HOSPITAL

CULINARY
Ika Ratna Palupi, M.Sc

1
OVERVIEW
• Aspek kuliner makanan rumah sakit
• Menu planning & Food production in hospital
• Menu makanan rumah sakit di Indonesia &
berbagai negara
• Patient meals are an integral part of hospital
treatment and the consumption of a balanced diet is
also crucial to aid recovery.
• Since the patient often suffers from anorexia (loss of
appetite) due to illness, a tasty and healthy meal
plays an important role in providing comfort from the
symptoms.
• Providing nutritious and appetizing food is a key part
of high-quality and effective hospital treatment.

3
 “Makanan RS meskipun
sudah memiliki standar
perlu mendapat
perhatian kulinernya
ASPEK agar memenuhi asupan
KULINER gizi pasien di RS karena
dan rasanya nikmat.”
“Ahli gizi yang bekerja di rumah
CITARASA
sakit selain memahami teori
pada
prinsip terapi diet juga memahami Kolaborasi gizi + kuliner
PELAYANAN
prinsip dasar kuliner dan
GIZI untuk mencapai tujuan
menerapkannya dalam bentuk
misi makanan rumah sakit
masakan yang dihidangkan secara
yang berselera meskipun
menarik, aman, menggugah selera
menjalani diet
dan dapat diterima oleh pasien.”
Definisi Kuliner ASPEK KULINER MAKANAN RUMAH SAKIT
1.
Rentetan kegiatan pengolahan makanan PERENCANAAN
dimulai dari memilih bahan yang MENU
berkualitas dan mengolahnya secara
tepat menjadi hidangan yang nikmat
dilengkapi dengan penampilan yang
menggugah selera dan memenuhi 2. PENGOLAHAN
kesehatan MAKANAN

3. PENYAJIAN
Ibu Tuti Sunardi MAKANAN
5
PERENCANAAN
Perencanaan menu sesuai dengan tujuan menu

• Faktor-faktor yang mempengaruhi perencanaan menu

Pengembangan resep (recipe development)

Pemilihan Bahan makanan: BMS, BMK

• Golongan makanan: Sayur-sayuran, Buah-buahan, Serealia dan

kacang-kacangan, Umbi-umbian, Tepung-tepungan, Tahu, Susu
cair, Susu bubuk, Telur, Daging sapi, Ikan, Dendeng sapi, Ikan asap,
Makanan kemasan
6
 PENGOLAHAN MAKANAN
Komposisi sesuai dengan
resep
Proses memasak sesuai
Penampilan potongan
dengan ketentuan &
bahan
secara higienis

A. ORIENTASI PENGOLAHAN B. MACAM / JENIS OLAHAN C. TINGKAT KEMATANGAN

• pengolahan berorientasi untuk • Dry Heat: dibakar • pengaturan suhu
massa (umum) → makanan non
diet
• Moist heat: dikukus, direbus • lama pengolahan
• Pengolahan satuan (Perorangan) • Oil heat: digoreng, digoreng
dengan pesanan (dokter/ahli gizi) dengan sedikit minyak
→ makanan diit

D. PENYIAPAN PENGOLAHAN D. TEMPAT PENGOLAHAN E. PERALATAN

• Personal hygiene • Ventilasi • Peralatan makanan
• Higiene alat • Cerobong asap masak
• Tempat sampah • Saniter • Peralatan makan
mentah
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Food Production in Hospital
▪ Food production is a chain link between menu planning, meal services,
appearance, palatability and nutrition requirements.
▪ While planning a hospital menu, products are selected considering patients
ethnic preferences, cultural behaviours, nutrient profile, convenience of
storage/preparation and prioritizing reduction in wastage and making the process
cost-effective.
▪ Traditional food systems are based on delivering regional and freshly cooked
meals that are prepared in the hospital kitchen using locally sourced ingredients.
▪ “I have seen first-hand how using fresh, locally-sourced ingredients and cooking from scratch have
improved the quality of their meals and I want to help more hospitals follow suit by sharing what
works best across the country.” (Matt Hancock, UK Health and Social Care Secretary) https://www.gov.uk/government/news/hospital-food-
review-announced-by-government
9
 Hospital Menu Planning

