Nutrition

12/13/2018
Volume 1, Issue 1

Services Newsletter
Inside This Issue
Macaroni & Cheese
Macaroni & Cheese Makeover 1

Makeover Patient Services Accomplishments 2

Retail Team: A Year in Review 3
myTime Trades and Offers 4
By Chef Scott Stewart, Production Supervisor Clinical Nutrition Update 5
Production Cook/ Supervisor 7
A team effort between Nutrition Services and Speech Language Pathology
led to a new macaroni & cheese recipe. Two months and four test recipes Protein Bowls 8
later, we formulated a mac & cheese dish that expands options for pa- Therapeutic Diet Training 9
tients with dysphagia and Heart Healthy diets prescriptions. The end re- People and Sustainability 10
sult is a creamy, low fat, and delicious recipe that not only is available for
more of our patient population, but also allows a little comfort to the pa-
tient’s day. We would like to thank Alexis Weisser, a Sodexo future lead-
er-in-training and dietetic intern, for her contributions to this project.
 2

Patient Services Accomplishments in 2018

By Carla Maldonado, Patient Services Manager

In 2018, the Patient Services, Production, and Clinical Nutrition teams worked together to launch Protein Bowls! We began
with a pilot on C54 (the Burn Unit.) The patients served by C54 typically require extra protein in their daily intake. Soon after
this trial period, we added Protein Bowls as a permanent fixture of the patient room service menu. We serve four different
protein bowls: the Breakfast Bowl, Asian Bowl, Southwest Bowl, and Garden Bowl.

Throughout the year, Patient Services and Production collaborate to provide special holiday menus for our patients, including,
but not limited to: Valentine’s Day, the 4th of July, Thanksgiving, and the end-of-year holidays. We always remember to bring
a little joy to our patients who spend these special days in the hospital.

We have added additional menu items for the acute patient population this year. Patients prescribed an NDD #1 (Pureed) diet
now have the option to order pasta, lemon cheesecake, and strawberry cheesecake. These items turned out to be a hit!
For patients prescribed NDD #2 and NDD #3 diets, we added a new Macaroni & Cheese recipe. Another benefit of this change
is that our mac & cheese is now appropriate for Heart Healthy therapeutic diets, which is something that is unheard of!

Lastly, we added two more flavors of Nestlé Vitality Waters: Tropical Mango and Watermelon. These waters expand the op-
tions for patients who must follow Clear Liquid diets.
 3

Retail Team: A Year in Review

By the Retail Team (Valerie Longfellow, Deb Nielsen, Christie Williams, & Paul Vaillancourt)
The Retail team had a busy year! We implemented new menu rotations at our Favorites and World Cuisine stations, incorpo-
rating comfort food favorites and new trendy dishes in both areas. World Cuisine changes include two different options per
week, giving customers ten new made-to-
order options. With this change, we saw a
5 percent increase in sales.
The FDA announced new labeling require-
ments for all food service organizations.
This law requires that all items being sold
for consumption in retail spaces must have
calorie content clearly stated, in the same
font color and size as the price of the item.
This law pertains to both labels and men-
us. The new law required quite a bit of be-
hind the scenes work to complete, as all
menu boards (162+), as well as Simply-To-
Go labels, paper menus, and signage had
to be recreated, re-formatted, and rebuilt
utilizing PowerPoint and Sodexo software
systems. For a team with no background in
graphic design or marketing, the results of
this project were appealing, professional,
and gratifying for the team as well as our guests.
CaterTrax was implemented to replace our long-standing outdated paper/email ordering system. With this system came a new
menu to better suit the current catering guidelines. The addition of this software to our operation has had a drastic impact on
the amount of back of house/admin work that was previously being done by the team. Next up for CaterTrax: Clinic Stock.
It was a year full of big events for our catering team as well. We
planned and catered the all-employee picnics for both Regions
and Gillette and the end-of-year celebration Chili Feed. Another
big event we were involved in this year was a volunteer lunch-
eon at the Wellstone Community center in St Paul. This event
was 100 percent donated by our department to help Keystone
Services show their appreciation for their many Meals On
Wheels volunteers. Another exciting event we were honored to
be a part of was the Hospital Board Dinner. Our chefs show-
cased their talents by preparing a delectable menu that includ-
ed Chanterelle Mushroom tartlets, Pork Steamed Bun Sliders,
hand-rolled sushi, and Molecular Caprese!

