Today's menus reflect varied diets, demand for more options

Host Amber Smith: Upstate Medical University in Syracuse, New York, invites you to be The Informed Patient, with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith.

Today I'm talking about food, specifically hospital food, with two of the people who oversee the food operation at Upstate Medical University. Daniel Ellithorpe is the senior director of food services, and Eric Adams is the system director of food service and hospitality. Welcome to "The Informed Patient," both of you.

Eric Adams: Morning, Amber. Thanks for having us.

Daniel Ellithorpe: Thank you.

Host Amber Smith: I want to give listeners an idea about the scale of the food operation at Upstate. About how many people do you feed per day?

Daniel Ellithorpe: So, in our patient services format, we serve about anywhere, on average, from 325 to 350 patients per meal.

So, about 1,050 people per day, just in the patient meal side.

Host Amber Smith: So, that's just patients, but you may also have visitors, and then employees, right?

Daniel Ellithorpe: Correct.

So, during our retail operations, on average, of Monday through Friday, I mean, we'll have about anywhere from 1,600 people go through the register.

It's just how many rings (of the cash registers) are actually put through. So they can be buying anywhere from a soda to a muffin to a full-course meal.

Host Amber Smith: It sounds like you're busy from before sunup probably until after sundown.

Daniel Ellithorpe: Correct.

Yeah, and on the weekends our private transactions are about half of that, on a Saturday and a Sunday.

Host Amber Smith: So, how early does your breakfast shift arrive to start preparing the food for the day?

Daniel Ellithorpe: So, our cooks come in at 4:30 in the morning. Our patient services breakfast meal begins service at 7 o'clock in the morning, and our retail cafe operations begin at 6 in the morning.

Host Amber Smith: So you probably at 4:30 start making breakfast foods and things like that, but you probably also start with lunch and afternoon meals, too, right?

Daniel Ellithorpe: That doesn't usually start till around 7, 7:30 for lunch. Then, like, our dinner meals will start around 10:30, 11 o'clock.

Host Amber Smith: Can you walk us through how hospitalized patients get their meals these days?

Daniel Ellithorpe: Well, from start to finish, I can kind of run through that.

We have what we call a patient dining associate, and they are assigned to certain floors. And when they go up to the floors, or to the units, they visit the patient in the room, and we'll take their menu. We do have a standardized menu that we use, but it features chef's specials for each day for each meal.

So they'll kind of walk the patient through what our options are and what we have, and they'll take the order. And then from that point, the order is put into our meal ordering system. And when it's actually time to prepare the meals or the trays, they print off the tickets for that unit that they're assigned to.

And then they'll start producing the trays. They put everything on the tray, from the hot food or cold entree, whichever ones they decide, to their silverware, their drinks, any side of fruit or dessert that they have. Once all those trays are completed for that whole unit or floor, they bring the cart. They put, first of all, put all that in the cart, and they bring it upstairs, and then they pass it out to every patient that they've taken their order for. About an hour after that, they'll go through and pick up all the dirty trays after, and then it kind of runs into that cycle again for the next meal.

Host Amber Smith: So, what happens to people who maybe are in the emergency room waiting for a bed to become available? Do they get a meal service in the emergency room?

Daniel Ellithorpe: They do. There's two different options there. I mean, we do supply what we call, like, a house tray. So, our house trays typically are chef's specials for that day because we don't have anybody that can actually get down there and take those orders. So we do supply meals for those folks while they're there, during the mealtime. And if they happen to come in after operations for us have closed, like, 11 (p.m.) to 7 in the morning, there is what we call a box lunch down there that has, like, a turkey sandwich and pretzels and a beverage and a cookie for them to have until they either get moved to a floor or a hot meal for the next meal.

Host Amber Smith: How often is it that you need to accommodate a special diet for someone, who may have to eat a special diet when they're in the hospital, pureed food or low sodium, things that are medically required?

Daniel Ellithorpe: A lot. That's a big part of the patient meal services because there are many people that come in with different diets and different consistencies of food that they need to have.

When we design our menu that has our chef's specials on it, it is meant to hit a lot of different diets, whether it's low fat, low sodium, low cholesterol. Those are all kind of built in when we create those menu items. And I want to say currently there are, like, 20 different diets that we have here, whether it be low fat, low salt, low cholesterol, you got the diabetic diets, and there's probably three or four different tiers within those. Now you have the gluten-free diets, you have vegan and stuff of that nature, so it's pretty vast.

