By Michael J. Critelli | MakeUsWell Newsletter,
On Tuesday, September 22, I spent several hours in the Emergency Department at Stamford Hospital after my wife fell on a New York City sidewalk. As on previous occasions, the care she received was exceptional. But when I went looking for lunch in the hospital, I encountered a puzzling contradiction: Why is it sometimes so difficult to find convenient, healthy food in a place dedicated to improving people's health?
Let me begin by emphasizing my admiration for Stamford Health. It is one of Connecticut's remaining independent healthcare systems, serving an extraordinarily diverse population. Its staff is consistently polite, professional, compassionate, and deeply committed to its mission.
I have written to its CEO, Kathleen Silard, more than once to commend the care my wife or I have received. When I experienced an episode of dizziness five years ago, I received the same exceptional treatment.
My experience this week reinforced that admiration. The clinical care was excellent. But it also raised questions about an aspect of healthcare that deserves more attention: the food available to employees, patients' families, and other visitors.
When Healthy Food Is Hard to Find
At approximately 2 p.m., 90 minutes after my wife had been admitted to the Emergency Department, I went looking for lunch.
The dining facilities I could locate had stopped serving lunch. The most convenient alternative I found was a Farmer's Fridge vending machine offering a selection of cold foods, including several salads that appeared to be nutritious.
I commend Stamford Health for making these options available. Unfortunately, the experience revealed several shortcomings.
The salad containers did not have labels adjacent to them that made it easy to match the physical products to the descriptions on the ordering screen. The screen provided ingredient information, which was helpful for people with allergies or food sensitivities. But the selection offered limited options for individuals with multiple dietary restrictions.
The utensil dispenser was broken. Nearby beverage machines offered numerous sugary drinks.
None of these problems was particularly serious in isolation. Collectively, however, they demonstrated how difficult it can be to make healthy food genuinely accessible.
Providing nutritious food is only the first step. People also need to identify it, understand its ingredients, find options compatible with their dietary needs, and obtain it conveniently.
That brings me to two larger questions.
1. Why should hospital employees and visitors have difficulty obtaining healthy meals outside conventional dining hours?
2. Why should foods and beverages that healthcare professionals routinely encourage people to limit remain prominent offerings in healthcare facilities?
The Special Responsibility of Healthcare Systems
Hospitals face legitimate challenges in providing food services.
Patients may require medically prescribed diets, fasting before certain procedures, or other restrictions. Hospitals must maintain rigorous food-safety and infection-prevention standards. They must also accommodate diverse nutritional requirements while managing staffing, procurement, and operating costs.
But employees and those accompanying patients for what are often several-hour diagnostic and treatment processes have different needs.
A nurse working a twelve-hour shift should not have to choose between a convenient meal and a nutritious one. A family member spending an unpredictable number of hours in an Emergency Department should have access to healthy food without leaving a loved one unattended.
In my case, I could have left the hospital and gone to a nearby restaurant. But that would have meant being away from my wife for an extended period when she might have needed me to help make a medical decision.
As it turned out, she did not. But there was no way to know that in advance.
Hospitals have a responsibility to consider the needs of these populations, particularly because they often have limited alternatives. This requires healthcare leaders to think about food services differently.
Traditionally, hospital food services have been evaluated partly on their ability to control costs, generate revenue, and contribute to institutional overhead. Those considerations are important, but they should not define the entire value of the operation.
What if hospitals evaluated their food services by how much they contributed to employee health, patient experience, family wellbeing, and the institution's broader mission?
That would change the questions healthcare leaders ask and the solutions they pursue.
Healthy Food Can Be Good Business
Several healthcare systems have already demonstrated that nutritious food and financially sustainable food services are compatible.
One system which owns healthcare systems in both New York and Connecticut, Northwell Health, has undertaken a major transformation of its dining operations under the culinary leadership of Bruno Tison, a Michelin-starred chef.
Its initiatives have included replacing heavily processed prepared foods with freshly prepared meals, eliminating deep-fat fryers, substantially reducing sugary beverages, and creating restaurant-quality dishes using healthier ingredients and cooking techniques.
Northwell has also introduced teaching kitchens that bring chefs and dietitians together to help employees, patients, and visitors develop healthier eating habits.
These initiatives demonstrate that hospital food can be nutritious, appealing, and an important component of the healthcare experience.
The Partnership for a Healthier America's Hospital Healthier Food Initiative provides additional evidence.
The initiative encouraged participating hospitals to improve the nutritional quality of patient meals, cafeteria offerings, vending-machine products, and food marketing.
In reporting results from an earlier phase of the initiative, the Partnership noted that Henry Ford Health System experienced increases in cafeteria sales ranging from 2% to 10% across its locations after adopting healthier nutrition standards.
That is important because it challenges the assumption that improving nutritional quality necessarily comes at the expense of financial performance.
The opportunity is not simply to replace unhealthy foods with healthier alternatives. It is to rethink the entire food-service experience.
Could hospitals make nutritious meals available throughout the hours when employees and visitors need them? Could they provide better ingredient and allergen information, accommodate more dietary restrictions, and make healthy choices more convenient and affordable?
Could food services become an integral part of an institution's commitment to employee wellbeing?
These are management and leadership questions, not simply cafeteria operating decisions.
Making Healthy Eating Part of the Healthcare Mission
In 1986, after my wife underwent a Cesarean section at New York Hospital, the nursing staff gave us menus from local restaurants that would deliver meals directly to our hospital room.
It was wonderfully convenient and provided an enormous range of choices. Of course, unrestricted restaurant deliveries into patient-care areas could create infection-control and security risks that hospitals must manage carefully today.
But the underlying idea was valuable: make it easy for patients' families to obtain the food they need without leaving their loved ones.
With today's technology, hospital leaders should be able to develop even better solutions, including designated delivery locations, mobile ordering, and convenient access to freshly prepared meals.
The broader opportunity is to recognize that the hospital food environment is part of the healthcare environment.
We typically think of hospitals as places where professionals diagnose diseases, perform procedures, administer medications, and help patients recover.
But hospitals are also workplaces and gathering places for families. The foods and beverages available there influence the everyday choices of thousands of people.
If a healthcare system encourages patients to eat nutritious foods, reduce added sugar, manage chronic conditions, and improve their long-term health, shouldn't it make those choices easier within its own facilities?
A healthcare system that makes healthy food readily available to its employees demonstrates that it values their long-term wellbeing, not merely their ability to deliver care.
A healthcare system that makes nutritious meals conveniently available to families recognizes that supporting loved ones and caregivers is part of supporting patients.
I would never want my experience looking for lunch to overshadow the exceptional medical care my wife received at Stamford Health. On the contrary, I believe the institution's commitment to excellence creates an opportunity to extend that same standard to other aspects of the healthcare experience.
A hospital that delivers exceptional medical care should aspire to deliver an equally exceptional environment for healthy living.
Healthy food should not be a special accommodation or an afterthought. It should be readily available, affordable, appealing, and convenient.
Given what we know about the relationship between nutrition and long-term health, healthcare institutions should be setting the standard for making healthy eating the easy choice.
That commitment should extend all the way to the cafeteria and beyond.