Rudi Keyser’s daughter was treated for cancer at Great Ormond Street Hospital (GOSH). He tells us how a decade later, as its Interim Head of Catering, he implemented an innovative app to help young patients to eat.
In 2011, my then 18-month-old daughter always seemed to be poorly. Despite numerous GP visits, we were told it was simply seasonal colds/flu. However, eyebrows were raised during a visit to her paediatrician, and a few days later, she was diagnosed with acute myeloid leukaemia. This began a six-month stay at GOSH, where 10 years later, in November 2021, I became Interim Head of Catering. It was, and still is, an organisation I hold very close to heart.
I decided to build a new system which would allow patients to order food when hungry, with the aim of delivering freshly cooked food within 30 minutes from order - within their own ‘appetite window’.
I spent my first few weeks observing how the catering service worked. The kitchen and catering staff were brilliant in so many ways, though the feedback around food was often negative. I also observed that the food provision hadn’t changed since my daughter had been discharged. During her stay, I’d bought into the idea that young patients on chemo don’t eat because of flavour profiles changing, but during my chats with patients, parents, dietitians and ward staff, it dawned on me that the issue wasn’t only about this or poor food choice, but also about mealtimes.
Hospital catering has been burdened with getting lots of food out at specific times throughout the day, causing service bottlenecks. This resulted in hot meals being served cold, or delivered hot to a patient who wasn’t hungry at that time, so the meal was left at the end of the bed. By the time the patient lifted the lid, the meal wasn’t very appetising.
I decided to build a new system which would allow patients to order food when hungry, with the aim of delivering freshly cooked food within 30 minutes from order - within their own ‘appetite window’. Over nine months, I implemented a basic food-ordering system. I had an ever-changing list of patients, generally referred by dietitians, identified as struggling with food choices or flagged for not taking in enough calories.
Each day, I’d do my ‘rounds’, asking patients what they’d like to eat and, more specifically, when. The answers were simple. Teenagers and young adults don’t want dinner served at 5pm. They want dinner around 7pm and love a ‘takeaway’. So, that’s what we did. My fantastic team made deliciously dirty burgers and cheesy, saucy loaded fries, sweet and sour chicken noodles, fragrant curries and more! These were all delivered by hand, in a brown paper bag in a takeaway experience.
I remember the first patient, a teenage boy, on his third round of chemo. He was losing weight and refusing to eat. After his first personalised ‘dirty burger’, his mum said he’d have “eaten the wrapper”, had he been able. A teenage girl, really struggling with treatment, set us challenges every day. It was a highlight for her and for me, seeing her eyes light up every time we took her order or delivered her food.
By the time we got signed off to run a ’proof of concept’ for my food app, my team was well-drilled in tweaking orders and running food directly from kitchen to bedside. The app was so simple in its complexity. Think Deliveroo, but for hospital! Each bedside was given a QR code, linked to the patient’s dietary requirements which could change daily. The patient, parent or team member could scan the QR code, and a menu, dynamic to the patient, would be populated. We rolled this out across six wards, for six weeks, offering tailor-made meals to patients and even parents, too! The findings were overwhelmingly positive and the GOSH innovation team concluded the app should be rolled out permanently. The concept was also submitted to Public Sector Catering Awards for Best Innovation - and won!
From Contact magazine issue 101 - Winter 2023