Pictured
Top right: Chefs Nhia Michael Thao, Mike White, and Scott Stewart, and Retail
Manager Valerie Longfellow with a spread for the Hospital Board Dinner
Bottom left: Nutrition Services team volunteering at Wellstone Community
Center (left to right: Retail Supervisor Deb Nielsen, Executive Chef Mike White, Retail Manager Valerie Longfellow, Chef Scott Stewart, Patient Services Su-
pervisor Sean Lally, Patient Services Supervisor Kal Stoen)
 4

Retail Team: A Year in Review (cont.)

We have made quite a few changes in our partnership with the Green Team to align with HealthPartners’ sustainability and environ-
mental efforts. Plastic stir sticks have been replaced with wooden stir sticks, plastic bags previously given for customer use have
been replaced with paper, and most importantly, we have eliminated
all bottled soda and offer only canned and fountain soda.
This fall, we introduced our Pop-Up Farmers Market, which has been a
big hit with customers. We source local, organic produce from The
Good Acre, a non-profit food hub specializing in sourcing produce year
round from local sustainable farmers.
We have added tortillas as a choice at our Omelet station for breakfast.
This simple addition to our menu allows customers a bit more variety to
the already large selection of eggs and omelets offered daily.
New Value Meals were introduced to help all colleagues and visitors
make better healthier choices for lunch and dinner for a lower price.
Loyal Customer Cards, as well as a 5 percent Deduct-It discount have been added as incentives to our loyal customers and visitors.
Loyalty cards offer a “spend $50 get $5 free” incentive that all visitors and employees can use at any time.
The Deduct-It discount is exclusive to employees who have signed up for the Deduct-It program through the Human Resources de-
partment. This is yet another great way to say “Thanks” to our colleagues for choosing to dine with us.
What we have listed is just a small sampling of the many things the Retail Team has done in the past year. We will be looking to im-
prove and expand our offerings in 2019 to meet the needs of our patients, families, and colleagues.

myTime Trades and Offers

By Sean Lally, Patient Services Supervisor
The Nutrition Services call center is a very important part of the department. Not only do the Call Center Associates take hundreds of
phone calls per day to help guide patients through ordering a
meal, but they are also the first group in the hospital to use a
switch process through myTime. The department’s current
process for switching or requesting an employee to work their
shift is to fill out a form to turn in for approval. The new pro-
cess for the call center is to use MyTime to request for some-
one to either switch or give away their work shift. The interest-
ed party will accept the shift, and this will then be forwarded
to a supervisor that has access to review the request on
MyTime.
The department’s Operations Coordinator, Jenna Baumberger,
went through the steps to get this process started. She part-
nered with HR to set up the employees’ accounting units, job
classes, and rotations through myTime to make the switches
possible. Jenna set up trainings with Patient Services Supervi-
sors and employees to teach them how to utilize the switches
in myTime. A follow-up meeting was conducted with employ-
ees to discuss how the new process was going.
Our department is the first to use this new process, but we will not be the last. There are other departments in the hospital that are
in the process of switching (no pun intended) including the ICU, Pharmacy, Lab, and the Emergency Department.
 5

Clinical Nutrition Update

By Sarah J. Johnson, MBA, MPH, RDN, LD, Clinical Nutrition Manager

2018 has marked the beginnings of the HealthPartners Nutrition Practice and Evaluation
Steering Committee. This committee is comprised of clinical nutrition leaders across the
HealthPartners organization with the goal to promote consistent, positive, and holistic ap-
proaches to nutrition care and provide patients, employees, and community members with
needed nutrition resources. Early on, to get us started on common ground, we established a
“Philosophy of Nutrition Practice” and “Key Principles of Nutrition Health.”

