Hospital food: not good, not enough, on plastic

Patients of Polish hospitals are badly fed. Instead of cold cuts, they get luncheon meat, and instead of butter – milk fat. – Once, a catering company served us a hard-boiled blue egg, spinach mash and watery potatoes for dinner. It was impossible to eat it – says a patient from Wrocław.

1. Patients: Hospital food is not good, not enough. Lunches are cold and not everyone can use plastic cutlery
2. Most hospitals order meals from catering companies. NIK investigated that these companies used expired products, did not report allergens, used cheaper substitutes and offered underweight portions
3. Dietitian: In malnourished patients, more complications are observed, which means a longer and therefore more expensive hospital stay. Convalescence takes longer, wounds do not heal, and mortality increases
4. You can find more such stories on the TvoiLokony home page

Meals in hospitals

80-year-old Weronika from Wrocław has been struggling with atrial fibrillation for years, and frequent cardiac arrhythmias forced numerous hospitalizations in cardiology departments. The Wrocław inhabitant has the worst opinion about nutrition in hospitals.

– In March, the doctors put a pacemaker on me and I must admit that if not for my family, I would have been hungry from morning to night. Meal times are absurd: breakfast at 7am, lunch at noon, and dinner at noon. 16. The first meal for sick people is a cold milk soup with overcooked noodles, a little nail-sized amount of butter for two slices of bread, plus three slices of the worst-quality sausage or some luncheon meat. For dinner one time, a catering company served us a hard-boiled blue egg, spinach slush and watery potatoes. It was impossible to eat it – says the woman.

Meals in hospitals worth photographing

Pictures of hospital meals have been circulating for years on social media: unappetizing, even repulsive, with absurdly small portions, often with ingredients that are difficult to identify.

There are many Facebook groups whose members post photos of these culinary creations and ironically describe them as aspiring to Michelin-starred restaurants.

A photo of a dinner for a 28-year-old woman suspected of coronavirus has recently been published in the group “Hospital meals”: on a plastic plate there are two slices of wheat bread, a piece of butter and a pile of goo. The author added a comment: «No possibility for your own food, and the pink one – it’s cottage cheese. I would like to add that I am lactose intolerant, but I did not have an interview in this area ».

Hospital malnutrition exists …

… And this phenomenon has serious clinical consequences.

– And it’s not just weight loss, but it can also be related to it. Along with progressive malnutrition, there is a risk of so-called syndrome of weakness, weakness or depletion of reserves, sarcopenia, i.e. age-related loss of muscle mass, impaired immunity, decrease in protein concentration, mucosal atrophy and poorer oxygen use, which result in impaired wound healing and an increased risk of pressure ulcer formation. In malnourished patients, a significant increase in complications is observed, resulting in a longer stay in the hospital, longer convalescence, and even an increase in mortality – explains Kamila Chatys, nutritionist at the Geriatric Hospital. John Paul II in Katowice.

It also regrets that many hospitals still carelessly approach the issue of hospital nutrition, considering it an insignificant element of therapy. – Meanwhile, research clearly shows that it is difficult to achieve rapid recovery in a malnourished patient. This results in a multiplication of treatment costs, which would be more advantageous to allocate at the beginning of the financing path, i.e. by investing in proper nutrition of patients.– he sums up.

Food in hospitals. They feed badly

The fact that the problem of nutrition in hospitals is serious can also be seen through the reading of various reports. The Supreme Audit Office (Supreme Audit Office) last informed about this in 2018, and even then officials alarmed that it was terrible.

The reasons? Here are some of them: Hospitals are not required to hire nutritionists, so they often don’t. There are no sanctions for identifying improper feeding of patients. There is no reliable and effective supervision over catering companies, and some hospitals do not have the right to inspect these companies. In addition, there is an under-financing of nutrition costs.

Nothing has changed since the NIK audit, and the COVID-19 pandemic has made it even more difficult. And if it were not for the fact that in most hospitals, families have the option of delivering food parcels through their staff, the patients would certainly be starving.

