Danville, Penn.-based Geisinger Health System's foodservice department's introduction of Healthy Selections+ (HS+) not only encourages customers to eat healthfully but introduces them to options many have never experienced.

The South of the Border Bowl at Geisinger Health System consists of sauteed onion, black beans and tender farrow tossed with fresh pico de gallo, salsa verde and queso fresco topped with a fried egg. Photography courtesy of Geisinger Health System; photo by Matthew Cervay"We restructured a year ago and hired Executive Chef Matthew Cervay to work with me to rewrite our healthy selections program, then called G [Geisinger] 150, based on 150 ingredients that offer high nutritional profiles and are prepared in healthful ways. HS+, introduced in January 2017, is more about the best foods you can eat," says Mary Ruzzi, RD, LDN, program director, system foodservices.

HS+ focuses on minimally processed nutritional ingredients that contain no added sugar and are free of antibiotics, hormones, artificial preservatives, colors and sweeteners. Entrees contain fewer than 500 calories, and have at least 10 grams of protein and 5 grams of fiber. "So the focus is on nutrient-dense foods, such as whole grains, legumes and fresh fruits and vegetables," Ruzzi says. All HS+ recipes feature at least 3 nutrient-dense foods. For example, the anasazi and garbanzo bean blend salad bar recipe contains tender anasazi and garbanzo beans tossed with pumpkin seeds, lemon and fresh herbs.

Cervay holds monthly meetings with production supervisors and managers to review new recipes and answer questions. Before the rollout, Cervay held monthly on-site training sessions and made training videos to support staff as they learned knife skills and plating techniques.

"To prepare HS+ menu items, we find using combi ovens with steam or combination heat/steam settings is particularly beneficial," Ruzzi says.

Ongoing Effort

All retail cafes in Geisinger's seven acute care hospitals are introducing HS+. "We started with the rollout in January 2017 and introduced 28 salad bar recipes," Ruzzi says. "In February we rolled out soups, in March, grab-and-go, we skipped April, and rolled out breakfast recipes in May. During June, July and August we rolled out new locally sourced vegetable recipes. Matt is working on entrees and sides to roll out later in the year."

"The fresh and local produce isn't pricing higher," Ruzzi says. "Yet when we transitioned to fresh vegetables, we had production challenges to be sure we didn't overproduce. On the other hand, antibiotic-free chicken is more expensive, so we've reduced the portion size from five ounces to four ounces. We've also been systemizing purchasing so we're picking one product in a category to use

for the whole system for cost savings."

Ruzzi works with the corporate communications team to market the new HS+ recipes and concepts. Marketing includes point-of-sale signage and labeling, promotional fliers and internal communications on sites such as the foodservice website. "We've also created life-size Chef Matt signs to direct customers to the new HS+ options," he says.

Ruzzi and Cervay are also rewriting menus to include HS+ in the 2018 patient services menu lineup. Geisinger Medical Center and Bloomsburg feature room service, and two more hospitals are scheduled to go live with room service soon, while the others use bedside ordering on tablets with a traditional trayline.