Balancing fiscal responsibility with customer preferences has been a traditional challenge for onsite dining programs when creating menus and individual dishes. Recently, other considerations have elbowed their way into the mix as well, most prominently the need to serve items that are healthful for both the diner and the planet—which puts even more pressure on procurement and production costs. In healthcare, nutritional requirements governing patient dining add still another factor to consider.
In some ways, it’s the ultimate Iron Chef challenge, except it’s not a TV show but real life with real customers to satisfy and a real environment to protect.
FM recently approached Chef Jeffrey Quasha, CEC, CCA, AAC, who is senior director of culinary innovation for Morrison Healthcare, to give his thoughts on how he and his team approach these challenges. Morrison is a unit of Compass Group USA, which has made a significant commitment to adopting a range of sustainable practices, from plant-forward dining to food waste reduction, while still menuing dishes that are healthful and appeal to an increasingly diverse and quality-conscious customer base.
Here is that conversation, edited for length and clarity…
FM: What do you look at first when designing a menu or a specific dish?
Quasha: We always start with great food first! All of our dishes start as an idea, like an ethnic trend or a passion bowl build. When we used to set up our lines in our cafes—the “Old School Morrison Cafeteria’s”—we would always start with the protein or center of the plate first. But now, we’ve flipped the script and start with our whole grains or regen agriculture grains like quinoa and then our vegetables and then protein last. So we went hypothetically from an eight ounce chicken breast to now doing a four ounce NAE—no antibiotic ever—chicken breast, which is the so-called garnish. This allows us to use underutilized seafood, NAE chicken, as well as more premium proteins because we're doing smaller portions while still providing over two cups of food per bowl build. It’s just a whole different mentality of delivering great flavor while keeping our guest full and satisfied. If anything, we're giving them more wellness-based food while not telling them it's wellness-based, kind of a “stealth health” approach.
Also, we menu the right foods at the right seasons. For example, we’re not going to offer a Caprese salad in December, when the tomatoes are gassed or out of season. We do have core menus, but we try to float seasonal limited time offers and promotions in at the right times of the year. As of this year we have over 68 pop-up restaurant style concepts and we're in development of four new ones for next year. They are concept menus—Filipino, Peruvian, bibimbap or broth bowls for the wintertime—that completely take over an existing station.
Two years ago, we created six pop up brands that are 100% vegetable and what I call “single entity,” which means that the plant is used 100%. So, for example, with Cauli Club, our cauliflower concept, we're using not just the cauliflower itself but also the stems and the other scraps. We started teaching our chefs to stop buying processed vegetables and to start bringing in, say, carrots with the greens, because in our Carrot Greens concept, we use every single part of the carrot. We don't peel the carrots anymore either. In culinary school, I was always taught to peel all the vegetables, after which we would throw all the peelings away. Now we're telling our chefs, don't peel those sweet potatoes because there's so much energy and fiber and all the good, dense nutrients in the skins.
FM: Have you found any of the popups to be especially popular?
Quasha: Cauli Club is probably one of the most successful among the vegetable ones, as well as Silver Kings, which was corn based, that a lot of our Midwestern accounts were looking for. We have 15 entree re-imagine station concepts our chefs can choose from to run, including the last one we launched—Harvest, our first all vegetarian, 100% plant-based entree station. We’ve now gone all the way from the old school Morrison cafes with the fried chicken and the Salisbury steak that put us on the map to 100% plant-forward entree stations! So now, instead of a country fried steak, we have country fried cauliflower…
FM: Are you surprised that people are going for these plant-forward choices?
Quasha: I think after COVID the world kind of changed and people are more cognizant of where their food comes from, so having the right food in the right seasons and having more plant-based options aligns with that. One goal is to have the meat eater or the flexitarian who is in that long line at the grill waiting to get that burger they always order see that there’s an even longer line where we're serving bulgogi rice or noodle bowls that are 100% plant based.
