The Tray Matters

Elevating tray presentation helps make food more appealing to patients.

A sample tray from University Hospital.

In 1998, Jackson County Memorial Hospital in Altus, Okla., received an overall meal service score of just 38% in its Press Ganey survey. By 2003, that number had soared to 93%. Key to the positive reviews—although not the only reason—was improvements made to patients’ tray, says Danielle Jensen, R.D., director of food and nutrition.

“People eat with their eyes first,” says Jensen. “You don’t want to overwhelm them with portions; you don’t want to overcrowd the plate. Patients can lose their appetite quickly if there is too much food and they grew up having to clean their plate.”

Paying attention to details was just one of the lessons learned from consulting firm Don Miller and Associates, hired to facilitate change in the hospital’s foodservice program.

Presentation is very well planned at Jackson County. Not only are the plate cover, plate bottom, mugs and bowls color coordinated, but the tray and tray liner also match. And because color is a critical element, explains Jensen, staff members avoid having one-color meals. If the meal contains corn and peaches, for example, cranberry salad is added to brighten the plate. Edible garnishes like fresh chopped parsley or ground paprika sprinkled on menu items are also used. Also, staff make sure the plates look clean and neat and not thrown together.

Seeing the tray from the patient’s point of view is key, notes Jensen.

“In addition, we make sure we serve what we say we’re going to serve,” Jensen says. “If we are serving oven-browned potatoes, then the potatoes are browned. Grilled chicken has grill marks.”

Item placement also makes a difference. Since most people are right-handed, the mug is placed on the lower right side of the tray with the handle at 4:30 (imagine a clockface.) Silverware—not disposables unless requested by patients—goes toward the bottom right for easy reach. “You want everything there for the patients so they don’t have to hunt for things,” says Jensen. The condiments are placed in a small container so they’re not scattered all over the tray.

“It looks so much nicer,” notes Jensen.

To train employees to do things consistently, photographs of trays showing proper food and servingware placement are used. “A picture shows details that you may not normally catch when you are in a hurry to serve the customer great hot food,” says Jensen.

Garnishes and presentation: At Memorial Sloan-Kettering Cancer Center in New York City, which has always enjoyed high customer satisfaction ratings—it ranked in the 99th percentile for overall food quality in the second quarter of 2012—making meal trays look appealing is another way of encouraging patients to eat better.

“Patients already have existing barriers and poor appetites and are not excited about food to begin with,” says Veronica McLymont, R.D., director of food and nutrition services. “Imagine if the tray does not look appealing. An attractive tray, one that’s put together well, will encourage them to eat, or try to eat, even before they taste the food.”

MSKCC uses a larger than typical tray, that McLymont says “is a crisp, beautiful black.” A customized liner with a muted design of fruit and leaves adorns every tray, with coordinating napkins. Meals are served on white china with actual flatware; the only plastic is for patients in isolation.

Eye appeal is furthered with a food and nutrition department-branded logo that appears on the menu, napkins and all printed materials. The logo’s design is a soup ladle with a heart inside and the tag line, “Care in Food.”

Employees, known as expeditors, are responsible for placement on the tray. They use drawings to guide them where items go, depending upon what patients order.
“Garnishing is very important to us,” says McLymont. Chefs use microgreens, thyme, basil, strawberries and lemon wedges to coordinate with meals.

McLymont is particularly proud of the presentation of puréed food for patients with swallowing issues, such as those with head or neck cancers. “They usually have a runny diet that’s very unappealing and doesn’t taste good,” she says.

Now, whatever a patient orders can be puréed. For breakfast there is French toast custard that’s shaped and tastes like French toast. For dinner, chicken paté with mashed sweet potato and carrots may be on the menu

“When it’s served, it’s decorated with sauce and a swirl—just like a restaurant,” McLymont says.

Letting the food shine: At the University of Missouri Hospital in Columbia, food reigns supreme. While presentation is important, for Rocky Galloway, a former restaurant owner now turned chef and supervisor of patient foodservices, “it’s more about the food, not the utensils and servingware. We’re bringing restaurant sensibility to hospital cooking.”

Under Galloway’s direction, foodservice is focused on fresh ingredients and housemade menu items, and the tray is a vehicle to showcase these offerings. Visual appeal comes from the food itself. The colors from freshly steamed vegetables make the tray look better, says Galloway. “I like the foods to be vibrant in color. It helps people have more appetite,” he says.

To ensure food is served hot—Galloway’s menu includes fresh salmon, oven fried chicken, Jamaican spiced kebabs with chicken and vegetables and shrimp scampi—an induction-based warming system on the tray carts keeps food at its proper temperature as trays make their way from the kitchen to the patients’ rooms. “We use a monitor to track every tray in the system, so we can control how long it’s been sitting, how long it takes to get to the patient,” explains Galloway. “No hot things are served cold and no cold things get hot.”

Since he started, the hospital has experienced its highest jump in customer satisfaction, moving from 72% to 92% in one year, says Galloway. “Once we started focusing on the food, everything really started to blossom.” 

More From FoodService Director

Industry News & Opinion

Amherst-Pelham Regional School District in Amherst, Mass., is updating its lunch debt policy to no longer single out students, MassLive reports.

Under the new policy, students with lunch debt will be given the same meals as their peers, regardless of how much they owe. School officials will also be communicating directly with parents of students who have accumulated debt instead of through the students themselves.

The updated policy comes just before U.S. school districts will be required to publicly list their lunch debt policies, per new USDA requirements starting July 1...

Menu Development
eureka

Since California’s state motto is “Eureka!” it seems fitting that a recent conversation with the director of hospitality at San Diego’s Palomar Health led to the biggest aha moment I’ve had in a long time.

I called Jim Metzger in late April with the purpose of discussing Palomar’s recent commitment to the goal of making 60% of its total menu plant-based by this summer. It seemed a lofty number, and I was curious how the public health system planned to get there.

But my personal eureka didn’t come while we were talking about how Palomar had cleaned up the impulse-buy zones...

Industry News & Opinion

Labeling foods with indulgent buzzwords such as “sweet sizzlin’” and “crispy” can lead consumers to make healthier food choices , according to a recent study out of Stanford University .

In the fall 2016 study, researchers labeled vegetables in one of the school’s dining halls using terms from four categories: basic, healthy restrictive, healthy positive or indulgent.

The green beans, for example, were listed as “green beans” for basic, “light ‘n’ low-carb green beans and shallots” for healthy restrictive, “healthy energy boosting green beans and shallots” for healthy...

Ideas and Innovation
sparkling water

Our carbonated soft drink sales at Earls.67 reflect a national trend; we’re continually down on carbonated soft drink sales by 8% to 9% on an annual basis,” says Cameron Bogue, beverage director at the contemporary-casual chain Earls Kitchen + Bar.

The issue with spa water

Many operators are intrigued with the offering, but they are learning that infused water can’t be offered at a cost to guests unless there is added value beyond cut-up fruit. Bogue says, “I was adamant that I didn’t want to charge for spa water.”

Agua fresca alternatives

At the original location of

...

FSD Resources