Host Amber Smith: This is Upstate's "The Informed Patient" podcast. I'm your host, Amber Smith.

I'm talking to Eric Adams and Daniel Ellithorpe, who are both involved in the food operations at Upstate Medical University.

Well, Mr. Ellithorpe, both you and Mr. Adams have experience in the food industry and in health care. So I wanted to ask you what trends you've seen over the years in terms of what things have changed in the industry.

Mr. Adams?

Eric Adams: Sure. I've been doing this for the last 13 or 14 years, and man, there has definitely been a lot of changes. I think as far as patient services go, room service has been the biggest thing for patients, kind of like when you're in a hotel, you're hungry, you look at the menu, and you order what you want. But obviously, within the hospital, if you do have a certain diet that you need to adhere to, that is followed as well.

It's something that we're working on to do here. We'd like to do that here at the hospital, at Upstate, as well as at Community (both Upstate University and Upstate Community hospitals), because it is a huge patient satisfier. So I think that is a trend that hospitals are trying to get to. I think that just stuff like Dan's talking about. Gluten-free and vegan have become very popular. We just started selling a lot of vegan sandwiches and other types of meals in the cafeteria, and it's going like crazy. So, just the different types of diets, I think, are just progressing.

Host Amber Smith: I was going to ask if there's a particular food that is popular these days that you're getting requests for, but vegan apparently is popular, right?

Eric Adams: It is.

Daniel Ellithorpe: Yeah, I'd have to say a lot of people just didn't know that they had like a gluten allergy before, but that seems to be a pretty predominant ask, or a diet, that people need nowadays. In addition to what Eric was saying, whole grains are kind of a big part of people's mindset and what they want to eat now too.

Host Amber Smith: For people that don't see something that they like in the cafeteria, do you see a lot of food deliveries from restaurants coming to the hospital?

Or is that even allowed?

Eric Adams: I can take that one. I think that every single person, you know, us on this call, everybody -- everybody eats a little different. We have, I think we have, a ton of options in the cafeteria. I think that if you ate at the same restaurant every single day, you'd want to eat somewhere else every once in a while, too.

So, I do think there's some ordering. They have the DoorDash (food delivery service) and all those fun things now, so I think there is some of that. I don't think, I KNOW, there's some of that. And then we also have done a good job partnering with a lot of food trucks, so between this (downtown) campus and Community campus, almost Monday through Friday, we have a food truck at the campus that just gives not only families, but staff, just another option.

What I've learned over the years is: People want options. They don't want to be either told what to eat or have only one option to eat; they want to have options. So we really try to do a good job of providing as many options as possible.

Host Amber Smith: Each hospital has a main cafeteria, right?

Eric Adams: Yup.

Host Amber Smith: Each campus, and then you also have some grab-and-go stations, is that right? Mostly for, I guess, visitors and employees and students?

Eric Adams: We have a small, what we call, like, a mini-mart, where people can come, and it's kind of supervised by video. There's nobody physically there. So they can come at any time of the day and grab stuff.

We do have tons of vending throughout the hospital. We're working with another vending company to try to provide some even healthier options. One's called Farmer's Fridge, and actually, daily, they load it with fresh salads, so salads and fruit. So we're trying to partner with them.

There's just all those options, and this campus also has a lot of retail locations that we're also trying to fill. We're starting to partner with some new vendors to get some more of the retail locations that were open before COVID. You know, the food industry took a big hit during COVID. So we're trying to get those open as well.

We were able to open a location over at 550 Harrison (an Upstate facility a few blocks from the main hospital) with Hope Café, and that seems to have been a great partnership so far.

Host Amber Smith: Well, let's get back to the daily cafeteria menu. When you set about to create the menu, what sorts of things do you take into consideration? Mr. Ellithorpe?

Daniel Ellithorpe: We are actually what we call a WellPower platform (a system stressing healthy eating) for our cafeteria, so we have certain criteria for our entrees and our sides so that you have what they call "fit criteria," which is the lower fat, the lower salt content. There's more whole grains used, kind of staying away from beef and doing more chicken and fish.

