Two Connecticut Hospitals Put Fresh Food at Forefront of Wellness InitiativesFresh food is the best food, the best tasting and the best for you. With the advent of the slow food, farm-to-table, local and organic movements, the American food culture seems to have embraced this notion. Fresh, nutritious food prepared smartly is the key to a healthy lifestyle; any doctor, nutritionist or dietician will tell you that. It’s interesting, then, that the concept of hospital food—the one place centered on health—has such negative connotations.
Pale meat topped with beige gravy, vegetables so soggy as to be unrecognizable and wiggly Jell-O—these stereotypical hospital foods are nowhere to be found in the kitchens of two local Connecticut hospitals. Griffin Hospital in Derby and New Milford Hospital in New Milford are doing something different, something decidedly better, for their patients, staffs and communities.
“We’re trying to change the perception of hospital food as bad,” says Amanda Asuzu, general manager of dining services for Unidine at Griffin and a registered dietitian. “Nutrition and food are part of the healing process. The meals we serve improve health and reduce the length of stay [at the hospital].”Malnutrition is a major issue for hospitals. About one-third of patients come in malnourished and another one-third become malnourished throughout their stay due to being placed on restrictive diets, being unable to eat or simply being uncomfortable and choosing not to eat. Encouraging patients to engage in a healthy diet during their stay is key to a speedy release and improved health in the future.
(Griffin's Moroccan risotto with shrimp, above)
An underpinning commonality between these two hospitals is their relationships with Unidine, a Boston-based dining management company established in 2001 to enhance food service in senior living facilities and hospitals. The Unidine program is focused on “fresh, delicious food, enhanced choices, greater flexibility and top notch service.” The company established a partnership with both hospitals after rigorous request for proposal (RFP) processes.
These partnerships wouldn’t have been forged without the hospitals’ desire to make serious changes. Both Griffin and New Milford, along with several other Connecticut hospitals, are affiliated with Planetree, a Derby-based nonprofit that shapes the healthcare model around healing the mind, body and spirit. Healthy eating is an important part of that philosophy. In both cases, it was a hospital executive who urged the institutions to put their money where their mouths were and show how important healthy eating really is.“With the astonishing upward trend in obesity, Marydale DeBor advocated that the hospital get on board with addressing this malady and bringing awareness to the community about it,” says New Milford Hospital Community Outreach and Integrative Medicine Coordinator Susan Twombly.
A partnership between DeBor, who was then-vice president of New Milford Hospital and coalition coordinator, Chef Anne Gallagher and pediatrician Dr. Diane D’Isidori launched the hospital’s Plow to Plate program in October 2006. Plow to Plate is a comprehensive two-prong initiative that unites hospital leadership and community-based programs to promote the use of local foods and agriculture as a means to well-being and disease prevention.
Plow to Plate is more than just a tagline, it’s an accurate description of how the food program works at the hospital. Under Food Service Director and Chef Kerry Gold (above), New Milford began partnering with local farms in 2008 and 2009 to procure fresh produce. It started with only a few, but today Gold partners with nine farms, including Sugar Water Farm in Warren, Marble Valley Farm in Kent and Ox Hollow Farm in Roxbury.
Two Connecticut Hospitals Put Fresh Food at Forefront of Wellness Initiatives
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“This was part of the RFP. It was written that [the hospital] wanted it local and fresh,” says Gold. “The slow food movement, it really made sense to get as much fresh and local produce as possible and, yes, it changes a model of corporate procurement. We work with rebates. That was the latitude I was given. You buy local and we’ll adjust our system."
“My farmers email me their product list,” he says in explaining the process. “If they’re all growing kale at the same time, I have to spread it out a little bit. I’m able to negotiate a price and they will work with us. We work within a CSA model of purchasing ahead of time. There’s less charge on the back end, but it also helps that farmer. It’s our way to partner with this community to say we’re in it with you. We like what you’re doing.”Once the shift toward fresh was made, intensive training moved the staff away from the “can to pan” model they had been following for years. Gold says there was a bit of a learning curve, but he’s extremely proud of the work that is being done. The staff now works with products they had never seen before like dinosaur kale, Jerusalem artichokes and wheat berries.
(New Milford Hospital's cafe, above)
New Milford also instituted a new composting program under the global Healthy Hospital Initiative that can process 300 pounds of food waste into 30 pounds of compost in just 14 hours. That compost is used on the hospital’s rooftop garden over the new ER.
During fiscal year 2014, New Milford served an average of 68,000 meals from its café per week and revenues reached $251,952. Additionally, 700 community members enjoyed their catering at hospital-based events. Outreach reached more than 4,000 people. The average plate costs $5.
