Historically, hospital foodservice has been very complex. There have been two menus: one for the patients and another for everyone else on campus.

By Joanne Shearer, RD, MS, CDE, LN Food and Nutrition Services Director Avera Heart Hospital of South Dakota This email address is being protected from spambots. You need JavaScript enabled to view it.

With the current emphasis on good nutrition not only for healing but for prevention, it made sense to me that we should put the health back into healthcare foodservice by offering wholesome nutritious foods to everyone. My idea was to serve up a heart-healthy Standard American Diet. In other words, take the "sad" out of the regular house diet.

So when our hospital opened in 2001, we designed a diet that the patients, their family members visiting them, our staff and anyone else dining on our campus could enjoy. While looking at heart protection and installing the good fats, this diet also allowed us to keep red meat as a part of it, which is important to most people who visit our hospital.

Taking this approach affected our equipment selection and the way our cooks approach preparing food. For example, we use a convection oven that allows our culinary staff to produce wonderfully flavored products that are lower in fat. Not including items such as a fryer in our equipment package meant that we had to train individual cooks about batch cooking and how to time everything because oven-baked menu items will not hold as well as deep fried food.

In an effort to help provide a better quality experience for our patients, we went with a spoken menu. Under this program, foodservice ambassadors visit each patient and take their order for the next meal period. Patients like the person to person contact and I believe this has increased their nutritional intake because our ambassadors can use their experience to help provide a meal that meets the individuals' needs. And because the patient gets what they want, this approach has reduced plate waste by 30 percent.

While our menu works well, our foodservice team continues to look for ways to improve. For example, to me it seemed like we were generating a lot of waste for a smaller facility. And being raised on a family farm where my mom was in to recycling long before it became as fashionable as it is today, it was built into me not to be wasteful.

So I began researching ways to reduce the amount of polystyrene cups our facility uses by half. In doing so, I consulted Healthcare Without Harm, an organization that provides online resources for foodservice operators serving this segment, that helped shape my efforts. From an environmental perspective, my research showed that switching to reusable cups was the preferred way to go, but our facility did not have enough warewashing capacity and storage space to accommodate this. Biodegradable cups were the next best option, but I soon learned we did not have a way to compost these items, which meant they would end up in the trash anyway — thus defeating the purpose of this exercise.

We finally decided to begin selling double-walled plastic mugs in our cafeteria. Employees purchase the mug and receive a discount on soft drink purchases. They are responsible for washing their mugs and bringing them back to cafeteria. After educating our foodservice staff and employees, this effort did, in fact, help us reduce consumption of polystyrene cups by 50 percent. While these efforts have generated an annual savings of more than $1,700, more importantly, they have positioned the hospital as environmentally friendly.

By taking the variation out of the system and reducing the overall complexity, we have been able to increase quality and reduce costs.