• Poster
  • April 8, 2014

Bringing Public Health to a Children's Hospital: Improving Nutrition for Patients, Families, Visitors and Staff (#1)

Presented at Transforming Children's Health Care - Together: 2014 Organizational Transformation Conference Poster


Nan Peterson, MS, RN, Director, American Family Children's Hospital
Amy Mihm, MS, RD, LAT, Clinical Nutrition, American Family Children's Hospital
Emily Wallace, MS, RD, CNSC, Clinical Nutrition, American Family Children's Hospital


  • Identify the process for assessing healthy food choices
  • Formulate a plan for improving the hospital food environment
  • Plan for evaluation of the new food venue


As a children's hospital, we see the consequences of preventable diseases. As a leader in the pediatric community our goal is to serve children and families, enabling them to achieve optimum health and not to contribute to the problem by serving unhealthy food and beverages.

Initiative Description:
Through the collaboration with our Children's Hospital Association FOCUS on A Fitter Future hospital colleagues, we gained the expertise and leverage to initiate change in our cafe. Utilizing the CDC food and beverage assessment pilot tool, we were able to obtain baseline data to determine we were not “healthy” in our choices for patients, families, visitors and staff. A complete remodel of the area was required in order to provide healthy food and beverage choices. The process required hospital leadership support, the development of an entirely new menu, collaboration with the physical plant staff for the renovation and budgetary resources. The organizational infrastructure required to implement the changes included marketing and public affairs, culinary services, wellness, patient and family advisory council and staff councils.

We built a partnership with REAP, our local "Buy Fresh, Buy Local" food group that connects farmers and purveyors with restaurants and schools. We were the first "farm-to-hospital" for our region. The whole concept reflected a major culture shift for our organization.

Results/Outcomes or Potential Results/Outcomes:
Because of the changes we made, all food and beverages at the new café meet “My Smart Choice” recommendations, which are based on national guidelines and incorporate best practices for product choices, placement, promotion, purchasing practices, preparation and portion size. We removed all sugar-sweetened beverages from this location and added a children’s menu. Data from the summer of 2012 (prior to the remodel) will be compared with August 2013 data obtained post-remodel, including financials, menus and marketing promotions.

Lessons Learned:

  • Leverage the work of others and utilize best practice resources
  • Communication, communication, communication
  • Leadership support is critical
  • Once you make a big change, don’t underestimate the follow-up required. For us, some examples:
    • Consistency of following the menu
    • Efficiency in making each salad and sandwich fresh vs. pre-made grab-n-go
    • On-going training needs of staff
    • Moving forward, keeping it fresh as a destination.

Prior to change, we did not complete a formal evaluation of customer satisfaction for comparison. Pricing strategy not embraced at this time.

Stretch goals for next year:

  • Vending
  • Inpatient meals
  • Family meals
  • Increasing physical activity options for parents and caregivers
  • Healthy food choices at meetings and celebratory events