UW Hospital cafeteria makes eating healthy easier, fun
MADISON - It started with the removal of sugar-sweetened drinks and deepfat fryers back in 2014. Poof! They were gone. But the culinary staff for the University of Wisconsin Hospital system were just getting started. By the time they were done with a major overhaul of their cafeterias’ food offerings, healthy salads, alternative grains, ethnic specialties, and local farm-fresh fruits and vegetables would rule the day, and the plate, for the system’s nearly 15,000 employees and other diners.
Before this effort, the cafeteria served “standard hospital fare,” according to Megan Waltz, director of culinary and clinical nutrition services for UW Health. That would include traditional mashed potatoes, pot roast, turkey and, of course, burgers and other favorites from the grill.
“I think it was good food, but the healthy choices weren’t necessarily the easy choices,” Waltz said.
The culinary team took a step back and decided a change was in order. Dietary recommendations from the Centers for Disease Control and Prevention were consulted as “kind of a road map,” according to executive chef Ellen Ritter, who joined the team in 2015. It just made sense.
“We feel that as a health care organization, we’re charged with modeling what healthy eating can be,” sous chef Lisa Boté remarked.
Once employees “started to forgive us a little bit,” as Waltz said, for taking away their Coke and fries, the team decided to shift to a positive focus. For 2016 they launched a yearlong campaign, “52 Weeks of Wellness: Here’s to a Healthier You,” with a different healthy change earmarked for each week.
The very first week, they reduced the price of the salad bar from $8 to $4.99 a pound. Results were profound.
In 2015, the cafeteria sold about 12,000 salads a month, Waltz said. That next January, with the change in price, it sold 18,000. And sales have continued to rise. In January 2017, 21,000 salads were rung up.
They also began to upgrade the salad bar choices. Iceberg lettuce, previously occupying
the largest bin, gave way to healthier greens like kale, shredded brussels sprouts and something called “power mix.”
Later they switched to weighing the salads before the dressing was added (making the dressing essentially free), and they started making dressings in-house. Color-coded utensil handles (green for “go,” yellow for “eat in moderation”) further encouraged wise choices.
Other examples from the 52 weeks of change: the introduction of gluten-free soups, addition of an “ancient grain” oatmeal for breakfast, switching to Wisconsin sources for various foods such as microgreens and pastured beef, and more price reductions on healthy items. With rare exceptions, these were permanent changes, not weekly specials.
Between 2,500 and 3,000 people go through the cafeteria lines every day just in the main hospital cafeteria. In 2016, including all six UW Health venues, patients and catering, a total of 2.6 million meals were served.
Besides employees, the cafeteria also feeds hospital visitors and students from the UW medical school and pharmacy and nursing schools. So the impact is far-reaching.
Throughout the makeover, the culinary team had one clear strategy: to make the healthy choice the easy and affordable choice.
Salad wasn’t the only menu item that got cheaper. Bottled water and canned sparkling water went from $1 to 75 cents; 4-ounce low-fat and non-fat yogurt cups, from $1.35 to 50 cents. When the price of a piece of whole fruit (banana, apple, etc.) dropped from $1.25 to 50 cents, sales shot up from 50 a day to 500.
How is this financially possible?
“We’re not losing money,” said Waltz. “We’re making enough to keep the operation going.”
Added Ritter: “While we may have seen a decline in revenue, our volume has increased so much. It’s a challenge to get everyone through the cafeteria lines.” Indeed, in 2016 the cafeteria service sold 500,000 more meals than in 2015.
And the prices for less-healthy foods like burgers and such (even fries, though now they’re baked) have not been lowered — and won’t be. When a custom omelet is ordered, veggies are free, but customers pay for any meats they want added.
Perhaps most importantly, their efforts have been blessed at the top.
“Senior leadership has been very supportive,” Waltz said. “They were willing to look at the cafeteria as a benefit to the hospital for employees and patients and not as a profit-driven area.”
But adding healthier food is one thing — getting people to eat it is another. The culinary staff knew the food had to also taste good and be interesting. One way they tackled that was with a program called Flavor My Plate.
Started as a way to reduce sodium in prepared foods while also increasing use of herbs and spices, it consisted of dishes representing an ethnic or regional U.S. cuisine, served two days a week as a special in two-week segments.
With a kitchen staff “from all over the world, we were able to draw on family recipes,” said Boté, who developed the program. “We ‘visited’ the Philippines, India, Thailand, Japan, Italy … then we started featuring different regions of the U.S.”
The program, which enticed diners with small samples first, was well received.
“What we found was that our customers really liked trying new things,” she said. “We got a lot of unsolicited feedback … ‘Thanks for trying something new;’ ‘Thanks for introducing different flavors’...”
Some Flavor My Plate dishes, including stuffed cabbage rolls and borscht, have become part of the regular rotation.
But the efforts didn’t stop with healthy and good-tasting. Local and sustainable were two other values the team pursued.
The food service operation now buys directly from 50 to 60 small Wisconsin farmers. “We probably served 150,000 pounds of produce last year from local farmers,” Ritter said. “Even our frozen vegetables are from Wisconsin, and most are organic.” They buy their pastured beef from state farmers through a beef broker. “We feel good that the money is staying in the state.”
Connecting with the Madison community has also been a goal. The cookies they sell now come from a local program called Just Bakery, where ex-convicts receive vocational training in baking. The bakery uses the hospital’s recipes, and the cost is about the same as it was when they baked the cookies themselves, Ritter said.
Through a program called Chefs Spotlight, local chefs come in from time to time for a lunch period and serve specialties from their restaurants.
“It’s been going on for about a year, and our customers love it,” Boté said. “They get to eat food from a favorite restaurant or from a place they haven’t tried before. And the restaurants get to promote their business. It’s a win-win.”
Said Ritter: “When you have staff working 8- to 12-hour shifts, we like being able to offer something of restaurant quality.”
And the culinary team isn’t done. This year, the focus is on eating seasonally. Harvest of the Month showcases a different Wisconsin seasonal fruit or vegetable each month, woven throughout the menu. January was cabbage. February was winter squash. March is root vegetables. Leafy greens, asparagus and rhubarb will follow.
Ritter emphasized that no one is trying to be the nutrition police. People have choices. Comfort foods are still available, traditional meals are still served for Thanksgiving and Christmas. The softserve ice cream machine is gone (“We told them it broke and we couldn’t get parts.”), but it was replaced with a freezer case filled with small cups of Babcock Dairy ice cream and frozen fruit bars. Balance is important.
“And we make everything for patients,” Ritter said. “We don’t want to say ‘no’ to a patient. In a hospital that’s the only choice they have. It’s something they look forward to.”