last 20 years.
| 20 years ago |
Today |
|||
| Portion | Calories | Portion | Calories | |
| Bagel | 3” diameter | 140 | 6” diameter | 350 |
| Cheeseburger | 1 | 333 | 1 | 590 |
| Spaghetti with meatballs | 1 cup sauce and 3 small meatballs | 500 | 2 cup sauce and 3 large meatballs | 1,020 |
| Soda | 6.5 ounces | 82 | 20 ounces | 250 |
You will see that in most cases the portions have doubled and along with that so have the calories! It may feel like an uphill battle but these growing portions can be beaten!
When you are out for lunch you are probably not carrying measuring cups and spoons. Good thing you always have your hands!
Below are some common measures to help you determine serving sizes and decide how big (or small) of a portion you will have.
|
Your fist |
1 cup measure OR 2 servings of pasta/rice |
|
2 handfuls |
2 cup measure OR 2 servings of leafy raw vegetables/salad |
|
2 thumb tips |
2 tsp OR 1 serving of cheese |
|
Deck of cards |
1 serving of meat, fish, chicken |
Follow the tips below to make healthier choices in regards to portions when eating out:
Being aware of how much food you are eating at each meal will help you lead a healthier lifestyle and reach certain goals you may have set. Bigger isn’t always better.
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Gastronomy & Hospital Foodservice
February 20th, 2013It has been said 100 times before, “Hospital food stinks!” Over the years hospital food has definitely got a bad rap. However, I question why? Is it the equipment we are using? Is the food itself just bad? I believe hospital foodservice of higher quality can be achieved and has direct relations to the concepts of gastronomy.
Gastronomy…
Gourmet dining. Is there space in hospital food service? Gastronomy embraces the concept of enjoying the very best in food and drink. It encompasses reflective eating, cooking and food preparation. This means that gastronomy truly questions how the food was prepared, where it came from, how it was cooked, and how it tasted. The goal of gastronomy is for total enjoyment of the food.
Wait a minute…
What would be considered high quality hospital foodservice? High quality hospital foodservice encompasses good food and positive communication between employees, patients, colleagues, and managers. Ultimately, a truly enjoyable experience wants to be created. The food should be enjoyed in its entirety from preparation to service.
The gap between the two
What is the difference? Nothing. Both share a common goal of client/patient satisfaction. It is a little far-fetched to think we could create an environment that would completely resemble the environment of gourmet dining but I challenge you to think that we could get fairly close.
How can this be achieved?
High quality hospital foodservice can be achieved by incorporating the concepts of gastronomy in every day practice. This is done through the food, delivery of the meals, and interaction.
The food
The food is clearly a key component to creating the best possible “gourmet” experience in the hospital. The concepts of gastronomy to consider are reflective preparation and reflective cooking. Earlier I questioned if the equipment was the problem. The answer is no. Whatever quality of food you decide to put into that equipment is going to be the quality of the food that comes out.
Good food in = Good food out.
This does not mean that all hospitals have to go back to the 1930s and scratch cooking. Ownership over the food served needs to be taken. This means considering the quality of food you are purchasing. Question whether everything that is put in the equipment needs to be processed. Consider bringing fresh and local products back into the hospital kitchen. Simple recipes made with fresh ingredients from your own neighborhood can be cooked in a retherm cart and are cost effective and also delicious to taste. Not only are you going to make patients happy but you are also supporting local farmers and giving back to the community.
The delivery
Another component to high quality hospital foodservice is the delivery. This also encompasses the reflective preparation and reflective cooking concepts in gastronomy. The delivery of the food should be on time and at the right temperature. Where the delivery can fail is when the process of preparing and cooking the food is bogged down by non-value added steps. This requires foodservice to re-evaluate their delivery system and consider lean principles. Is there room to become more efficient, faster, and effective at delivering the food? Evaluating these processes gives the possibility of opening up FTEs to focus on another key component interaction.
The interaction
To achieve quality hospital foodservice positive interaction is required. This relates to the reflective eating concept of gastronomy. A connection with the patient needs to be created.
Studies have documented the effect of personable service on patient satisfaction. Hospitals have implemented training programs where the focus was solely on creating a connection with the patient. Creating a connection included:
Consider how this includes the choice of utensils, plates, and napkins used to present the food. Being knowledgeable about the food includes explaining to the patient where the food came from and how it was prepared. When including fresh and local products be sure to tell the patient what was made with those foods. The patient will then know your commitment to the community and will feel great about the foods they are eating. Also don’t forget about garnishes, a small touch that can go a long way.
Hospitals have seen that without changing anything with the food, patient satisfaction increases significantly demonstrating the impact of creating a connection with the patient. Ultimately, creating a connection with the patient affects the overall environment for the patient allowing for a more enjoyable dining experience.
While this may sound great, you may think it is not doable since in hospital foodservice we are always being asked to do more with less. Making this connection can seem to be “not in the budget.” However, remember the lean principles. Implementing lean principles can save time and open up FTEs to be used towards creating a patient connection. After evaluating the preparation and delivery process of the meals, FTEs that are no longer needed to do these tasks can be used to create the connection.
Putting it all together
The concepts of gastronomy focus on truly making an enjoyable dining experience. This is a common goal shared with hospital foodservice that is trying to reach a higher quality and ultimately higher patient satisfaction. Considering the concepts of gastronomy and including them into everyday practice will bring hospital foodservice to level of gourmet dining. Small changes over time will have a huge impact. I challenge you to think outside of the box and reach for the gourmet dining experience.
