The evolution of hospital meals

- Nutrition is an essential part of our well-being. However, hospitals don’t have a very good reputation when it comes to their skills at feeding their patients. In this one place that aims to heal our bodies, healthy food is often their last concern. An ascertainment with 16,000 patients showed that only 50% of them eat their hospital lunch. Aside from the quality, there are many other factors for this large number.

Even logistically, caring for several hundred beds in large clinics and supplying food and drink is already a very complex task. Furthermore, more than ten different professions are part of the food supply chain – far beyond kitchen, care management and the nutrition team. Caretakers play an important role within this process, yet there are often too little staff members on a team, resulting in personnel overburdened with other tasks, leaving the patients without sufficient individual care. Patients who require support while eating will especially suffer from the lack of attention. Patients’ preferences and nutrition concepts are often neglected. Examinations and therapeutic measures can make the situation even more complicated. A patient who has a scheduled exam around noon will in many hospitals be forced to eat a cold or microwaved meal later.

As most hospitals have a limited budget for meals per capita per day, for economical reasons it is hardly possible to supply every patient with their individual meal requests regarding schedules and eating habits. For financial reasons, the preparation takes place in central kitchens miles away from the respective hospital. Even when the meals leave the kitchen hot and in good quality, they will arrive at patients’ tables cold or overcooked.

There is no doubt that many improvements can be made within the nutrition management of several hospitals. After all, nutrition has switched from being a fundamental need, to an effective part of a doctor’s therapy and prevention, within the past few years. This important shift is also visible in several studies on undernutrition and malnourishment. According to these studies, approximately 25% of all hospital patients suffer from undernourishment or malnutrition. Many patients becoming affected during therapy development as an inpatient. The affected patients suffer more often from complications, remain in hospital longer and are at a higher risk of death, than patients with a healthy nutrition status.

In the past few years, developments have led to the revaluation of nutrition strategies at hospitals. Many places are working on their supply and logistics for patients. The red cross hospital in Kassel established the Kassel model, which aims at individual patient care in regards to nutrition. The plan combines affordable strategies with knowledge about modern nutrition medicine on patients who suffer from malnutrition. The main aspects of this model have been published and also adapted in various clinics all over Europe. This model recommends to equip all viewing rooms for patients with calibrated digital scales, such as the seca 878 as well as measuring sticks, like the seca 222. With these tools, the patient’s size, weight and BMI can be determined with standardized measures.

Our tip: to enable a visibly more effective and time saving procedure, we recommend using the ultrasound measuring station seca 287 which is suitable for radio transmission and can measure and wirelessly transmit all the mentioned parameters in only one step. Alongside these measurements, the doctor records the patient’s detailed nutrition details. With the data from the measuring devices and the case history at hand, malnutrition can be detected and treated early on.

To evaluate the patient’s nutrition status, the seca mBCA 515  and the mobile seca mBCA 525 are especially handy. These devices not only measure the BMI, which can be calculated with a standardized formula, but also determine the exact body composition. The ratio of fat and muscle tissue as well as the body water can be accurately distinguished from one another. This data also offers valuable information for various other applications.

The nutrition plan for patients suffering from malnutrition by the Kassel clinic also states to include liquid meals rich in calories, such as shakes and snacks, alongside a diversified main meal. The patient’s actual calorie intake should be monitored regularly, according to the offered meals and if necessary, the nutrition plan has to be adapted. Regular advanced training for the staff members is also required. Another way to deal with malnutrition can be seen at Uniklinik Heidelberg. After a central kitchen was responsible for patients’ meals for over 30 years, the food supply is now being decentralized. In the future, meals will be prepared in stationary kitchens to enable a more precise catering to the individual patient group’s needs. Service personnel who are in charge of nutrition are now responsible for supporting patients during their meals in bed. This will especially improve the situation of immobile patients and those of advanced age.

An innovative procedure that is currently being tested was developed by the Isala hospital in the Netherlands and aims at supplying elderly and cancer patients with individually produced food from a 3D printer. The meals are based on blended products and can be combined according to every patient’s individual needs. Well balanced and well tasting nutrition not only positively influences the course of disease but also has a positive effect on the psychological well-being of a patient. A survey in Freiburg has shown that the quality of a hospital’s catering services has become an important criteria for judging the hospital’s medical care: if a patient is being taken care of in regards to nutrition, the doctor’s medical competencies are rated higher.

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