▪ Many of the problems that arise in the

provision of nutritionally balanced food are
potentially preventable with good
planning.
▪ One major step in improving the food
provided in hospitals is to ensure that
hospital menus meet the needs of the
patients.
▪ "There are a lot of patients who are looking
to hospital to model the type of foods they
should be eating.“ (Dr. Monica Kidd, Family physician)
https://www.cbc.ca/news/health/hospital-food-lacks-proper-nutrition-1.1162338

Khanna, T. 2019. Food Service Management Module Book. Tamil Nadu: Alagappa University.
Hospital Menu Planning
▪ Planning a menu effectively requires the collection of a wide range of information and input from
numerous groups within a hospital. A menu planning group is responsible for implementing local
protocol for provision of food and fluid for patients.
▪ Core membership needs to include a senior member of catering staff, a senior nurse, doctor, a senior
dietitian and allied health professionals and patient representative.
▪ The planning group is responsible for:
○ Menu planning, including the use of standard recipes
○ Ensuring food and fluid meets the requirements of the individual
○ Setting meal times appropriate for patient groups
○ Analysing all dishes and menus for nutritional content by a dietitian at the planning stage
○ Consulting patient groups about new menus/dishes before they are introduced.
▪ Recipes are designed and tested for safety, cost effectiveness, nutrient and texture profile, ease of
preparation and service in the home setting and most importantly to ensure they are liked by the patients.
Menu Planning for Patients
▪ Food provision should be planned in order to be receptive to patient’s dietary needs along with
harmoniously working with the medical, nursing and other healthcare staff (integrated in the clinical care).
▪ The dietary staff has to consider that the food should be similar to that which is eaten at home as home is
associated with better food intake and greater enjoyment of meals.
▪ To assess the dietary needs of different patient populations, the details to following is required:
○ Age
○ Sex
○ Cultural, ethnic, social and religious diversity
○ Physical and/mental health needs (food allergies and need for therapeutic diet, physical disabilities
that may affect their ability to eat and drink, the need for equipment to help with eating and drinking,
social / environmental mealtime requirements)
○ Food preferences (likes and dislikes)
○ Length of stay (LOS)
○ Nutritional risk
▪ Data sources: health information departments, patient surveys, nutritional screening data, compliments and
complaints, other hospital staff, menu item uptake and wastage

Menu Planning for Patients
The patients in a hospital can be described
as:
• Nutritionally vulnerable: normal nutritional
requirements but with poor appetite and/or unable
to eat normal quantities at mealtimes; or with
increased nutritional needs
• Nutritionally well: normal nutritional requirements
and normal appetite or those with a condition
requiring a diet that follows healthier eating
principles
• Special or personal dietary needs, e.g. religious or
ethnic dietary Hospital Food Production
requirements
• Requirement for a therapeutic diet e.g. modified
texture diet, allergy free diet and renal diet
▪ There are some groups of the population whose
dietary needs may need to be considered
separately when planning a menu:
▪ Children
▪ Elder people
▪ End-of-life patients
▪ People with learning and physical
disabilities
▪ Maternity patients
These groups of patients may have different dietary
needs to the younger adult population and if these
are not met, then they may end up in a ‘nutritionally
vulnerable’ state.
▪ Menu is a prime factual document and as such
should be reviewed and updated regularly in
order to continue to meet the dietary needs of a
potentially changing hospital population along
with season as well as financial effectiveness.
Bagaimana Prinsip Menu di Rumah Sakit?
http://ugm.id/MenuRSTriWidiastuti (open with ugmail only)

14
 Malnutrisi rumah sakit
dapat disebabkan penyakit
penyerta, bukan kurang
asupan
Teknik pengolahan yang
benar, sesuai menu
• Kombinasi hidangan, misal: berkuah dan tidak
berkuah
• Pasien kanker (Ca) dianjurkan bentuk
makanannya kering

Ang sio hie Perhatikan budaya makan

setempat Gunakan ketersediaan
• Jenis ikan apa yang digunakan dalam peralatan
menu RS?

