At Hopkins Children’s, Joshua Koneval, 9, gets what he wants when he wants it. The proof’s in the Jello. In the doorway of his hospital room at Hopkins Children’s is Eunice Richardson with a tray of Fruit Loops, Jello and Teddy Grahams and a big smile. On the hospital’s pediatric oncology unit, patients like Joshua can order to their heart’s content from a kid-friendly menu, 7 a.m.-7 p.m., and have it delivered to them.
And boy, does Richardson deliver, not just tasty food, but hugs, comfort and encouragement, and, for new families in particular, an extensive knowledge of what children undergoing chemotherapy might just love: “Bacon and chicken noodle soup,” she says. “Chemo changes the taste buds, so they will often crave salt.”
Richardson, a Hopkins employee since the early 1960s, and longtime member of its catering group, has been with the unit’s room service program since its inception several years ago. “I can do VIP with my eyes closed,” she says, referring to her work serving meals to patients in Johns Hopkins’ upscale Marburg Pavilion. “So I just combined that with my love of children and people to take care of these little sick children and their worried families.”
Developed in a collaboration between Pediatric Nutrition at Hopkins Children’s and Sodexho Healthcare Services, Johns Hopkins’ food service provider, “At Your Request-Room Service Dining” models the meals-on-demand service that will be available to all inpatients at Hopkins Children’s when its new building opens in 2012. Gone will be the days of routine meal trays, delivered by the clock – morning, noon and night, whether a child is awake, hungry or even in his or her room. In the new hospital all children will be able to choose what they want off a menu and have their food delivered when they want it.
With a seed grant from the Johns Hopkins Women’s Board, the nutrition service and Sodexho launched the hospital’s first a la carte program on the pediatric oncology unit in 2006. The year-long pilot project was designed to improve patient and family satisfaction with meals and subsequently increase patients’ intake of the calories and nutrition they need. “Children undergoing cancer therapies, including chemotherapy, tend to lose or have reduced appetites,” says pediatric nutritionist Amy Schwartz, “just when the demands on their systems require that they maintain weight and energy.”
Nurses and families were called in to suggest menu items. “They know what children like,” says Director of Pediatric Nutrition Sylvia McAdoo.
String cheese and Rice Krispie Bars are among the newest additions to kid-friendly nosh that includes pancakes, omelets, turkey (“with or without gravy”), Chef Boyardee Macaroni and Cheese ®; cheese quesadillas, and snacks like Teddy Grahams and Gold Fish (listed under the “Children’s Favorites” section). Kids can wash it all down with milkshakes, juices, hot chocolate and more.
“After chemo and medications to reduce nausea, hunger comes and goes for these children,” says Schwartz, who closely monitors their intake. “Now the food they want comes at a time they’re craving it, so they are most likely to eat it, helping meet their calorie needs.”
Recent surveys of patient and family satisfaction with food and food service on the unit reveal marked improvement. As correlating evidence, tube feedings have decreased.
The culinary fare is drawn from the pantry, refrigerator or stove of a small kitchen on Brady 3 in Johns Hopkins Hospital, which also services the patients in the Marburg Pavilion – the hospital’s most upscale adult patient quarters. Pediatric patients are served within 20-30 minutes of their order by Pavilion staff, replete in black and white attire, which adds to the appealing charm for many children. The food is delivered on brightly colored trays with a placemat. The first meal brings with it a toy or little present of some kind.
The grant from the Johns Hopkins Women’s Board helped finance some of the kitchen’s special equipment used for the children’s fare, including a deep fryer and a blender for smoothies and the ever popular milkshakes. As for project funding, says Women’s Board President Elaine Born, it was simply “a no-brainer. Making a child’s stay more hospitable and comfortable is a compelling call to action.”
At present, pediatric oncology is the only unit at Hopkins Children’s offering the meals-on-demand service. Additional staff, resources and planning are required to expand the program to all pediatric patients and manage the myriad dietary restrictions (including food allergies, potassium restrictions and liquid-only diets) in a hospital full of children.
At Hopkins Children's, full-scale planning begins this September. A new kitchen is under construction in the basement of the Orleans Street parking garage. "We’ll be working with the Sodexho group to see how many specialized diets we can manage,” says Assistant Director of Pediatric Nutrition Tiffani Hays, “and how best to train 'At Your Request' staff in the intricacies of special diets.”
Adults will have more food options in their new hospital building too. Called “Personal Choice,” their food service will allow them to select a la carte for each of their three meals - breakfast, lunch and dinner. The meal request will be entered electronically at bedside. Among the wrinkles to be ironed out in food services for the young and old(er) is how to monitor what, when and whether patients are eating throughout the day.
For now, Richardson continues her special brand of a la carte: delivering the food her children want with love. “I tell my children and their families that it’s going to be all right,” she says. “Anything you want, I tell them, I’ll get for you.”
Recipient of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins 2008 Jennifer L. Brager Humanitarian Award for Clinical Service, Richardson finds her love and appreciation are returned. “She is a ray of sunshine,” reads one parent’s testimonial. “My son loves the menu, but when Eunice delivers the food, with her warm, kind, loving way she feeds our whole family.”