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TABLE 1

Roadmap of Program Design and Stakeholders

PlanningStepsPartner (Role)BarriersResolution
Decision to develop SFSP site in clinical areas at CHOP Determine opportunity for clinical location Office of Community Relations and Government Affairs (convener) Establishing partner in clinical setting Clinical champions of the program identified in the ED 
 Partner with regulatory bodies Pennsylvania Department of Education (oversight) and USDA (funding agency) Determining opportunity for a closed program site (available only for patients and/or siblings) and establishing a plan for food source and communication with regulatory bodies Closed site established and decision made to partner with community agency with experience administering SFSP 
 Reconcile any conflicts of interest with hospital food services Hospital food services Potential concern regarding profit margin Partnership in an effort to address food insecurity among patient population 
Organization of clinical site Establish clinical site buy-in ED leadership, clinical champions (members from nursing, nurse practitioner group, physician group, and child life specialists), and environmental services (trash collection) Concerns regarding allergies, choking hazards, waste management, and length of stay Establishment of age limits in program, clearly marking ingredients, and verbal disclaimer to caregivers; partnership with environmental services to ensure frequent trash collection during program operation; and time-limited pilot period during low-volume hours 
 Determine food purveyor NDS (community partner, food provision, communication with state and/or federal regulatory bodies, staff training) — — 
 Train staff NDS and clinical champions Biases in meal ticket distribution Education that all children (ages 2–18) are eligible if not NPO, Career Path interns provided nursing staff with daily reminders of program operation and patient eligibility, screensavers on patient-facing computers encouraging caregivers to ask about the program; and multiple clinical champions present during hours of program operation 
 Determine staffing Career Path (staffing) — — 
 Determine food storage Facilities (provision of dedicated refrigerator) Concerns regarding infection prevention and food theft Dedicated program refrigerator in locked room 
 Establish flow diagram of program operation ED leadership, clinical champions (members from nursing, nurse practitioner group, physician group, and child life specialists), hospital security (food delivery), and Career Path (staffing) Concerns regarding flow of operations and ensuring hallways are clear and families stay in the room for the duration of patient care Delivery of food by interns to individual patient rooms (Table 2) 
 Establish plan for extra food and/or returned components of meals Fostering Health Program (recipient of surplus food) and clinical champions Ensure expired food is discarded before donation Clinical champions discard expired and/or perishable food before donation 
PlanningStepsPartner (Role)BarriersResolution
Decision to develop SFSP site in clinical areas at CHOP Determine opportunity for clinical location Office of Community Relations and Government Affairs (convener) Establishing partner in clinical setting Clinical champions of the program identified in the ED 
 Partner with regulatory bodies Pennsylvania Department of Education (oversight) and USDA (funding agency) Determining opportunity for a closed program site (available only for patients and/or siblings) and establishing a plan for food source and communication with regulatory bodies Closed site established and decision made to partner with community agency with experience administering SFSP 
 Reconcile any conflicts of interest with hospital food services Hospital food services Potential concern regarding profit margin Partnership in an effort to address food insecurity among patient population 
Organization of clinical site Establish clinical site buy-in ED leadership, clinical champions (members from nursing, nurse practitioner group, physician group, and child life specialists), and environmental services (trash collection) Concerns regarding allergies, choking hazards, waste management, and length of stay Establishment of age limits in program, clearly marking ingredients, and verbal disclaimer to caregivers; partnership with environmental services to ensure frequent trash collection during program operation; and time-limited pilot period during low-volume hours 
 Determine food purveyor NDS (community partner, food provision, communication with state and/or federal regulatory bodies, staff training) — — 
 Train staff NDS and clinical champions Biases in meal ticket distribution Education that all children (ages 2–18) are eligible if not NPO, Career Path interns provided nursing staff with daily reminders of program operation and patient eligibility, screensavers on patient-facing computers encouraging caregivers to ask about the program; and multiple clinical champions present during hours of program operation 
 Determine staffing Career Path (staffing) — — 
 Determine food storage Facilities (provision of dedicated refrigerator) Concerns regarding infection prevention and food theft Dedicated program refrigerator in locked room 
 Establish flow diagram of program operation ED leadership, clinical champions (members from nursing, nurse practitioner group, physician group, and child life specialists), hospital security (food delivery), and Career Path (staffing) Concerns regarding flow of operations and ensuring hallways are clear and families stay in the room for the duration of patient care Delivery of food by interns to individual patient rooms (Table 2) 
 Establish plan for extra food and/or returned components of meals Fostering Health Program (recipient of surplus food) and clinical champions Ensure expired food is discarded before donation Clinical champions discard expired and/or perishable food before donation 

—, not applicable.

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