Food for thought: Nutrition’s contribution to healing

By Shaylin Kemmerling

Imagine catering a wedding – three times a day… every day… of the year… with 39 different dietary considerations and individual food and beverage preferences. That’s the equivalent of what Bluewater Health’s Nutrition & Food Services group achieves, with a laser focus on innovation to contribute nutritionally to our patients’ health outcomes.

What patients eat – or don’t eat – while they’re in hospital can have a real impact. Research shows almost half (45 per cent) of patients are clinically malnourished on admission and those who eat less than 50 per cent of their hospital food are at risk for longer stays and/or readmission. In fact, a Nutrition Care in Canadian Hospitals study found malnutrition increased length of hospital stay by three days. Malnutrition can also result in delayed wound healing, impaired immunity, lower quality of life, loss of independence and impaired function.

Bon Appétit

Many factors can prevent patients from eating, ranging from lack of appetite related to their condition or environment, to food quality and selection, to physical barriers such as position, tray placement and packaging.

At Bluewater Health, a variety of approaches ensures nutrition while in our hospitals in Sarnia and Petrolia contributes positively to both patients’ health and their hospital experience. On admission, patients’ nutritional status is assessed, with a treatment plan identified for those who are malnourished or at risk. Patients also complete a preference form on admission and are only given foods they like – since there’s no nutrition in a sandwich you don’t eat.

Recently, department staff started a ‘scratch cooking’ movement to maximize the capabilities of their Burlodge carts, which are essentially – but much more than – ovens on wheels. They’ve begun preparing additional menu items – including pasta, baked goods and more – in house. Many improvements are trialed in our Petrolia facility, which we’ve nicknamed our ‘innovation hub.’

“We have found that freshly-prepared foods not only positively impact patient stays, but enhance staff engagement as well,” says Phil Sanders, National Director of Operations and Technical Services, Burlodge. “The Nutrition & Food Services team at Bluewater Health has always been forward-thinking and innovative and they were keen to incorporate some new recipes into their menu to benefit local patients.”

Department staff considers ideas to improve taste and/or quality without increasing cost, and the suggestions just keep coming! For example, small packages of croutons were replaced with bulk purchases put in cups, improving freshness and making it easier for patients with limited dexterity to open – all at a lower overall cost.

The combination of scratch preparation and preference forms allows for shorter, more accurate forecasting and less food waste. The hospitals’ cost per meal day has decreased 25 per cent since 2015, while quarterly patient satisfaction surveys show a 28-30 per cent improvement in taste and temperature of hot food from July 2015 to October 2016.

Department staff carries out R&D on the frontlines and monitors trends in the food industry to adapt best practices and innovation. The broader hospital staff looks forward to quarterly taste panels, where our team can try new ideas on a big enough scale to gauge success.

With a focus on freshness and presentation, the organization purchases as much local/Ontario-sourced, fresh food as possible, and participates in MEALsource –a program under St. Joseph’s Health System’s group purchasing organization which helps 30 Ontario foodservice operations ensure supply consistency at the best price. “We use a two-stage RFP to help determine best value for our members on the products that best fit their individual need, ” says Wendy Smith, Contract Specialist, MEALsource. “Participating institutions commit volume, or not – and we proceed with decisions on that basis. Bluewater Health has always been revolutionary and not afraid to try new approaches to achieve the best result for their patients, their organization and the health system.”

A helpig hand

While the vastn majority of patients (90 per cent) can manage mealtime in hospital on their own, mealtime assistance can help with better nutritional intake on the road to recovery. Hospital volunteers not only provide companionship, they help with hand hygiene and check that patients have any assistive devices they need, before making sure the meal tray is within reach. They encourage patients to finish high-protein and nutrient-dense foods such as fruits and vegetables, and supplements first and offer to open packages and lids, cut food, butter bread, etc.

Quality food that meet patients’ dietary needs and preferences, combined with a pleasant and social environment during mealtime, helps patients maximize their nutritional experience and supports their healing.

Shaylin Kemmerling is a Registered Dietitian and Manager, Nutrition & Food Services and Diabetes & Clinical Nutrition at Bluewater Health’s two hospitals in Sarnia and Petrolia, ON.