A meal with goals
Recognisability is a key ingredient in a meal at Aarhus University Hospital. “When the patient puts the food in their mouth, it should taste like something they know, maybe from childhood,” says Bente Sloth, Head of Food Services at AUH. She admits that it can be a pragmatic approach that the food must be recognisable, but she finds that it is the good old-fashioned food that patients want to eat. She also says that the food must be healthy: “Not healthy in the traditional sense, but it must be full of protein and energy and fat, because you get well faster that way. We don’t serve fine, elegant and fancy dishes that you’ve never encountered before.” But other slightly more pragmatic considerations also effect the meal served to patients at AUH.
THE LAST 30 CENTIMETRES
A good meal with Bente at the helm is based on more than just tastiness. Some things are a little more important than others in the system. “We have to deliver 9 #megajoules, in other words, 9,000 kilojoules per patient per day and we have an economic framework for that. It’s actually the number one success criteria we have. With us 9 megajoules in ingredients costs between 4-6 Euro per day. That’s not a lot of money we have for six meals,” she explains about one of the requirements she and her staff have in making a good meal. However it is still possible to have a mainly organic #kitchen with homemade products in the hospital’s own bakery and butchery, which Bente Sloth is a pioneer of.
”That being said, we’re working with the last 30 centimetres,” she explains about the distance from the plate to the mouth. The last 30 centimetres exists as a theoretical concept that Bente Sloth works with and puts into practice for the catering kitchens and staff on the wards. “It’s the last 30 centimetres that are crucial to whether the food becomes nutrition — what will it take to get the patient to eat the food on the plate?” she asks. She knows just what it takes. Taste, smell and quality, enticement and nutritional care, arrangement and serving are parameters that are part of the centimetre measurement.
“Taste, smell and quality are what we’re all about with the food here. The mainstay of our entire method of production is that we have to have the right ingredients and we don’t use additives. It should taste healthy and natural, so it smells right. It should taste like real food.”
Enticement and nutritional care she explains, such as the grandmother-like approach of getting the food in the patient with a certain amount of care and pampering.
Serving and presentation: “When the patient sees the food on their plate, it should be arranged nicely. At least neat and orderly, as we have some challenges, because we don’t have the dietary professionals to arrange the food in the departments. It’s also about airing out the ward and making sure it’s nice and clean,” says Bente Sloth about the requirements the meal has in her kitchen.
At AUH you are not a guest, but a patient, and the food may be very tasty, but your appetite may be very small. You come here to be healed, not for the food and as part of this, the meal has an important function: “If patients do not get energy or protein, then they can’t heal after a major trauma or surgery. And you have to keep in mind that a lot of patients are affected by their illness with nausea, sadness, depression or chewing and swallowing problems,” says Bente Sloth.
It is in these situations the Grandma method is often put into practice, and in fact, studies have shown that nutritional care can make a difference: “A cancer department has participated in a scientific project, which shows that when you give patients nutritional care, they actually eat 20% more kilojoules,” explains the Head of Food Services, who is in charge of the large-scale production at AUH, where they purchase approximately 700 tonnes of food a year.
The menu is planned by production leaders three weeks in advance and offers seasonal ingredients: “It’s also possible to order vegetarian meals or other dietary food, if you order separately, because we have a fixed-menu plan. But we’re pretty firm about patients having to follow the menu we make,” says Bente Sloth, because large-scale production requires that kind of management. “You could say that we have to make a few dishes here that satisfy a lot of people, and that is in fact the greatest challenge with such a wide target group. By limiting the menus, we deprive the patient of a little bit of freedom of choice,” she says.
However, if you are dying, then it is another matter: “Then we make whatever they request and we make anything from fried liver to soufflés or chocolate mousse for breakfast, lunch and dinner, if that’s what they want,” says Bente Sloth, and that can be done partly because the hospital has its own bakery and butchery, and moreover, there are not a lot of items that aren’t in stock.
Bente also says that food requested from dying patients is actually almost always old-fashioned food.
TAKE-AWAY FROM AUH
In the catering kitchens at AUH qualified staff make food for 3,000 people a day. The contrast from serving at a restaurant could hardly be greater. However there is an overlap. Taste is the focus, as well as fresh ingredients, and the food is made from scratch and the diners are in the spotlight.
“The starting point is in the same food we make. We also make homemade mayonnaises, crispy fried onions and soup stock etc. We make a lot of things ourselves. The big difference is that we can’t pamper a plate the same way that you can at a restaurant. So there are some parameters in the last 30 cm that we have a bit of a hard time living up to. We don’t go out and pick flowers to put on the plate, but my dream is that we can do a lot with the arrangement.”
Another dream that Bente Sloth has that is actually taking shape is the pilot project ‘Food basket - come home safely from the hospital,’ a collaboration with the City of Aarhus. The target group is the infirm, elderly, single, malnourished and severely ill.
“They often come home to an empty fridge and so the risk of being readmitted to the hospital for this group is high. These patients are given a food basket for four days, which is made based of the specific requirements of lots of energy, protein and fat. There are also some protein rich drinks, a small placemat and a small flower. The idea is that it is also important to create a little comfort in the dining situation, as it helps you have the desire to eat,” she says and concludes: “What we’re hoping for with this small pilot project is that we can actually document that food makes a bigger difference than we realise.”
Published by HOUNÖ
Text: Journalist Lousin Hartmann
Photography: Rasmus Bluhme, Moment Studio and Signe Birck
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