PHILOSOPHY OF NUTRITION PRACTICE

Nutrition practice encompasses the art of integrating evidence-based nutrition science with
behavioral change science to impact overall health and wellness.
 The role of the registered dietitian nutritionist (RDN) is to support the transla-
tion of science-based nutrition goals into actions that individuals incorporate
into their lives.
 Understanding each individual’s values, preferences, lifestyle, and environment
is important as new skills, behaviors and attitudes are addressed to ultimately
improve health and wellness.
 Medical nutrition therapy (MNT) delivered by RDNs in a person-centered man-
ner supports the achievement of the triple aim.
 MNT requires support from the entire health care team and is a vital compo-
nent of holistic health care.
 The Nutrition Care Process (NCP) includes assessment, diagnosis, intervention,
monitoring and evaluation.
KEY PRINCIPLES OF NUTRITIONAL HEALTH
 Nutrition recommendations must be evidence-based for specific eating
patterns (e.g., vegan, gluten-free) and medical conditions (prevention and
treatment). Eliminating entire food groups is rarely recommended (e.g. no car-
bohydrates, avoid dairy.)
 Assessing factors that influence food intake is critical to selecting priorities for
nutrition recommendations. These factors include: cultural influences, health
beliefs, current knowledge, family support, access to food, financial status,
medical history, literacy, and numeracy, among other influencers of food intake
of each individual.
 Obtaining nutritional health for disease prevention and treatment (or for over-
all health and wellness) is a process that usually involves a series of nutrition
therapy encounters to assess, diagnose, support, and guide interventions. Sec-
ondly, outcomes should be evaluated and therapy adjusted as needed.
 Nutritional health should be supported throughout the healthcare system from community to ambulatory care to hospitali-
zation and long-term care; through access to nutrition resources and support and reinforcement of the importance of nutri-
tional health from all staff and programming.

Pictured
Top right: Megan Turner, RDN, presenting research on early enteral nutrition in burn patients at the American Burn Association annual meeting, Chicago, IL
Bottom right: Martha Palomino, RDN, presenting research on tube feeding placement in ALS patients at ALS Association 2018 Conference, Fort Worth, TX
 6

Clinical Nutrition Update (cont.)

At Regions, about 85 percent of the RDN’s time is spent at the bedside providing direct patient care, with the majority of time spent identify-
ing, assessing, intervening on, and monitoring patients with acute disease-related and chronic malnutrition. Research shows that nutrition
status is linked to many clinical quality indicators. Intervening on patients with malnutrition can mitigate negative outcomes:

In addition to direct patient care, the clinical nutrition team takes on quality improvement and research initiatives aimed at system changes
to sustainably improve the nutritional status of our patient population, improve overall health outcomes, and ultimately reduce the overall
cost of care. We have made a concerted effort in 2018 to try and publish and present our great work in order to better contribute to the
greater healthcare community.

Pictured
Left: Rachel Miklya, RDN, and Emily Niswanger, RDN at STEM Career Fair
Right: Clinical Nutrition Manager Sarah Johnson and Kimberly Duffy, RDN at annual Oncology Dietetic Practice Group conference
 7

Day in the Life of a Production Cook

By Chef Mike Thao, Production Manager
The production cook is a vital part of Nutrition Services; every area in the kitchen is connected to this position. The timing of soups, sauces,
and entrees must be in sync to ensure our patients are getting the best nutrition possible. Before anyone wakes up to the smell of Peet’s
coffee brewing in the Overlook Café, our production cook is already simmering soups and thickening gravies. Each day, the production cook
is tasked with making sure the kitchen is up to par with 20 different items, which include seasoned taco meat, two types of rice, macaroni
and cheese, chicken pot pie mix, and all pasta noodles.
Every week, up to 22 different soups are made from scratch and distributed to up to six different outlets on and off the Regions Hospital
campus. On average, 55 gallons of soup are produced each day. Many of the soups are crafted in one of three 60-gallon steam kettles.
Our production cook also produces over nine gallons of sauces and gravies each morning. All of these sauces and gravies are made from
scratch. Before hanging up her/his apron and going home, the production cook preps recipes for the following day, where s/he will start all
over again.

