Stanford Medicine Newsletter Updates For the Local Community


At Your Request

New food program provides custom service, healthy choices

Stanford Hospital’s kitchens were renovated, and new chefs were hired to accommodate the new system of custom-preparing all meals for patients.


Breakfast at 11 am? Not a problem. Peanut butter with sourdough toast? Not a problem. Want to order your next day’s meals to arrive at a specific time? That’s fine, too.

As with room service at a hotel, just about any food now can be delivered between 7 am and 8 pm to patients at Stanford Hospital and Lucile Packard Children’s Hospital through a new program called At Your Request.

With its ultra-customized and varied menu, this type of hospital bed dining is a much-needed departure from traditional hospital food service, which industry-wide had developed a notorious reputation. At Your Request represents the gold standard in an era of individualized treatment protocols and medication regimens.

The taste test

Stanford’s program was crafted with input from patients, who seem very pleased with the result.

“Ah, that looks good,” said patient Bob McMaster as food technician Drexell Libed carefully placed a breakfast tray before him on the program’s debut day in September. A resident of Napa, Calif., McMaster has diabetes and has traveled to Stanford for treatment several times in the last few years.

McMaster lifted the lid on his entrée—an omelet with strips of sweet red pepper and sautéed mushrooms, accompanied by whole wheat toast and a dish of fresh squares of cantaloupe. The omelet and toast were still warm, and McMaster quickly put his fork to work.

“We come here because the doctors have the expertise to handle the complexity of his problems,” said his wife, Shelley. “Now the food is like going to a restaurant.”

Meals made to order

At Your Request is designed like a restaurant service, with each meal prepared according to a patient’s specific order. Some food items, such as diced fresh fruit, are pre-made, but meals are prepared to each patient’s specific request as much as possible. No longer will batches of 500 meals be cooked and then held for delivery three times a day, mass-production style. Now meals will be cooked and served only as ordered.

“Everything will be à la carte, and everything is fresh,” said Sergio Herrera, a head cook at Stanford Hospital.

The meals are marked with a barcode that is scanned at three points in the process to make sure the meal is on track. The goal is to send a meal to a patient within 10 minutes of preparation.

Patients, or a helpful family member, can phone in orders, selecting items from a paper menu. A dietary assistant responds, tracking the patient’s name, general medical notes, and dietary allowances and restrictions on a computer screen.

Patients can pre-order several meals at once, to be delivered any time between 7 am and 8 pm.

Diet analysis

Each ordered item is evaluated by a software program that analyzes all ingredients, monitoring carbohydrates, salt, potassium or other dietary restrictions. Patients with glycogen storage disease have their own set of menus, while transplant patients are offered low-microbial food.
The software includes 120 types of medically dictated dietary requirements and restrictions, as well as 36 of the most common food allergies.

Menu items not allowed on a patient’s specific diet will not appear on the active ordering list. When a patient’s order reaches a limit for fat or salt, the order is flagged and the dietary assistant works to find an acceptable substitute.

The new system offers triple the number of choices and many more variations than previous hospital menus. For instance, sandwich possibilities include a deli-style array of choices for bread, meats, cheeses, and extras such as cucumber, avocado, pickle and bacon.

Behind the scenes

Under this system, “patients are likely to eat more of their meal because they can have more of what they would really like to eat,” said Florence Fong, administrative director of hospitality.

Stanford Hospital’s kitchens went through a $1.2 million conversion to prepare for the change. To its roster of 64 full-time jobs, Stanford added the equivalent of 20 more full-time cooks and more food assistants to deliver trays.

“Seven of our cooks are culinary school graduates,” Fong said. “They are really on the ball.

Patrick Gonzales, a California Culinary Academy graduate, has been cooking at Stanford for eight years and was more than happy to make the change. “I said, ‘How soon?’ I think patients will feel less like they’re in a hospital, and the people making the meals will have more of a sense of ‘I’m cooking for an individual.’”

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