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In an effort to increase patient satisfaction, Intermountain Healthcare Primary Children's Hospital recently began implementing limits on how much food a patient can order at once.

Primary Children's Hospital offers scratch cooking, plenty of options

Homemade favorites and custom orders keeps pint-sized patients happy

Getting kids, especially littler ones, to eat can often be challenging. It's even harder - and more important - when they're sick. At Intermountain Healthcare Primary Children's Hospital in Salt Lake City, UT, young patients are enticed with from-scratch fare and plenty of flexibility.

"The #1 thing for kids is that they're supposed to grow. So whatever our patients are going through, we want them to still get the nutrients and energy to deal with that and grow," says Robin Aufdenkampe, M.S., R.D.N., Intermountain Healthcare Assistant Vice President of Nutrition Services.

The 200-bed hospital, which serves between 230 and 300 meals a day, has worked hard to create its own homemade versions of the comfort foods kids love, like mac and cheese and chicken nuggets. "When you bite into a nugget you can see the chunk of chicken breast, so it's more identifiable that way," says Abby Jaffa, a culinary manager at the children's hospital. From-scratch items allow the hospital to control things like sodium, fat, and sugar content. That means that patients, including those who may be on special diets, are able to eat the coveted menu items.

The challenge is making a nugget a mac and cheese that's acceptable to every kid. "Every family makes their mac and cheese differently, so what one child expects might not be what another child expects," Aufdenkampe says. Getting the item in question just right usually involves extensive research and testing. "Our chefs will make a mac and cheese 20 different times, with different cheeses and pastas. All of that work is done long before something ever gets on the menu, so we know what we're going to serve is really the best we can provide."

Options like milkshakes, sandwiches, pizza, and smoothies can be made according to a patient's taste. "We have a lot of bandwidth to customize orders and meals," Jaffa says. "We can flavor the milkshakes and smoothies, most are with frozen fruit. For some of the kids who need increased calories, it's a nice way to get extra calories in."

Patient food orders are taken room service-style, where a patient or their caregiver calls to place their order. "It's meant to kind of feel like they're at a hotel," Jaffa says. When an order is placed, a staff member will typically try to prompt a kid to try something healthy. "They might say 'well, you ordered French fries. Would you like to try some fruit with that?'" Aufdenkampe says. Meals are typically delivered within 45 minutes.  

In an effort to increase patient satisfaction, the hospital recently began implementing limits on how much food a patient can order at once. Often, parents would order multiple entrees or items because they weren't sure what their child would like. "But then a lot of the food gets cold and the patient usually isn't satisfied," Jaffa explains. To ensure food stays at a palatable temperature, dining services now encourages single-entree orders. "We'll say, 'What can we get you started with?' and if a patient ends up wanting something else, they can call us back and we'll rush it right up to them," she adds.

Jaffa notes that younger patients tend to gravitate towards milk shakes and smoothies, pizza, mac and cheese, and fresh fruit more than anything else. But many tweens and teens are looking for something a little more sophisticated, recent meetings with the hospital's youth advisory committee revealed. "That helped spearhead out investigation into more culturally authentic foods. We're going to look at our adult facility to see if any of the foods we serve there will work in our kitchen," says Jaffa. Two possible contenders are tacos and quesadillas, since they're easy for patients to customize.

Recently one patient asked for a tuna melt, which isn't typically on the menu and proved a challenging request. "We weren't sure we'd be able to give him a good-quality one with our equipment, because the bread might get soggy by the time it was delivered to him, so we're still experimenting with that one," says Jaffa, who notes that textural changes can often ensue in the quest to keep a patient's meal hot until it reaches their bedside. "A toasted sandwich doesn't always stay toasted very well, for instance. So we're chronically experimenting with things, like how can we keep the fries from getting soggy?"

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