Pictured

Left to right: Production Cook Jammie Jefferson completes a wide array of daily tasks to feed Regions Hospital patients

What does a Patient Services Supervisor do?

By Kal Stoen, CDM, Patient Services Supervisor
Starting at 5 AM, the Patient Services Supervisor wakes the kitchen up every morning. Nutrition Services comes to life as more cooks, call
center associates, and food service workers trickle in. There are always warm welcomes as we begin to prepare for another day of serving
patients. And then, the race begins!
Patient Services Supervisors make sure that each area is working at its full potential. We ensure that patients are served as quickly as pos-
sible, floors are stocked with the necessary snacks, tube feedings, and beverages that patients need, and staff has everything they need to
perform their jobs. Whether it’s helping out in the dish room, washing pots and pans, delivering a cart of patient meals, or assembling the
food and patient trays, we do what we must to make sure all areas of Nutrition Services are running smoothly. At the same time, we field
calls on the phone and Vocera to assist patients and staff throughout the hospital with any questions or needs they may have.
The AYR (At Your Request) room service line runs from 6:30am to 7pm. During this time, we help to manage a constant flow of patient
trays. We conduct safety in-services, safety committee meetings, and monthly safety audits. Another important aspect of our job is inter-
viewing applicants and providing annual reviews. On top of this, we complete a variety of other projects such as tray accuracy audits, tray
passer audits, meal rounding, and test trays.
There is never a dull moment in the day of the Patient Services Supervisor, as managing a kitchen of this magnitude definitely keeps us
moving (which we love!) One thing I can say is that this is the best management team that I have ever worked with and I am truly grateful
to be a part of the HealthPartners organization. Our jobs challenge us every day; this makes us push ourselves and grow as a team.
 8

Protein Bowls Expand Food Options for Patients

By Ornela Beslagic, MBA, Nutrition Services Director

Earlier this year, our Production, Patient Services, and
Clinical Nutrition teams worked together to create our
newest entrée item: Protein Bowls. This item was initial-
ly created as a supplement to help patients with in-
creased needs optimize calorie and protein intake for
better healing. After a two-month trial period, Protein
Bowls were added to the room service menu and made
available to most patients.
Protein Bowls also allowed Nutrition Services to provide
patients who follow a vegetarian diet with more protein
options that do not involve meat, eggs, or medical sup-
plements.
Megan Turner, the Burn Center Registered Dietitian,
mentioned our Protein Bowls at the American Burn Conference in Chicago this past March. There were inquiries from numer-
ous hospitals across the country for information about our Protein Bowls, and we still hear from hospitals around the Twin
Cities.
With Protein Bowls, we are proud to bring innovation to patient care from a nutrition-focused perspective.
 9
First-ever therapeutic diet training
for Regions Hospital cooks a success

By Annie Clarkin, Dietetic Intern

Production-focused diet training myTime Codes for Cooks

Cooks throughout the operation work hard to meet the
Jenna Baumberger, our Operations Coordinator, kicked
nutritional needs of patients; however, it is important
off the meeting. Many cooks throughout the operation
that they have opportunities to relate the work they do
are cross-trained on a variety of positions, and therefore
back to the patients they serve. Alexis Weisser, Annie
pick up shifts for different job classes. Jenna instructed
Clarkin, and Amanda Van Haren (all future dietitians) col-
cooks on using myTime to accurately report Nutrition
laborated to provide a therapeutic diet training for cooks.
Services labor hours. During the training, Jenna discussed
Together, these three reviewed a variety of therapeutic
cost centers and accounting units and described how to
diets, portion sizes, and major allergens on the patient
punch in and out of the different CCs and AUs. Jenna
stressed the importance of using the orientation (OR)
code when training on new positions or completing
myLearnings. Jenna emphasized how proper clockings
greatly reflect our productivity hours. By managing their
myTime, cooks can help contribute to proper payments
for labor, accuracy for financial reports, and separating
productive and non-productive hours.

trayline.
Amanda examined the different therapeutic diets and
touched on the reasons a patient might be prescribed a
specific diet. Annie described the use of proper utensils
and providing accurate portion sizes for each item, espe-
cially for individuals with restrictive dietary needs. Alexis
wrapped up the training by discussing allergens seen on
the line and special instructions for each allergen. She
examined how to communicate an allergen and the nec-
essary precautionary measures to prevent cross-
contamination such as changing gloves, using separate
utensils, and covering the plate with a plastic dome or lid.