30-50 porsi = 1 pemasak Pengetahuan bahan

(RS), porsi selebihnya = makanan, misal: snack
dikalikan → Manajemen pisang kepok tanpa gula
waktu (rasa manis alami)

Tetel pisang Menyusun menu baru

Penyusun menu harus
setiap 4 bulan agar pasien
gemar memasak
tidak bosan
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https://food.detik.com/info-sehat/d-3287490/begini-caranya-mengatur-
rotasi-menu-makanan-di-rumah-sakit

16
 ▪ Necessary dietary modifications (e. g., liquid or
pureed food, low-salt or low-protein diets) can
make meals particularly unappealing. In these
cases, the medical requirements will indeed
outweigh the normal culinary expectations.
However, every effort needs to be made to
maximize taste and appearance, in addition to
nutrition.
▪ Reducing portion size and increasing the energy
and nutrient density of meals can encourage oral
intake for patients with decreased appetite. This
can ensure patients are not overwhelmed by a
large meal and thus are more likely to eat what is
provided, in turn increasing energy and nutrient
intakes (Kim et al. 2010).
Kim, K., Kim, M., & Lee, K.-E. (2010). Assessment of foodservice quality and identification of improvement strategies using hospital 17
foodservice quality model. Nutrition Research and Practice, 4(2), 163–172. https://doi.org/10.4162/nrp.2010.4.2.163.
Therapeutic diets is an
umbrella term used for a wide
range of diets for patients with
specific requirements, such as
texture-modified diets, gluten-
free diet, allergy and intolerance
diets, (allergen-free diet),
diabetic diets, diet–drug
interaction diets, macronutrient
modified diets (fat, protein, and
carbohydrates), fiber-modified
diets, fluid diets, and many
Do Rosario, VA & Walton, K. 2019. Hospital Food Service. DOI:10.1007/978-3-319-75388-1_74-1. In
others. Handbook of Eating and Drinking. Switzerland: Springer Nature

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A typical patient meal | SunMed
https://www.youtube.com/watch?v=_6fQQ1UiWi0
It is important
that patients are
provided with a
diet that is made
up of a
combination and
balance of foods
Soup Salad

Proteins (Chicken/ Fish/ Vegetarian) Rice & Vegetables

Dessert
https://www.youtube.com/watch?v=FXACNnEJKK4
Hospital menus should be based primarily on
clinical needs as well as on patients’ preferences
and other important characteristics such as
variety, quality, aesthetics, and taste of the
food.

Pada praktiknya…

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M
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P
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 VIP

Kelas III
VIP Kelas I dan II Snack DM &
VIP
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Inside the Singapore’s Tan Tock Seng Hospital
Kitchen: Operation Feed The Sick
https://www.youtube.com/watch?v=32RHTIY7-gc
PENYAJIAN MAKANAN Faktor Penyajian
Makanan:
1. Tenaga penyaji
Penyajian makanan tidak baik
2. Penampilan
maka seluruh upaya yang
makanan
dilakukan guna menampilkan
3. Alat saji
makanan dengan citarasa yang
makanan
tinggi akan tidak berarti
4. Garnis

Penyajian makanan Penampilan makanan →

merupakan faktor dalam merangsang indera
penampilan hidangan terutama indera
yang disajikan penglihatan yang
bertalian dengan
citarasa makanan itu 25
 Penyajian Makanan
Pemilihan Alat
• Penyajian makanan dengan piring, mangkok atau tempat penyajian
makan khusus yang lain: alat yang digunakan harus sesuai dengan
volume makanan yang disajikan
• Hindari kesan makanan disajikan melimpah karena alat penyaji
yang digunakan terlalu kecil atau sebaliknya kesan makanan
disajikan terlalu sedikit

Cara Menyusun Makanan

• menyusun makanan dalam tempat penyajian makanan harus
dilakukan dengan cermat sehingga memberikan kesan menarik