I want to try to inspire the person who might have chosen to eat the meat that day to look over and see what's happening over there with the plant-based choices, see that amazing double-fisted Buffalo cauliflower sandwich that’s dribbling down someone's chin and realize it's cauliflower, not meat. You know, for years the veggie plate was whatever mashed potatoes and vegetables the chef was serving that day, but I say, why can't vegetables be as sexy and amazing as what we're giving to meat eaters?
FM: How do you convince people that healthier items like plant-based dishes taste as good as the traditional dishes they’re used to?
Quasha: You can't fake food and that's the biggest thing. You have to have some accountability about what you're presenting to the consumer. For example, you can't fake great barbecue—it's either great barbecue or it isn’t—so one of the things we did was make barbecue tofu ribs that we actually smoke to get that beautiful pink smoke ring around the outside, and then glaze it with barbecue sauce. To me that's an amazing plant centric veg-forward option that we're offering to our guests that maintains accountability.
So, yes, we are designing dishes that are more wellness-based, but not telling anyone that it's healthier—that “stealth health” approach. For instance, most of our bowl builds are under 450 calories, but if I told you you're eating under 450 calories you might think it's not a lot of food. But when you add up a half a cup of grains, two cups of vegetables that are either raw, fermented, pickled or roasted, and then you put three ounces of protein on top, that's two cups of food, which is a lot of food, yet under 450 calories. So you're getting a better-for-you bowl build, but we’re just not saying it.
FM: Are you able to fit these menu programs into your menu economics?
Quasha: Absolutely! I have a rule of five, which means that we don't feature an ingredient in any of our recipes unless we could validate five purposes for it. So for example, if I'm going to bring kohlrabi in as an ingredient to make kohlrabi mashed potatoes, then I'm going to make sure that I have five recipes to use it in. Also, because we use the rule of five when we bring products in, our chefs get inspired to be creative. Take tahini, for example. For years, you would buy tahini and it would just sit on the shelf because its only purpose was to make hummus. But now, while we still use it to make hummus, we also use it in things like dressings and sauces, so now we've got more purposes to justify ordering it.
FM: How important is ingredient versatility, given ongoing supply channel challenges, and how do you use things in different ways?
Quasha: We love plus-one applications! Take balsamic dressing. Hypothetically, just by adding frozen fruit like strawberries or bananas, or some Asian flavorings, you can create multiple dressings out of one. You can also take Ranch and add BBQ sauce, or you can take BBQ sauce and you can add strawberries or raspberries to make different sauces. We try to stick to our core items and then plus-one them. If I add hatch chiles to a potato soup, then I have a variation. Add bacon and I have another variation. A lot of times, the innovation is just taking something we're already purchasing and adding one ingredient to it—making a Chipotle BBQ sauce from the Cattlemen's BBQ sauce that we're already buying, for instance. So instead of buying something pre-made that may not even be available, we can make it ourselves by adding one ingredient.
FM: How do you balance customer preference and nutritional considerations designing a dish?
Quasha: When I design a dish, I always start with great food first. We start with the whiteboard and just write down what we want to do, then develop dishes that fit the concept of the food that we want to create. When we actually start cooking it and developing the flavors, I use tricks like adding more citrus or malts or vinegars to add more flavor on the front end in order to decrease the fat or the sodium on the back end.
Of course, there are some instances where I’m not going to lessen the integrity of the dish. For example, a fried green tomato BLT has to have fried tomatoes. If you have an air fryer that's great, but we're not going to bake the green tomatoes, and I would rather just not serve that dish than compromise it. Basically, we always start with great food first to create the dish, then work backwards to manipulate it to fit the nutritionals.
We get three chances a day to serve great food to our patients. When you're lying in a hospital bed, one of the things you're looking forward to is that meal, so we want to make sure when that dome is lifted, we're awing them and inspiring them with great food that's better for them.
FM: How do you incorporate regional and demographic preferences into your menus?
