Going backwards — Fresh food preparation may be lost in Scarborough-Rouge merger

The Scarborough Hospital has been an innovator in food services at its main campus. Last year it garnered considerable media attention by bringing in a consulting chef to work with the hospital in developing a menu that would feature locally grown foods that are prepared from scratch in their kitchens.

Toronto Chef Joshna Maharaji told the Toronto Star last year “now their humanity is required when they work. Now they have to smell and taste and make judgments instead of just executing a very standardized plan. That’s real evidence of change.”

Now that change may be under threat as The Scarborough Hospital looks to standardize food services with its potential merger partner, the Rouge Valley Health System.

Instead of going to the innovative service Scarborough began, merger talks appear to be leaning towards the less-than-optimal rethermalized food service at Rouge.

This is the kind of system that hospitals across North America are moving away from – rethermalized food service in which the meals are prepared off-site and delivered to the hospital. Cooked, reheated, chilled, and reheated, the process also strips many of the nutrients out of the food. It sends a bad message to patients about the kind of food they should be eating when they return home. The system is also far less flexible, potentially undoing Scarborough’s goal of giving patients greater choice closer to meal times.

Anne Marie Males, Scarborough’s former VP of Patient Experience, told the media last year that she was so excited by the fresh food service that she thought she might seriously cry. She explained to the Star “Why do we feed sick people food you wouldn’t serve at home? When we have sick people we should be giving them really good food.”

Moving towards rethermalized food makes it more difficult to implement a local foods initiative, something the Ontario government has been pushing in recent years. The Scarborough Hospital has been also working towards better meeting the needs of a diverse patient population. They are seeking certification or the equivalent from the Halal Monitoring Association and are working with a local mosque. If the final decision is to go to “airplane food,” then much of this work may be undone.

In the workbook notes the committee looking into the merger of “hotel services” recognizes the potential for poor publicity and public reaction to the loss of fresh and local cooking for patients.

They also note the waste of dollars invested in upgraded cooking and conventional kitchen equipment at Scarborough.

Their solution is to develop “an effective communications strategy to explain the reasons for choosing to make a change.” The community should see this for what it is – a major step backwards. There are some things you just can’t explain away.

The best practice the two hospitals appear to be concerned with is the bottom line, not the experience for patients. If this is the direction the merger process is headed, then clearly the public should be alarmed.

It is unlikely that the hospital will do a broader analysis, such as the relationship of fresh nutritious food to the healing process and what the impact will be on patient days. For a relatively small difference in food costs, the new merged hospital may actually add to the far more expensive clinical costs it could experience as a result of such short-sighted thinking.

At this point the committee is suggesting that this requires more analysis.

No kidding. The Scarborough Hospital is the best practice when it comes to food services. There is no question that Scarborough has been breaking new ground that is a winner with patients. It is not the only one either: MacKenzie Health (formerly York Central) also moved to fresh food service and improved patient satisfaction scores.

Rouge Valley has also been working on their own quality initiative for food services. Their goal is to get the meals to patients hot.

Clearly the expectations are not quite the same.

—

One final note about the potential merger: Previously we had reported on the remarkably open process the two hospitals were engaged in. Turns out that it is a little less open than we thought. Word has come to us that the 16 community town halls will be by invitation only. There may be a role for an external organization, such as the Ontario Health Coalition, to offer the “uninvited” a forum of their own.