Is Hospital Grub in Israel Getting a Little Less Grubby?

Sight of mush and pale chicken may be thing of the past, after 'hotel standards' are introduced.

Dan Even
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The familiar sight of mush and pale chicken on an orange plastic tray are slowly disappearing from the wards of Israel's hospitals, replaced by more palatable options.

In recent months, a new movement has taken shape to improve the food patients will get, bringing them home-style meals, complete with real china and new means of keeping the food warm or cold until it reaches their beds.

Last month a new forum was set up that brings together all the heads of the food service systems in the hospitals in an attempt to get rid of the stigma attached to hospital food. Some 50 general, psychiatric and geriatric hospitals and nursing homes have joined the online forum. In February, they plan to get to know each other at their first conference.

"Today we are introducing hotel standards to the hospitals, and we take an interest in the welfare of the patients and in improving the service as if it were a hotel," says Eyal Almog, a former hotel chef who heads the food division at Western Galilee Hospital in Nahariya. "Seven years ago, we introduced an afternoon menu for the patients, and they can choose their main course and a side dish."

The director of the hospital, Dr. Massad Barhoum, adds: "We have been getting positive responses about the system, and we have proven that hospital food does not have to be worse than a home-cooked meal."

Almog says the aim of the forum is to exchange strategies and thoughts.

"For example, in anticipation of Passover, we can help one another on how to clean the kitchens. After all, we are the biggest institutional kitchens in the country which produce thousands of meals in tandem. We can give each other tips how to operate a special kitchen, for example what machine to use to prepare hundreds of helpings of mashed potatoes," he says.

One of the instruments recently introduced in the hospitals is the blast chiller, which cools food taken from the oven to four degrees celsius to keep it fresh for up to five days. In some of the hospitals, there are now ovens next to patients' beds to warm up food.

The new system, known as "cook and cool," replaces that of the traditional "cook and serve" and already has admirers among forum members. The food is also looking better.

"We decided to change the china from plastic to porcelain and to put emphasis on foods with different colors and different tastes to create diversity," says Almog. "The idea is to take simple ingredients like turkey, chicken and beef and to make delicacies out of them."

Sometimes challenges face them because of paients' medical conditions.

"It is necessary to reduce the amount of salt that penetrates the meat during the kashrut process so that it is suitable for patients with high blood pressure," he explains.

Batya Brenman, head of food service at Rambam Medical Center in Haifa, is convinced there is room for gourmet food in the land of IVs and ICUs.

"They say that breakfast is one of the most important meals of the day so we have upgraded it for all the patients. We serve them omlettes, bread, cheeses and corn flakes every day. When the patient begins his day with a hearty breakfast, it has an effect all day long," she says.

Improving hospital food is also a challenge from the medical point of view. A study carried out in recent years at Beilinson Medical Center and Rambam - part of a European study that has been carried out continuously for four years in medical centers in 32 countries - found that in Israel only 20 percent of patients ate everything on their plates.

The remainder are in danger of developing malnutrition that increases their chances of dying. Data collected in internal medicine wards show that only 35 percent of the patients on average ate all the food items they were given. One quarter touched only half the items at every meal and the remaining fifth ate only one quarter of the food, or didn't eat them at all.

A similar picture emerged from the surgical wards. Cancer patients were at the greatest risk of developing malnutrition. Only 10 percent of them ate all the food they were given and more than half did not touch half the food on the tray.

Data collected this year show that the situation has not improved. Studies from 15 internal, surgical and oncological wards showed that 80 percent of the patients ate less than half the food on their trays and died more frequently during their hospitalization.

"We have a problem with the image of the food in the eyes of the patients, the families and the medical staff," says Dr. Irit Hermesh, a senior physician in the gastroenterological department at Rambam and chairwoman of the Israel Society for Clinical Nutrition. "To eat a meal in the hospital is no less important than to get a dose of antibiotics."