Recovery requires fuel, and the fuel the body needs for healing is food.<\/p>\n
Under the watchful eyes of caregivers at hospitals, rehab centres, nursing homes, assisted-living units and similar organizations, interventions to improve intake and nutrition can happen quickly and on-site. <\/p>\n
But once a patient is discharged, nourishment can slide. Larry Altier, System Director of Food and Nutrition Services at Lee Health System in Fort Myers, Florida, says this is especially true for \u201cpatients\u2014most typically in the 55-plus range\u2014who have some form of acute or chronic disease state that causes them to not get adequate nutrition and who are at risk for malnutrition.\u201d <\/p>\n
Many factors can account for inadequate nutrition and the impact plays out in many ways. \u201cPeople who are undernourished or don\u2019t eat enough will have a harder time healing,\u201d says Dana Fillmore, Gordon Food Service Healthcare Segment Manager, RD, CP-FS, \u201cand they\u2019re at a higher risk for being readmitted to the hospital.\u201d <\/p>\n
A better solution for both is real food, an approach endorsed by Nourish, a Canadian nonprofit advocating culture change in healthcare foodservice. Now, thanks to new and emerging outreach programs that get good, real food onto the plates of high-risk populations, help is on the way.<\/p>\n
The objective of such programs, Fillmore explains, is \u201cto stick to the role of general good nutrition, to make eating convenient for patients and to make sure they\u2019re not skipping meals. Eating well is key to one\u2019s well-being and ability to heal.\u201d<\/p>\n
These programs are more SuperWorks than Meals on Wheels. With Meals on Wheels, meals must follow strict nutritional requirements and institutions are often reimbursed for them. The home meal service programs that target this population offer components of simple, tasty meals for pickup or delivery in small enough portion sizes for households with one or two people. The menu can be flexible, anything from prepared in bulk, pre-portioned and provided shelf-stable to fresh and\/or frozen.<\/p>\n
For individuals discharged from skilled-nursing or assisted-living settings that offered meal programs, this outreach overcomes obstacles such as acquiring foods and having to prepare them. For these individuals\u2014especially the elderly\u2014who are not ready for Meals on Wheels or who can\u2019t afford commercial meal-kit delivery, outreach facilitates eating, healing and remaining in their homes.<\/p>\n
The following example shows how a home meal service that is targeted to independent living apartments in a continuing care community might look.<\/p>\n
Clinically driven and targeted to specific patient needs, Lee Health\u2019s Flavor Harvest at Home program typically serves those ages 55-plus who have some form of acute or chronic disease that causes them to be inadequately nourished. They also must meet two of the six clinical criteria for malnourishment identified by the Academy of Nutrition and Dietetics. Once a week for four weeks, a combination of fresh, frozen and shelf-stable meal components that support their nutritional needs is delivered by a driver who makes sure the food is secured properly in the home. After 28 days, recipients are re-evaluated. <\/p>\n
After just 18 months, Altier notes, enrollment eclipses 1,000 participants\u2014and it is well-received. \u201cThe first week of the program the recipients are reserved; they barely open the door and keep drivers at arms\u2019 length. By week three, there\u2019s a total change in demeanour, health status is elevated and they open the door and engage with the drivers.\u201d<\/p>\n
Even better, the results are positive. \u201cAbout 59% of the patients with similar conditions who didn\u2019t take the meal program were readmitted,\u201d Altier says, \u201cwhereas the group that got the meals had a readmission rate below 25%. Flavor Harvest at Home had a positive effect from a variety of different measures. This is not just a food program; this is a medical-care program that incorporates food.\u201d<\/p>\n
Such programs, Fillmore says, offer opportunities to feed the bottom line and improve an operation\u2019s financial health. Moreover, Altier notes, the cost\/benefit ratio can be impressive: Lee Health estimated that the cost of Flavor Harvest at \u201c$231,000 and change,\u201d but assessed the net value at \u201cclose to $1.3 million, conservatively.\u201d<\/p>\n
Reduced readmissions.<\/strong> \u201cHospitals are being proactive about improving care by helping with food at home,\u201d Fillmore says. At Lee Health, a significant decline in readmissions yielded significant savings.<\/p>\n Shorter stays<\/strong>. \u201cWe found significant reduction in the length of stay for those patients we identified as at risk early in the process,\u201d Altier says.<\/p>\n Marketing.<\/strong> Delivering entr\u00e9es beyond independent-living villas helps nursing homes and continuing-care communities build awareness of who they are and the services they offer.<\/p>\n Narrow networks.<\/strong> \u201cHospitals are the ones who refer to rehab, skilled nursing and senior living communities,\u201d Fillmore says. \u201cIf they\u2019re going to send someone to a skilled nursing facility, they\u2019ll send them to the one that keeps people healthier longer.\u201d<\/p>\n Sales-driven revenue streams.<\/strong> Fillmore says there may be room \u201cto make money back at minimum and potentially upcharge if you want the program to be revenue-generating.\u201d She adds that if you do upcharge, be sure it\u2019s a nominal amount that the target market can bare. Another option: Scale up production even further to offer the meals as takeout fare for employees and\/or visitors. <\/p>\n The bottom line? \u201cMore and more people will be doing this to reduce healthcare costs,\u201d Altier predicts. \u201cIt costs less to feed people for 28 days than to bring them back to the hospital.\u201d<\/p>\n Altier adds that \u201cBetter basic care doesn\u2019t get any more basic than nutrition.\u201d<\/p>\n The following principles, Altier says, laid the foundation for Lee Health\u2019s Flavor Harvest at Home program. <\/p>\nGetting started<\/h3>\n