As of now, pretty much all our coolers, our set for our bottled beverages, is 80% healthy beverages and 20% are sugar. We're kind of trying to not really push people that way, but, if we make it predominant, in front, and I like to call, like, "stealth health," where you're just kind of presenting foods that just look appealing and taste good. And people don't know that they have a better health benefit for them, but I think it's going a long way. So there are certain criteria when we plan our menus that we look at.

Host Amber Smith: Do you have a really popular item that when you have it on the menu, it sells out really quick?

Daniel Ellithorpe: Out of all the stations, consistently, our salad bar is the busiest station on a day in, day out, out of any item that we sell. Monday through Friday, we do have what we call an "entree reimagined" station, where it's kind of like a "build your own," and it varies from different types of concepts. One day it'll be a Latin theme, next time it'll be a Mediterranean, next time it'll be, like, Indian cuisine, it'll be like a loaded-type baked potato. But people are kind of able to go in there and create their own, like, meal, for the most part. There's bases and toppings and proteins and stuff that you can put on there to customize it, to make it your own.

Host Amber Smith: Well, since your career is sort of devoted to cooking for people who are ill or recovering from injury, is there any advice you can offer for people who are at home taking care of someone who's under the weather or recovering? Are there certain foods that are good for that? Or certain foods maybe to stay away from?

Daniel Ellithorpe: Well, definitely keep on your water and your fluids, staying away from sugary beverages.

Meals high in protein do have great healing values to them, as opposed to deep-fried chicken fingers, stuff like that. I'd say, definitely, home-cooked meals, roasted meats, steamed vegetables, stuff of that nature, are definitely better for you, and they're going to help with the healing process.

Host Amber Smith: Let me ask each of you to share your favorite meal and your favorite healthy snack. Mr. Ellithorpe, do you want to go first?

Daniel Ellithorpe: Oh, jeez. Favorite meal? I like to eat a lot. Culinary is my background. So, I mean, I can't say I have like one favorite meal. Healthy snack? I love hummus. I'll dip anything in hummus and make a good snack of it.

But yeah, I just like too much. If I had a preference over fish, it'd be sea bass. At a preference over, like, chicken, it would probably be like a quarter chicken or something like that. So it all depends on the situation and stuff I'm in.

Host Amber Smith: Mr. Adams?

Eric Adams: For me. I'm definitely a chicken guy. I try to get as many different recipes for chicken as possible, so I do that, but I also love hibachi. I don't know what it is about getting good food from a hibachi, but I love that with some sushi.

Snacks? I, unfortunately, am a chip guy, so I really have to be careful with myself. I love me a good crunch, but the boring side is I definitely drink a lot of protein shakes, so, got to get your protein intake.

Host Amber Smith: Do you have any predictions for how food service in the hospital is liable to change in the coming years? Are there trends that you see?

Daniel Ellithorpe: Well, we started using robots actually to deliver food. I mean, there's been a few bumps in the road, but I think there'll be more of that, that will happen. I think it'll be more, like, I know some places are starting with the patient ordering their meals by themself through an app, so they can kind of see what their options are and then order it that way. Then it's just delivered.

More whole grains, definitely. Besides that, I mean, I think it'll be a little bit of a change. Eric did mention before, room service, that's probably still going to be at the top of everybody's mind as time progresses.

Eric Adams: To add to that, I also think one thing that hospitals have done over the last few years is really recruit chefs. There's always been a stigma over hospital food, just going to plop some stuff on a tray, and it's no good. But over the last few years, chefs have become really predominant in health care and have done a great job helping design and improve the food for the patients, because let's face it, when the patients are here, they don't have a lot of choices. And, we want to try to provide a good meal for them then, so at least maybe they have something to enjoy for the day.

And I think our chefs are doing a great job with that.

Host Amber Smith: Well, I appreciate both of you making time for this interview. Thank you.

Daniel Ellithorpe: Yep, no problem.

Eric Adams: Thanks for having us.

Host Amber Smith: My guests have been Eric Adams and Daniel Ellithorpe. Mr. Adams is the system director of food service and hospitality at Upstate, and Mr. Ellithorpe is the senior director of food services at Upstate. "The Informed Patient" is a podcast covering health, science and medicine, brought to you by Upstate Medical University in Syracuse, New York, and produced by Jim Howe.

Find our archive of previous episodes at glenviewelectric.com/informed.

This is your host, Amber Smith, thanking you for listening.