Eating Well: Hospitals find that healthful food is better for kitchens and customers

One cook prepares a watermelon salsa to accompany blackened mahi mahi. Another assembles smoked salmon BLTs on croissants with wasabi mayonnaise. A third, Ryan Conklin, places chicken satay -- spears of grilled chicken with a Thai peanut dipping sauce -- onto a platter.

"I worked at the Four Seasons Hotel in Manhattan. This was on the room-service menu," said Conklin, a Culinary Institute of America graduate. "Now we're doing it at a hospital in Raleigh, North Carolina."

Conklin is one of five culinary school-trained chefs now working in the kitchen at Raleigh's Rex Healthcare.

Jim McGrody is the reason the hospital's food is better these days. McGrody, 42, another Culinary Institute of America graduate, became the director of the food and nutrition services last fall. It used to be run by an outside contractor.

"I wanted to put in restaurant-quality food," he said.

And it's working. Retail sales have increased by 30 percent at the hospital's cafeterias, said Lisa Schiller, a hospital spokeswoman. Patients are happier too. Schiller said that Rex ranked in the 28th percentile for patient satisfaction with "overall quality of food delivered to your room" before the menu changes, according to patient surveys. At the end of May, their ranking rose to the 58th percentile.

The Triangle is a competitive hospital market, but Schiller said that a competitive edge was not the hospital's motivation for changing its food service.

Schiller said that Chad Lefteris, the hospital's vice president of support services, made the change with patients in mind. "His goal was to give patients a time and a moment when they forget they are in the hospital," Schiller said.

The changes were noticed recently by Susan Hill, 71, of Raleigh. She and several family members spent a day at Rex while her granddaughter was treated there. As Hill said, they were a starving captive audience. They were pleasantly surprised by the hospital's quality food for a reasonable price.

"I think the whole family was pleased," she said.

Rex isn't the only hospital to see sales increase thanks to improvements in the cafeteria. N.C. Prevention Partners, which helped make all the state's hospitals tobacco-free as of July 1, has spearheaded an effort to get hospitals to provide more healthful food options for their employees and visitors.

The statewide nonprofit, based in Chapel Hill, focuses on reducing preventable deaths from tobacco, poor nutrition and inactivity. With its success ridding hospitals of tobacco, the nonprofit received a grant from the Duke Endowment to focus on nutrition at the same hospitals.

"We realized this was an incredible opportunity," said Anne Thornhill, the senior health-promotion manager at N.C. Prevention Partners. "North Carolina hospitals serve more than half a million meals in a week."

To receive what is called "red-apple status," the hospitals have to provide access to healthful foods to all employees regardless of when they work, market those foods and make them affordable. In the Triangle, Rex Healthcare, WakeMed and UNC Hospitals have already achieved red-apple status.

At Wake Forest University Baptist Medical Center in Winston-Salem, a 20-ounce regular soft drink costs $1.25, and diet drinks and bottled water cost less. Ashley Winton, a wellness and nutrition coordinator, said that the lower prices have led more people to buy diet drinks and water.

At FirstHealth of the Carolinas hospital in Pinehurst, prices of unhealthful entrees, such as fried fish and fried chicken, were increased from $2.10 to $2.50. Cheeseburgers went from $1.20 to $2.25. Meanwhile, the price of more healthful entrees, such as pineapple tilapia and pork tenderloin, decreased to $1.75. Even the price per pound at the salad bar dropped from $4.64 to $2.95.

Barbara Bennett, an administrative director at FirstHealth, says they expected to lose money the first year, but sales increased 4 percent.

They also learned some lessons. Bennett says initially employees complained about portion size. For example, cafeteria workers are now spooning out half of what employees used to get when they ordered oatmeal. But Bennett said that employees had been getting a double portion, which isn't healthful and no longer corresponds to the new nutritional information available in the cafeteria.

At Rex, McGrody said that the statewide initiative fell in line with the changes he had made in the kitchen. McGrody and his staff had to teach the cooks how to prepare dishes using fresh ingredients. Instead of handling only frozen meat, now the cooks cut up top sirloin to be marinated overnight for shish kebabs. They make two homemade soups daily. They make dinner rolls from scratch. The fruit cocktail isn't taken from a can but is prepared fresh, as are the vegetables.