At Griffin it was President and CEO Patrick Charmel who wanted to completely revamp the food program, replacing fried and frozen foods with fresh. Under Executive Chef Michael Zadroga (right) the entire food program was remodeled to expand healthy choices and return to the traditional model of scratch cooking.
“In the old trend, convenience food was acceptable,” says Zadroga, who joined Griffin in 2012. “It’s harder for me to do things from scratch. I need to be engaged. It’s just like being in a restaurant.”
Since committing to change, there have been a series of small battles won, like removing sugar-sweetened drinks from the coolers by the summer of 2012, eliminating the kitchen’s fryers by the fall of 2012 and not serving meals on paper in the cafeteria as of 2014. Last year, the kitchen won Department of the Year. Both Zadroga and Asuzu, who work side by side, call these wins “huge” for the overall plan.
The Griffin staff serves on average of between 1,700 and 2,000 patient meals per week, sends between 150 and 200 meals to the emergency room and serves between 2,300 and 2,500 meals in the retail space, which is designed to look like a chic cafeteria with high quality stations, including a sauté station, pizza station, salad station and chef’s table. The average cost of a meal in the retail space is $4.65. Their retail sales for fiscal year 2014 were $1,125,832.
It was important to Zadroga and Asuzu that the hospital moves away from the traditional tray line service, where meals are wheeled up to a wing and handed out factory-line style without muchconcern about preference. Instead, patients at Griffin are given ample options on a diner-like menu, including five specials each day. They can choose what they want, when they want, as many times as they want between 7 a.m. and 7 p.m.
(Chef Rocco Cufone at Griffin, left)
The menu features a variety of traditional dishes from different areas of the world because “we get people from all over and we want to make sure they are comfortable,” says Zadroga. He hired a diverse staff of cooks to bring knowledge into the kitchen. He’s very proud that his staff isn’t afraid to speak up and make suggestions.
The hospital participates in Unidine’s “Purée with a Purpose” program, which purées normal foods like chicken and carrots with small amounts of additives to add thickness and then molds them onto the plate to resemble to real foods.
Two Connecticut Hospitals Put Fresh Food at Forefront of Wellness Initiatives
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“When you take the lid off of a puréed meal it will look like chicken with grill marks, carrots and green beans,” he says. “It requires the next level of effort form the food staff. It’s not easy but it is attainable.”Asuzu has also worked to “liberalize” some of the restrictive diets served to patients, like the cardiac diet. She says there is evidence to support that the diet doesn’t need to be as strict on sodium as most hospitals enforce. Under her watch, Griffin believes in a “broader idea of what they can have.”
(Griffin's sliced turkey breast with beans and rice, above.)
“We try to educate while [patients] are in the hospital,” says Asuzu. “You can eat healthy and have it taste good. These things are not opposing.”
At New Milford, dietitians and clinicians meet with patients when they first arrive to discuss the Plow to Plate program and then take their orders before each meal.
“We’re high touch, low tech,” says Gold. “We want to get to know you and learn what you like. We believe that we educate them really well. There’s general instruction in our dining packet and they have ways to contact the dietitian.”But the healthy eating initiatives don’t stop at the hospital doors. Griffin and New Milford extend programs into the community through informational and catered events. Both hospitals invite the public in for meals. Gold says he emails his menus to more than 80 local businesses. People dine in or take out because “the price is right and the food is fresh,” he says. Additionally, both places offer senior dining programs, serving affordable three-course menus throughout the week.
(Chef Joseph Marino at Griffin, right)
“We have partnered with restaurants to have our logo on their menu to show customers what the healthier choices are. Twenty-eight restaurants have signed on,” says Twombly. “Now we want to tackle children’s menus.”
It’s clear these community initiatives are having a positive impact. A child obesity study conducted by the United Way in New Milford over the last three years has tracked a noticeable reduction in risk levels in children aged 4 to 6. Twombly and the New Milford Hospital team believe that is due to their message, plus the implementation of the affordable care act, which focuses on preventative medicine.
“Our visitors and our doctors have changed,” says Gold. “Now they eat the kale and spinach and quinoa. It’s really fun to watch a community change.”
In the last several years Griffin and New Milford hospitals have completely revitalized their food programs for their patients, staff and communities alike, causing positive, traceable change. Both are small hospitals holding 160 beds and 85 beds, respectively, but Asuzu assure that this kind of change isn’t just possible because of their relatively small size. The Unidine model can be scaled up or down. The key though is that “it has to be part of the culture,” she says. At Griffin and New Milford, it is.
“For an organization to make this change, it had to start with the leadership,” says Gold. “It has to be top driven and then the cogs can start to really move.”
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