Not good, not enough, on plastic – the whole truth about nutrition in hospitals

Patients also complain about hospital food to the Ombudsman: that it is bad, not enough, meals are served three times, not five a day. That lunches are cold and not everyone is able to use plastic cutlery.

– Nutrition of patients is an integral part of the treatment process and accompanies medical procedures – reminds Adam Bodnar, the Ombudsman from 2015 on his website. He adds that hospitals, for economic reasons, limit the amount of food rates and – to make it cheaper – outsource services to catering companies.

However, the NIK report from two years ago clearly showed that 70 percent. proven catering companies used expired products, did not report allergens, used cheaper substitutes, and offered underweight portions.

What does the patient have on the plate?

In turn, the Civic Network Watchdog Polska in its report entitled “Hospitals from the kitchen – report” points out that there are no criminal sanctions for finding irregularities in the nutrition of patients.

The authors of the report write:

There is a lack of reliable and effective supervision over hospitals and catering companies. For example, some hospitals did not contractually secure the right to conduct inspections at the service provider.

Unfortunately, despite the appeals, the Ministry of Health has still not issued a regulation that would define and standardize the energy value of meals and the characteristics of hospital diets.

Interestingly, the report’s authors found that although outraged patients post loads of photos of unappetizing hospital meals online, they are reluctant to file official complaints about this. Out of 305 hospitals asked about it, almost 300 did not report a single complaint. According to Watchdog Polska, this may result from the lack of awareness that such a procedure exists.

Hospitals save on food

Why do hospitals save on food? “Because they can” – replies Watchdog Polska. And he adds that each doctor will confirm that a poorly fed patient recovers slower, and thus is exposed to many complications.

It is the family that most often buys nutridrinks for their sick ones. Hospitals usually cannot afford specialized drinks to support treatment. One of the dietitians told Sieci Obywatelska that her facility receives a lot of free samples of supplements for oncological patients. What about patients who do not have access to nutritional supplements, are treated far from home and have no one to help?

Although the quality of nutrition is not a priority for hospitals, some facilities employ dietitians, usually one person for the entire hospital. The exact scope of duties of a hospital nutritionist depends on the unit employing him, but it is similar everywhere. This includes arranging menus, supervising transport to wards, ensuring the right temperature of meals, as well as taking care of their aesthetics. But if a hospital uses a catering company, the hired nutritionist merely approves the menus and does not influence them.

Food in hospitals. One nutritionist and 700 patients

Although most hospitals employ nutrition specialists, the number of jobs for these specialists is not adequate to the number of patients. In one of the Masovian centers, a dietitian looks after as many as 700 patients!

Most often, however, hospitals use the services of external catering companies. But often they did not stipulate in the contract that the preparation of meals could be controlled by a dietitian.

Moreover, many of them do not stipulate a minimum amount in the contract for the purchase of food preparation products. This means that the cheaper the products the company buys, the greater its profit.

Yet nutritionists are sounding the alarm that patient nutrition is absolutely critical to the recovery process!

— Many patients, especially the elderly, are malnourished at the time of admission to the hospital. In the perspective of hospitalization, this problem may worsen, turning into the so-called hospital malnutrition. In the scale of the current financing of hospital nutrition, malnutrition is often getting worse. And this extends the time of hospitalization itself, and thus increases the costs of hospital stay – notes Kamila Chatys, a dietitian.

Appeal for support for hospitals

Hospital directors predict that patient nutrition may worsen even further. Anna Brzęska-Mikoda, director of the Geriatric Hospital of Jana Pawła II in Katowice points out that the cost of nutrition has recently increased by about 20%, which is why the support of all organizations seems necessary.

– The possibilities of adequate financing by medical institutions are very limited. If organizations supporting hospital facilities are looking for ideas on how to allocate funds well, subsidizing hospital nutrition is an absolutely desirable action – appeals Brzęska-Mikoda.

And he emphasizes that the variety of diets, adequate caloric content of meals, additional snacks for patients with diabetes, or the use of specialized diets are not possible at low nutritional rates, which are around PLN 20 or even PLN 30 a day for three meals a day.

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