Penghias hidangan
• dapat menambah menariknya penampilan makanan yang disajikan
GARNISH
Makanan dihidangkan lebih
menarik dengan sentuhan garnish
untuk meningkatkan selera makan
https://www.youtube.com/ https://www.youtube.com
watch?v=UW6sA4UaPhw /watch?v=d7f9gA5hztU
Syarat garnish:
• Ambil bahan yang aman
dimakan
• Warna dipadukan dengan
makanan
• Bentuk tidak besar
• Berseni dan menggugah selera
• Dapat disiapkan sehari Pasta with
basil garnish
sebelumnya
 Rekomendasi Distribusi
Makanan
• Memberikan pengalaman yang
menyenangkan kepada pasien
setiap kali waktu makan
• Penampilan makanan: menarik,
kerapian, penataan, kebersihan
• Adanya pengecekan ”food
trays” pada akhir distribusi
• Makanan sampai ke pasien:
suhu hangat tetap hangat dan
suhu dingin tetap dingin
Masalah Umum Distribusi
Makanan Konvensional
• Menu berdasarkan pesanan →
makanan disiapkan dan
disajikan dengan atau tanpa
input pasien
• Makanan disajikan saat pasien
tidak siap
• Sisa makanan banyak
PATIENT MEAL DELIVERY SYSTEM

HOT THERMAL RETENTION SYSTEM

PELLET SYSTEM

• Piring dengan
makanan diletakkan di
atas ”Hot Pellet” dan
ditutup :
dome
• Plastic Insulated Base
base • Campuran alumunium
• Stainless Steel
PATIENT MEAL DELIVERY SYSTEM

Kereta Makan dengan CONVECTION

Pemanas HEAT BASE HEATER
• Energi panas → supply SUPPORT
ke makanan selama
proses transportasi
CART
• Panas cepat dikontrol
sesuai keinginan
• Kelemahan: Biaya Source: fsrfoodservice.com

pemeliharaan tinggi
PATIENT MEAL DELIVERY SYSTEM

INSULATED COMPONENTS
Baki plastik
Keuntungan
dengan lekukan

• tempat makanan • Tidak perlu

pokok, sayur dipanaskan
• dengan penutup (tidak
(2 pieces system) membutuhkan
• tanpa penutup ”special pellet
(1 piece system) dispenser”)
• Tidak
membutuhkan
kereta makan
pemanas khusus
Technology Enablers for Food Act 1983...

Passive & Active Temperature Systems : A Comparison

Passive Temperature Active Temperature System

Retention System
Heated & Refrigerated Meal Distribution Trolley
Insulated Trays or Containers

• Tray assembly line

do not need heated
bain marie if <2
• Tray assembly line requires hours holding
heated bain marie etc to hold • Temperature
food hot >650C controlled
• Difficult to control
Technology Enablers for Food Act 1983...ATS

RTS Ready To Serve

Heated & Refrigerated Trolley

Sejuk
Panas

Refrigeration
system

Cold
Hot <100c
>650C <40C

RTS produces heat for the hot oven side RTS produces cold air for the cold side from
through convection heating the self contained refrigeration system
Technology Enablers for Food Act 1983...ATS
Panas

One Tray
RTS Sejuk

Two Different Temperatures

+ 4 0C
+650C +100C
Panas Sejuk
Adjustable Hot & Cold
Sections on Tray
Choice of Tray Two Sizes
Large tray: 575mm x 325mm
Standard tray: 530mm x 325mm No ridges & stackable
 Suction lids to keep meals hot
https://www.youtube.com/watch?v=LSnXDC6sD-w

The Pro Cart Ultra: Hot and Cold All In One Cart
https://www.youtube.com/watch?v=cO9_tUdYcMA
DOME DRYING and STORAGE CART

https://www.y
outube.com/w
atch?v=E42hQ
p8sw-o

https://ww
w.youtube.
com/watch
?v=43aUQ
Source: fsrfoodservice.com 9e3WN4
Can Hospital Food Be Tasty & Healthy? | SunMed | Joanna Soh
https://www.youtube.com/watch?v=_6fQQ1UiWi0
PENYAJIAN MAKANAN PASIEN DI MASA PANDEMI DENGAN DISPOSABLE EQUIPMENT?

