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Clinical Nutrition

Conquest - Spring 2012

Mohammad Tekrouri and Carol Frankmann are proud of a new kitchen that is devoted 
to room service for inpatients and their caregivers.
Photo: John Everett

Room service part of personalized approach

By Sandi Stromberg

Imagine ordering your hospital meals from a special menu and having them delivered by hotel-trained wait staff. Or, as a caregiver, eating well while supporting a family member.

Imagine a dietitian helping you plan what to eat while you’re in cancer treatment, someone who cares that you’re getting the nutrition you need.

At MD Anderson, you don’t have to imagine.

“Nutrition is an essential part of every patient’s care. And our goal is to provide the best nutrition possible,” says Carol Frankmann, director of the Department of Clinical Nutrition. “Our specialized dietitians and hotel-style room service are two more ways that MD Anderson provides patients with personalized care.”

On the front line

Specialized in oncology-focused nutrition, MD Anderson’s clinical dietitians work closely with a patient’s medical team, assessing nutritional status and collaborating with the physician and team to implement personalized nutrition care.

Julie Hershorn, a senior clinical dietitian,
helps patients with head and neck cancers
who need feeding tubes.
Photo: John Everett

They are stationed in inpatient units, outpatient treatment clinics and at the four regional care centers located in suburban Houston.

Through MD Anderson’s telehealth facilities, they can take part in educational meetings to keep current in the field.

“Depending on which group of patients we work with, we need a totally different set of clinical skills,” says Julie Hershorn, senior clinical dietitian in the department. For 12 years, she worked with patients in bone marrow transplantation. Today, as she has for 14 years, she works with head and neck cancer patients.

“As an example of the differences,” she says, “patients with leukemia, lymphoma or myeloma — or those who have had a bone marrow transplant — experience drug-related side effects, such as nausea, vomiting and diarrhea. We provide special diets for them. Some patients may need a neutropenic diet, no raw fruits and vegetables, because of low white blood cell counts.

“However, head and neck patients sometimes need texture modifications, such as pureed and chopped foods and thickened liquids, because of aspiration risks. Also, for those who use a feeding tube, we provide training for taking care of the tubes and tube feedings.”

For Hershorn, the reward of her job is having a direct effect on patients and their care. “I get to interview patients and give them what they need, then help them manage to move on and heal.”

With other allied health staff, she also helps educate new fellows and residents about nutrition when they come each year.

At your service

In 1998, Frankmann and her staff worked with nurses, volunteers and patient advocates, as well as representatives from three nursing units, to pilot a room service concept. The idea was to imitate what works in an upscale hotel. From the pilot, they developed a model that they took institution-wide in January 2000.

“I came to MD Anderson in late 1999,” says Mohammad Tekrouri, associate director of Room Service. “I had been at the Ritz-Carlton and helped our department implement the program, as well as hire and train the team.”

“Menus are built to meet the needs of the patient at the time they want to eat,” Frankmann says. “That’s the best chance to provide good nutrition. We also are sensitive to cultural and religious traditions around dietary practices. For example, we have no-pork, kosher, vegetarian and vegan menu options.”

Dietetic specialists ensure the menu items are appropriate for restricted diets. Wait staff orient patients to room service and present a menu that is specific to each patient’s diet, along with a guest menu for family and caregivers. Orders are called into a center with trained and scripted employees who can help patients make choices, especially when they have side effects, such as mouth sores or no appetite.

When the chef tries new recipes, Room Service books a tasting session with nurses and patients. “Patient feedback is priceless when building menus and adding special items,” Tekrouri says.

“We serve more than 1,500 meals a day, and it’s all teamwork. Each employee contributes an essential part to make the process flow smoothly so patients receive the fresh, appealing food they ordered within 45 minutes or less, anytime between 6:30 a.m. and 9:30 p.m.,” he says.

Expertise, research, innovative practices

“We have a superb team — an incredible team,” Frankmann says. “Our clinical dietitians and Room Service employees are knowledgeable and passionate about caring for our patients. We’re committed to promoting health and healing through personalized nutrition care. And we all share the same vision: Through excellence and caring for others, we will lead the world in evidence-based, oncology-focused nutrition care.”

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