There’s a lot more to feeding people in a hospital than meets the eye – or stomach.
Meeting the requirements and catering to the desires of the myriad of different types of people admitted to or working at the average hospital takes far more than simply slapping food on a bunch of trays and delivering them to rooms or sliding them across a counter. Issues such as dietary needs and allergic conditions can’t be ignored, and good old varying taste inevitably comes into play when so many people are involved.
Taking on this big and complicated task on a local level are the workers in the dietary department at Texas County Memorial Hospital (TCMH). Heading up the department for the better part of the past five years has been Jeff Ijames, a long-time Houston resident who now resides in Mountain Grove. Ijames’ job includes everything from ordering truckloads of food and implementing daily menus, to coordinating with his crew the production and distribution of food within the hospital.
“Most people have no idea of all that goes into doing this,” Ijames said. “There are a lot of people and a lot of work involved in providing proper, nutritious food that also tastes really good.”
Prior to his certification as a hospital dietary director, Ijames’ background in the food industry included 17 years of experience in the restaurant field. With help from assistant supervisor Marlene Collins and dietician Jason Edwards, he oversees the work of 20 employees in TCMH’s dietary department.
Ijames said the group produces an average of about 75 patient meals a day, but also feeds hospital staff at a rate of 100 or more meals a day, and operates the hospital’s cafeteria (which is open to the public). But providing proper sustenance to patients is, of course, one of the main focuses of any hospital dietary department. An integral part of that aspect of the operation is Edwards, a Salem resident who also holds the same position at Salem Memorial District Hospital.
He said feeding patients is by no means done at random, but is instead carried out with specific goals in mind.
“Ultimately, physicians describe the diet patients need to be on,” Edwards said. “It’s our job to see that all of their nutritional needs are met within those parameters. That’s where we all work together to assure patients are getting the necessary protein, carbohydrates, calories, vitamins, minerals and everything else they need to heal.
“This is a very important part of the healing process.”
When patients are discharged from TCMH, they typically leave equipped with the necessary knowledge to continue eating in a way that’s in their best interest, and helps them stay on the healing path.
“If there’s any need for instruction, or someone doesn’t understand something, that’s where I come in an offer education on how to eat a certain way, how to prepare food at home, and even how to shop for food,” Edwards said. “Sometimes a patient has had a past history of eating well and may not need any education, but if they’re concerned about something, I’ll step in and say ‘this is what you want to accomplish and this is how you do it.’”
A challenge sometimes faced by Ijames, Edwards, and their cohorts is feeding a patient who literally can’t eat, due to injury that prevents chewing or swallowing, or some other condition that negatively affects normal food intake.
“Sometimes we might have to go to a puree, or even just liquids,” Edwards said. “The question then is, how can we get enough nutrition into them? Our job is to get them the food they can eat, and make sure it’s nutritionally adequate to keep their weight and strength up, and ultimately help heal them.”
Edwards has been dietician at Salem for more than nine years, and began similar duties with TCMH last December. He works in Houston on Tuesdays and Thursdays, and in Salem on Mondays, Wednesdays and Fridays.
After TCMH’s previous dietician left to take another position, Edwards’ dual role was adopted by administrators at the two facilities with the idea that each one’s dietary department could benefit through knowledge gained from the other.
“They got to talking about doing some networking,” Edwards said. “Hospitals working together is kind of an up-and-coming thing, and this was one way to give it a shot. It’s working well for me, and you get a good idea of what might work at one place that’s already happening at the other, and vice versa.
“I’ve already taken things to administrators at both hospitals that I saw going on at the other.”
“It’s been great learning what another hospital is doing,” Ijames said. “It’s allowing us to get insight from them that we might otherwise never get.”
Both Ijames and Edwards rely heavily on diet aides, who often man the front lines, so to speak, and deal directly with patients.
“Communication is a big thing to this department,” Edwards said. “I’m not here all the time where I can be able to communicate with patients, so that’s where the value of the aides really comes in.”
Ijames said the way those aides execute their jobs is one of the primary reasons the TCMH dietary department has recently been ranked high among similar departments nationwide. According to data compiled by Press Gainey, the leader among patient satisfaction survey groups, TCMH’s dietary department ranked in the 96th percentile and above in four categories in a national survey taken early in 2012, and in the 89th percentile in another.
“I think the biggest thing is that the people who work here really care about what they’re doing,” Ijames said. “They really care about the people they’re serving, and that comes out when they cook the meals, deliver the meals, and when they assist patients. Everybody likes it when they can tell someone genuinely cares about them, and that shows up in our scores.
“And those rankings come from among a lot of different hospitals, so that really means something.”
“This comparison is with the thousands of other hospitals Press Gainey gets data from,” TCMH Chief Executive Officer Wes Murray said. “Obviously, to be in the 80th percentile or above is fabulous, but to be in the 90th or above speaks even louder to what our dietary department does for our patients.”
Murray said dietary was TCMH’s department of the year for 2012, based on information gathered from patient exit surveys done by an outside vendor.
“I’m very proud of our dietary department, because there are nutrition standards and dietetics that come into play, and they do a great job of analyzing that and providing nutritious and tasty food for our patients and staff,” Murray said. “Our dietary department always ranks high, and always receives high marks, not only from the food being good, but also the way they interact with patients, from their smiling faces to their willingness to work with patients regarding their diet.”
The bottom line is, there’s more than one way to feed people who are within the walls of a hospital, and doing it right takes a coordinated, cohesive, and deliberate effort.
“It takes a whole lot of people working together to get this done on a daily basis,” Ijames said.
“A lot of people don’t see behind the lines, they just see a meal coming out,” Edwards said. “But it’s a complex process with a lot of time and employees involved.
“The bottom line is, patients are here because they have an illness, and everyone’s job at the hospital is to make them better. That’s the way we approach preparing their food.”
TCMH results in early 2012 Press Gainey survey ranking thousands of U.S. hospital dietary departments
(Category – percentile rank)
Quality of food – 98th
Overall meals – 96th
Temperature of food – 96th
Courtesy of person serving food – 89th