✓ Waktu produksi dekat dengan waktu penyajian

makanan untuk mempertahankan suhu
makanan (waktu tunggu makanan matang + 1
jam)
✓ No less than 5 colours with garnish (Disiapkan
sebelumnya dan simpan di chiller)
✓ Variasi warna dari sayuran yang diblansir (rebus
Menu makanan pasien COVID-19 rendam dalam air mendidih 1-3 menit)
(IDN Times/YouTube RSUP MH
Palembang)

Pengadaan alat
saji disposable
makanan berkuah
/ cairan suhu
panas
Simple garnish: cabai besar buang biji
dan daun bawang, iris tipis, rendam
dalam air es
https://www.masterclass.com/articles/what-is-blanching-guide-to-blanching-vegetables#what-is-blanching
10 World’s Best Hospital

39
How the Diet Office delivers meals to
patients | Cleveland Clinic Martin Health
https://www.youtube.com/watch?v=wIzukcPKFVM
How the Diet Office delivers meals to
patients | Cleveland Clinic Martin Health
https://www.youtube.com/watch?v=wIzukcPKFVM

The ticket print out at several areas: 1) start of the tray line, 2) if there are hot foods, it prints out for cooks, 3) cold area

The beauties of room service: you get to

order what you want when you want it
 Hospital Meals Around The World
#HospitalFoods #HospitalMeals
 https://www.youtube.com/watch?v=Lt0yF5sp9Cc
20. Poland : 0:51
19. Malvern, Australia : 1:30
18. Sydney, Australia : 2:03
17. Germany : 2:26
16. Tokyo, Japan : 2:49
15. Osaka, Japan : 3:11
14. Norway : 3:27
13. Malaysia : 3:58
12. France : 4:28
11: South Korea : 5:05
Bubur ayam
Telur, Teh
10. Massachusetts, USA : 5:22
9. Russia : 5:44
8. Sweden : 6:07
7. Canada : 6:28
6. Indonesia : 7:06
5. Britain : 7:24
4. The Netherlands : 7:43
3. Dubai : 7:56
2 Qatar : 8:29
1. California, USA : 9:06
Malaysia
Norwegia Steak daging, roti tawar, salad, dan yogurt

Polandia Roti tawar, mentega, sosis, timun

Tokyo, Jepang Sup Miso, nasi, ayam, sayur Korea Selatan Nasi, sup rumput laut,
telur puyuh
B
U
D
A
Y
A
India Roti Canai dan kuah kari Dubai, UAE Tenderloin with mango
salsa
M
A
K
A
N
Melbourne, Australia
• Salmon patties with saffron cream
sauce (Salmon dengan saus krim)
• Rice (Nasi)
• Parsnip soup (Sup wortel putih)
• Yoghurt banana cake (Kue pisang)

Australia Afrika Selatan

Daging, sup, kentang tumbuk, sandwich, roti Roti panggang, telur, sosis, tomat, kopi, susu
Perancis Salad, roti, pie, sejenis sayuran ikan Inggris
Onion pastry,
baked beans
for minestrone
soup, mashed
potato & beef,
pisang

Jerman Schnitzel, spatzle, salad, dan kue

Memanir dengan tepung panir/

tepung roti
 https://www.youtube.com/watch?v=wOueWALUFHA

QUICHE

CHORIZO

PASTY

STRUDEL

SALAD

BAKED
SALMON

FRUIT
JUICES
 Medical Tourism

Tjahjono D. Gondhowiardjo. Dikotomi Paradigma dalam Pendidikan dan Pelayanan Oftalmologi. Editorial. Ophthalmol Ina
2018;44(1):1-3.

Jumlah pasien asing yang rawat inap di Rumah Sakit Khusus Bedah BIMC Siloam Nusa Dua sebesar 910
orang pada Tahun 2016 dan mencapai 1107 orang pada Tahun 2017

Wirajaya, I.G., Prihandhani, I.G.A.A.S., Artha, I.G.N.A.P. 2020. Hubungan Perilaku Caring Perawat Dengan Tingkat Kepuasan Pasien
Asing yang Menjalani Rawat Inap. Jurnal Ilmiah Pannmed (Pharmacyst, Analyst, Nurse, Nutrition, Midwivery, Environment, Dental
Hygiene); 15(1):116-124.
Patel, I., Johnson, T.J., Garman, A.N., Hohmann, S., Pescara, P., Fowler, J. and Daneshgar, S. (2019), "The return on investment from
international patient programs in American hospitals", International Journal of Pharmaceutical and Healthcare Marketing, Vol. 13 No. 2,
pp. 171-182. https://doi.org/10.1108/IJPHM-09-2017-0054
Perceptions of an ‘international hospital’ in Thailand by medical
travel patients: Cross-cultural tensions in a transnational space

