Recipe for Success

Nutrition Staff Cooks Healthy Meals for Hundreds

It’s 5:30 a.m., and the sun is barely up, but Nutrition Services employees are already clocking in. Their day’s hectic but choreographed pace gets under way as soon as a truck, loaded with meats, breads and non-perishables, arrives at the loading dock behind NorthBay Medical Center. Another truck, loaded with fresh fruits and vegetables, arrives a few minutes later. Time is of the essence here, as hundreds of patients, guests and employees are looking forward to their breakfast.

While mornings may be busy, the pace never really slows until the last Nutrition Services employee clocks out at 9 p.m., says Kathleen Shafer, director of Nutrition Services for NorthBay Healthcare.

On an average day, staff can expect to prepare more than 460 trays for patients at both NorthBay Medical Center and NorthBay VacaValley Hospital, as well as more than 650 meals between the two cafés, and almost 100 special snacks and nourishments. In a week’s time, they’ll make more than 160 gallons of soup, prepare 205 pounds of chicken, 235 pounds of beef, 120 pounds of fish and 568 pounds of fresh produce.

On an average day, staff can prepare more than 460 trays for patients, as well as more than 650 meals between the two cafés, and almost 100 special snacks and nourishments.

On this day, however, work begins with an inventory of the deliveries, and then employees start preparing breakfast: whisking eggs and pancake batter, browning sausage and hash browns, and dicing fruit for the day’s breakfast. Two cooks are busily stirring up food for patient trays and the cafés. Staff has to move fast, because breakfast needs to be ready for plating on patient trays by 7 a.m., Kathleen says.

The plating process is like a choreographed dance, with trays filled assembly line-style. Atop each tray is a menu the patient filled out the day before. A Nutrition Services employee has already doubled-checked it to assure the foods selected mesh with the patient’s diet restrictions and doctor’s orders, Kathleen explains. As the tray slides down the line, employees add what the patient has requested, before moving it along to the next station: eggs, oatmeal, sausage or bacon there, hash browns there, toast, no toast. Juice, check. Coffee, check.

Because the kitchen at NorthBay VacaValley hospital is too small for large-scale food preparation, meals for patients must be made at NorthBay Medical Center. Patient trays are then transported to Vacaville by a delivery truck in insulated carts. When the carts arrive in Vaca-ville, they are placed in a special “retherm” unit that uses advanced convection technology to boost heat, or in some cases chill, the trays before they are delivered to patients.

All eyes are on the clock, because at 7:30 a.m. the truck leaves for Vacaville, the café in Fairfield opens, and the first groups of patient trays start to make their way around the Fairfield hospital.

The coordinated chaos in the kitchen continues all day long, Kathleen says. After breakfast, preparations begin almost immediately for the lunch and dinner menus. Employees chop vegetables for the fresh soup of the day, make salads and desserts, and bake and braise chicken and beef—perhaps for tacos at lunch or pork tenderloin for dinner. Patients can expect to start seeing lunch trays around noon and dinner service is started at 4:30 p.m.

Overseeing the menus are two highly trained chefs: Kerry Harris, manager of Nutrition Services for NorthBay VacaValley Hospital, who got his stripes serving soldiers in the U.S. Army, and Miguel Reyna, manager of Nutrition Services for NorthBay Medical Center, who obtained his executive chef degree from the San Francisco California Culinary Academy.

They create menus based on recommendations from the American Academy of Nutrition and Dietetics, using recipes for low salt-, carbohydrate-controlled, heart-healthy, diabetic or renal diets.

“We also accommodate patients’ religious or cultural restrictions. Sometimes, depending on the level of ‘strictness’ the patient follows, if we can’t prepare it, we will purchase it,” Kathleen notes. “Special requests from patients or physicians are not a problem.”

Even though the cafés closed at 8 p.m., staff still has lots of work to do.

“Evenings are a busy time,” Kathleen says. “We’re doing a lot of clean up, sanitizing, preparing a few meals for patients who may be admitted afterhours, and readying the kitchen for the next days’ meals.”

Making the Menu Fit Patient Needs

Every patient admitted to either NorthBay Medical Center or NorthBay VacaValley Hospital receives a nutritional screening as part of the Adult Admission Record, according to Kathleen Shafer, director of Nutrition Services.

Nurses ask their new patients several key questions—such as their height, weight, if they’ve experienced any unusual recent weight gain or loss, if they have difficulty swallowing, have recently been diagnosed with diabetes or are on chemotherapy.

The information is entered into the patient’s record, and when the registered dietitian reviews it the patient is assigned a “nutrition risk level.” Higher ratings are given for specific medical and physical criteria, such as with a non-healing wound, a brand-new diabetes diagnosis or chemotherapy regimen, or altered (tube) feeding.

Registered dietitians are also available to consult with patients who have questions, want more information about their diet or need specific nutrition education.

“Nutrition Services and our registered dietitians work very closely with the healthcare team to provide care that will help our patients to heal,” Kathleen notes.

“Our goal is to help our patients feel better, become stronger or healthier, and to return to their normal lives,” she says. “Sometimes that includes nutrition education that will help them get ready for a cardiac rehabilitation program, or whatever the case may be.”

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