Quasha: Our chefs along with our retail managers and onsite teams are able to pick what concepts work best for their region and their demographic, and of course we may also have client preferences. On the patient menu it's the same. We do have signature core menus whether it’s bedside ordering or dining on call, but we also still need to address regional preferences. So in the Pacific Northwest, for example, we're doing kanji and eggs for our patients. In the South, of course you have to have shrimp and grits on the breakfast menu. I love that regionality because my chefs are always challenging me or sending me messages asking, why can't we do this? I ask them to send a picture with a recipe and our team will then actually recreate that dish and then quantitate it with nutritionals. Usually when somebody sends me a regional preference dish, we’ll have it from ideation to implementation in five days.
FM: People often just want comfort foods in stressful environments like hospitals. How can healthful menus still meet that need?
Quasha: Comfort-centric is definitely huge in healthcare, and we try to provide it in healthy, authentic ways. For example, we have a station called Anoka that is like an old school Morrison concept, but rebooted with things like country fried cauliflower, Korean glazed meatloaf that's cooked on the grill and an awesome paprika crusted salmon. On the patient side, yes, we still have some amazing classic comfort dishes like the meatloaf and the mashed potatoes alongside regional favorites like the shrimp and grits or dishes with regional flavors and ingredients like a jerk chicken thigh over callaloo with Caribbean red beans and rice with a little bit of grilled pineapple salad on top.
American regionalism is actually more like global regionalism as America is such a melting pot, so we're being asked to do more global regionalism like conchi or ramen. At University of Miami Health, their food is absolutely amazing because they do a combination of Haitian, Dominican, Puerto Rican and Cuban. I get so inspired when I go down there because the kitchen is just a melting pot of food and flavors.
FM: Can you cite a Morrison site that can serve as an example of the latest innovations in healthcare foodservice?
Quasha: Well, we just did a brand new renovation of the cafe at Lancaster General in Pennsylvania that is built not so much like a cafeteria as a food hall. Also, because of what we learned during COVID, we now have ghost kitchens and virtual kitchens to better serve customers quickly. For example, nurses often only have 30 minutes for lunch, and in a large hospital, it might take them 10 minutes to get to the cafe, where they then have to order their food, pick it up and have maybe 10 minutes to eat before having to get back.
To solve this, we've gone more to a mobile ordering system in our cafes, which has an impact not just for the nurses but for the loved ones sitting bedside, because they can go on their iPhone just like they do at home and order from the cafeteria and know exactly what time to pick up. And with over a dozen different stations in the cafe, from Neapolitan pizzas and grain bowls to Asian and sushi-to-order, every type of ethnic cuisine from the surrounding community is represented in the cafe on a daily basis.
So now, the nurse, the nurse practitioner, the executive office staff or the loved one sitting bedside next to their child can go on their phone and order food and know exactly what time to pick it up so they're not missing anything important. It also helps our nurses relax because they don't have to be stressed out waiting in line in the cafe. Then on the patient side, we don't say we have patient food and retail food anymore, we only have our food.
The chef at Lancaster General has actually gone and started cross utilizing the same ingredients for retail and for a patient standard meal. That's a lot more efficient than having two separate menus and two separate production operations.
FM: Can economical menus be developed for serving evening and overnight staff when traditionally the counts are minimal?
Quasha: I started as a chef in a unit over 10 years ago when we had a third shift and we always had a grill, a salad bar and a deli. More recently, we’ve been adding micro-markets in our hospitals where you can just check out by scanning your food with the Mashgin unit [Mashgin is a vendor of self-checkout technology] and then go. We have grain bowls, fully composed hot or cold bowls, soups made from scratch and sandwiches in these micro-markets, so instead of going to a vending machine, you could go in a micro-market, pick something up, scan it and then walk out.
FM: Finally, any trends that you're seeing, in healthcare foodservice especially, that you're keeping an eye on?
Quasha: I think recipe authenticity is one of the biggest trends that I'm seeing now. It means that if you are doing regional Mexican or Filipino or Peruvian, you got to make sure that the dishes that you're creating are authentic and sourced properly. Another big trend is that consumers want to know where their food came from and what’s in it. I think these trends are here to stay. People want to know what they're eating and that you're helping them make more sustainable choices.