Highlights
• International hospitals’ for medical travellers in Thailand are hotel-hospital
hybrids
• The creation of a transnational culturally neutral ‘space of connectivity’ is
always incomplete
• Cross-cultural tensions affect the experience of the hospital
• Patients' backgrounds and relationships affect their experiences of an
‘international hospital’.
AndreaWhittakera Heng LengCheeb Social Science & Medicine. Volume 124, January 2015, Pages 290-297.
https://doi.org/10.1016/j.socscimed.2014.10.002
“We are doing our best to make food that meet the needs of
foreign patients as a growing number are visiting our hospital,
even though some kinds of rice, spices and other food materials
are difficult to secure in our country,” a SNU hospital source said.

http://koreabizwire.com/big-s-korean-hospitals-prepare-meals-for-foreign-patients/85453 51
Food Promotions in Hospitals (Kanna, 2016)
Some important marketing strategies that can work in Hospital cafeterias and
campus initiative, as recommended by the American Hospital Association are:
1. Increased quantity, quality, variety of fresh seasonal produce
2. Increased nutritional and packaging of grains
3. Revamped healthy vending options and labelling
4. More kitchens with no trans-fat, reduced saturated fat
5. Expanded offering of high fiber and lean protein sources
6. Reformulated lower caloric, sugar, sodium energy
7. More cafeterias providing accurate nutritional information
8. Pricing strategies to incentive healthy selections of meals
9. Creating policies regarding presence of healthy meal restaurants within hospital
10. Developing policies to run campaign on awareness of health like low salt day, water
day, 10,000 steps a day.
 Restaurant-style menu &
cooking
Individual choice vs Set
menu

Personalized service:
• Room Service (disadvantages:
increased labor cost, not all patients
are eligible for room service )

New food items

Lessons • International flavor
learned • Fresh prepared items, garden-fresh
ingredients
• Organic food
• Functional food: Yogurt with
probiotics, Juice with added vit C &
calcium
 Healthcare caterings’ consumers

Rutkowska, E., Czarniecka-Skubina, E. (2015). Catering services in Poland and in selected countries. Szczecin University Scientific Journal, No. 872. Service Management, 15 (1): 13–22

https://www.youtube.com/watch?v
=t3uw0yTF-78
 Katering Diet Rumah Sakit

https://www.youtube.com/watch?v
=FGKJg_F1ia0
 KEBERHASILAN pada penyelenggaraan makanan memerlukan:

Standar resep dari segi rasa dan penampilan yang konsisten

Meningkatkan penampilan pada:

•bentuk
•rasa
•temperatur
•warna
•tekstur
(Tuti
Soenardi) Garnish/penyajian

Pengolahan secara profesional → Tenaga CHEF

TENAGA CHEF
“First need in the reform of
hospital management? That’s
easy! The death of all dietitians
and the resurrection of a French
chef”
~Martin H. Fischer (1879-1962)
The addition of trained chefs
in hospital kitchens, along
with room-service dining, is
making hospital food an
essential part of healing &
rising patient satisfaction rates.
PROFESIONAL MENGOLAH MAKANAN
Menguasai teori + pendidikan skill
• Perilaku dan sikap diutamakan dibandingkan skill
Hal yang perlu dimiliki oleh seorang
Profesional Makanan:
• Memahami pengetahuan dasar
• Sikap positif terhadap tugas
• Mempertahankan dan meningkatkan
kemampuan kerja melalui belajar
• Dedikasi menentukan kualitas
• Pengalaman yang diperoleh dari praktik
• Pengalaman praktik hanya didapat dari
seringnya melakukan uji coba sehingga dapat
kreatif untuk memberikan order pada
pelaksana dapur
 YAYASAN GIZI KULINER JAKARTA
https://threspuspa.wordpress.com/2012/02/28/yayasan-gizi-kuliner-jakarta/

tutisoenardihealthyfood
https://www.surveymonkey.com/r/SurveiMemasak-Widget

60
TERIMA KASIH

Selamat
berkreasi