Before COVID-19 swept through Derby, Kansas, Rock Regional Hospital was a new facility, serving only a handful of patients each day. Once the virus hit, they experienced a spike in patients. Some days, all 24 beds and seven ICU suites were at capacity.
Richard Ensley, who has been at the helm of Rock Regional’s dining program since January of 2020, says the kitchen had to quickly shift its approach.
The hospital’s dietary aides typically discuss each meal individually with patients, in person. The kitchen can customize the standard patient meal within the limitations of the patient’s dietary restrictions. Patients can also choose from a menu of a la carte options. Patient meals follow a seven-day cycle.
Since foodservice staff members are not permitted in rooms of patients with COVID-19, they now go through meal options with these patients through nurses or over the phone.
They also had to adjust their food delivery system. Instead of delivering meals to COVID-19 patients themselves, the kitchen coordinates with the nursing staff. It’s a top priority, Ensley says, to make sure hot food stays hot and cold food stays cold for all patients. To get the timing right, the kitchen is in frequent communication with nurses.
Patients order meals no later than 90 minutes prior to meal delivery. Then the foodservice staff drops all meals in “contact precaution rooms,” where nurses pick them up and deliver them to patients. If the nursing staff isn’t ready, the kitchen holds the meals.
“If you have something in front of you that you enjoy eating, it’s going to make [your hospital stay] a little better,” Ensley says of their commitment to a pleasant experience. “Our dietary staff spends a lot of time with people making sure we give them what they need and want.”
For its patient menu and the hospital’s on-site café, the kitchen focuses on scratch-made meals made with fresh produce, proteins and herbs. An in-house dietitian reviews and makes necessary revisions to all menu items. The foodservice staff also stocks nourishment rooms so nurses can access ready-to-eat food for patients during off-hours.
The hospital café, which has primarily served hospital staff members since last March, operates on a four-week cycle, with one or two entrée choices and three to five sides daily. Recent café entrées include flavor-forward dishes such as pulled pork, grilled salmon, chicken piccata, street tacos and jambalaya. They also offer a daily housemade soup, such as chicken tortilla or French onion.
At the café, which serves breakfast, lunch and dinner on weekdays, they serve an average of 350 weekly meals. For patients, they serve 294 meals per week.
Asked if a small hospital, such as Rock Regional, is more able to give individual attention to patient meals, Ensley demurs. He notes that his employer, Luby’s Culinary Services, has a “very adaptable, patient-first mentality. I think offering some options for patients is really the next step forward for a lot of companies.”
Throughout the past year, the staff faced procurement challenges. A produce vendor had to change delivery dates on several occasions. And, like many food service operations, they struggled to find enough paper goods at the start of the pandemic. Low-sodium canned soups, which they serve in some circumstances, can still be a challenge to find.
In general, the kitchen has had to be in close communication with vendors about substitute products and special orders. They’ve learned to get their orders in early.
Though basic food preparation processes for the seven-person staff haven’t changed dramatically, their safety operations have. Every 90 minutes a timer goes off, cuing the staff to break down and deep clean the entire kitchen, including changing out the sanitizing water and cleaning all knobs and door handles.
When the café closed to the public, they shut down both the salad bar and the grab-and-go dessert station and moved all plates and silverware to the back. Ensley says they now stock the refrigerators with grab-and-go sandwiches and salads for quick meals.
Though they look forward to the day when they can welcome hospital visitors and the public back to the café, Ensley says it’s been gratifying to serve both patients and hospital staff during this challenging time. “Even though the café serves fewer family members than it did before, feeding the staff gives the kitchen’s work special significance,” he says. “It’s so rewarding. You get to know them. You get to know what they like. And you get to put smiles on people’s faces.”