Ultimately, the intent of this special training was to re-

mind our staff that patients trust us to take care of them
by providing appetizing, safe, and appropriate food that
promotes their unique health needs. We encouraged
cooks to speak out if they receive orders that seem odd
or might compromise patient safety. Additionally, we
Pictured
stressed that diet orders are legal orders that must be
Annie Clarkin, future dietitian, presenting the proper portion sizes for
followed. Overall, we want our cooks to know that they
menu items that are served to the patients.
do excellent work, and we hope this information will help
them understand their unique role in patient care.
 10

People Highlight: Alexis Weisser, Sodexo Future Leader intern

By Amanda Van Haren, Patient Services Supervisor
Every year, Nutrition Services hosts several dietetic interns and provides a supervised practice
experience for the areas of food service management and Medical Nutrition Therapy (MNT.)
However, this year, we had the unique experience of hosting a Sodexo Future Leader intern:
Alexis Weisser.

From May to August 2018, Alexis completed a number of important tasks for our department,
which continue to be highly appreciated! Alexis updated nutritional and cost information for all
of the patient room service menu items and kept patients safe by making sure food allergens
for all menu items were accurate and updated. Additionally, she modified meal ordering guides
that are distributed on nursing units for patients who must follow specific therapeutic diets.
Alexis also collaborated with the Production team to create special holiday menus for patients.

As of September, Alexis is an intern with the University of Minnesota’s dietetic internship pro-
gram. However, this does not mean we have had to say goodbye to Alexis just yet! She spent
her food service rotation with us and is now completing her Medical Nutrition Therapy (MNT)
Pictured
rotation with the Regions Hospital clinical dietitians. In November, Alexis developed and deliv- Alexis Weisser, Sodexo Future Leader
ered an in-service training to cooks so that they would become familiar with therapeutic diets. Intern, helping in production to pre-
With her knowledge, people skills, and can-do attitude, we are positive Alexis will make a fan- pare menu items for Café 640’s theme
tastic Registered Dietitian in the future! meal.

Sustainability initiatives in 2018

By Michael White, Executive Chef
Nutrition Services has made many chang- able to accomplish two goals: providing a The Good Acre to sell locally grown vege-
es over the last fiscal year to help lessen sustainable alternative to plastic and re- tables from the community in our cafete-
our impact on the environment. ducing the portion size of sugary offerings ria.
to our customers.
We have eliminated the plastic stir sticks It’s more important than ever for organi-
that were used for coffee drinks and re- We have introduced a new boxed water zations to do well by doing good. Whoev-
placed them with a more sustainable product which reduces the carbon foot- er they are and wherever they operate,
choice of wooden stir sticks. print when purchasing water. The boxed businesses must act for the well-being of
water reduces the amount of semi trucks the planet in order to create true value.
The straws in our retail operation have
needed to transport the product to the
been switched over to a bio-degradable
bottling facility and customer by 25 semi
straw that will help reduce some of the
trucks compared with traditional plastic
plastic that could end up in our oceans.
water bottles. The company is also dedi-
Plastic t-shirt bags are no longer being cated to the re-planting of trees in an
handed out and have been replaced with effort to prevent deforestation.
paper bags, which are available only by
We partnered with Urban Organics, which
customer request.
is a local aquaponics operation. This com-
We have switched out all beverages that pany supplies us with fresh organic
we were purchasing in plastic greens that we proudly serve on our salad
bottles that are also offered in aluminum bar.
cans. By making this change, we were We have also formed a partnership with