As harvest season approaches, we’re checking in on the Can Grow Garden, part of the Nemours Estate in Wilmington, Delaware. This encore episode was originally recorded for the Champions for Children series.
The Can Grow Garden is a collaboration between the Nemours Estate and Nemours Children’s Hospital, Delaware, to grow plants and provide a place for patient, family, and associate education and respite. The grown plants – mainly vegetables – provide food for the community helping to alleviate food insecurity and providing a platform to teach healthy cooking and eating. For more information about the Can Grow Garden, contact Judy Lieberman.
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Carol Vassar, producer and host
Ken Darcey, Gardens and Grounds Manager, Nemours Estate
Annie Thomas Bubel, Learning and Programs Coordinator, Nemours Estate
Judy Lieberman, Director of Volunteer Services and Auxiliary, Nemours Children’s Hospital, Delaware
Cindy Bo, Senior Vice President, Delaware Valley Strategy and Business Development, Nemours Children’s Health
Well Beyond Medicine Episode 28, Transcript
Carol Vassar, podcast host/producer (00:00):
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar. And now that you are here, let’s go.
As Harvest season approaches, we’re checking in with an encore episode from our Champions for Children’s series about the Can Grow Garden, which is part of the Nemours Estate in Wilmington, Delaware. The Can Grow Garden is a collaboration between the estate and the Nemours Children’s Hospital, Delaware, to grow plants and provide a place for patient, family, and associate education and respite. The cultivated plants, mostly vegetables, provide food for the community to help alleviate food insecurity and lessons on healthy cooking and eating. Here to talk about the Can Grow Garden is Judy Lieberman, director of Volunteer Services and the Auxiliary at Nemours Children’s Hospital, Delaware. Ken Darcey, the Gardens and Grounds Manager for the Nemours Estate in Wilmington. Annie Thomas Bubel, Learning and Programs Coordinator for the Estate, and Cindy Bo, Nemours Senior Vice President for Strategy and Business Development. The Nemours Estate, on which the hospital sits, has a long history of horticulture and agriculture, and that’s where the story begins. Here’s Ken Darcey to provide some history that leads directly to today’s Can Grow Garden.
Ken Darcey, Nemours Estate and Gardens (01:44):
Our founder, Alfred DuPont, did his estate, his house, and gardens here in Wilmington, Delaware, around 1909, 1910, and continued to build that property out until his death in 1935. At which point he had left a will that established that the property was to be left for the enjoyment of the public as well as on the property itself, a hospital for children was to be constructed. His wife at the time, Jesse DuPont, the good story there is she didn’t have to do anything until she had passed, but she felt it was so important to make this happen that she had the Alfred DuPont Institute open within five years after Alfred’s death.
And that work continued for several decades and a big part of Jesse’s interaction between the original estate, which was a self-sustaining garden, farm. They grew their own vegetables, they had their own crops, was bringing a lot of that to the kids that were in the hospital at the time. There was a lot of activity, a lot of historical records of those interactions. And then, as time went on after Jesse passed in 1970, the two entities began to kind of separate and individualize a little bit between the estate and the hospital, through nobody’s fault. Just these things happen.
So I was on board in 2014, and right around 2015, we had a lot of staff changes on both sides of the fence, so to speak. So we started working, I know I started working, my team and I with Weight Management, was the name of the department at the time, to really try to brainstorm how we can get back to some of those interactions. And that’s how the concept of Jesse’s farm came about. And that was this idea of bringing agriculture gardening to the children of the hospital in some way, shape, or form, and what does that look like?
And those ideas have kind of molded and kind of formed into where we are now, which is the Can Grow Garden, which had first took place in a courtyard in the middle of the hospital with the intention being we were going to bring produce and ways that you can grow fresh food yourself to patients in the hospital who might not know what any of this stuff even looks like, let alone how accessible it could be and how easy it could be to grow it even if you didn’t have a yard or a soil or anything like that.
So that was the beginning of the process. It has been a lot of bumps and valleys to get to this point, but we’re excited to be at this point in time now.
Carol Vassar, podcast host/producer (04:15):
Judy, I’m going to hand it off to you. Give me the vision for the Can Grow Garden presently.
Judy Lieberman, Nemours Children’s Health (04:22):
The Can Grow Garden is really an interpretive and innovative destination for our patients and families as well as our associates. We’re looking at it as an opportunity also for wellness. When the gardens are planted, it’s right outside of patients’ rooms, and the energy that happens is really exciting as people begin to walk through each of these beds. The other side of it is actually pulling together these different departments and actually having a holistic way to provide programming and education, and nutrition in a very easy and fun way of presenting the garden.
Carol Vassar, podcast host/producer (05:00):
Now, Cindy, the vision for Can Grow Garden is multilayered. It pulls on the history of Jesse and goes back to when the DuPonts lived on the estate itself. It includes partnerships both inside of Nemours and outside with community organizations. Talk about the purpose of Can Grow Garden from the perspective of community health objectives such as alleviating food insecurity.
Cindy Bo, Nemours Children’s Health (05:27):
Yeah, absolutely. Really, the connection to purpose of our Can Grow Garden brings to life many different aspects. Of course, the rich history that was referred to, as well as the integration of all the resources that we have across Nemours Children’s Health. That’s everything from value-based care to care delivery, to patient excellence, to child life, and so forth and so on. And so that integration allows us to locally and regionally address some of the issues that are really impacting our patients and families.
So, we call those social determinants of health, one of which is food insecurity. And so when we think about the purpose of our Can Grow Garden, we look to address some of those social determinants of health, like food insecurity. Our goal is to really play a key role in population health. And so when we think about our Can Grow Garden, it is not only to be an interactive, innovative space for our patients, families, and associates, it’s also to be able to address some of these larger aspirational goals as it relates to transforming population health.
Carol Vassar, podcast host/producer (06:38):
And as we just talked about, engagement is certainly a key pillar of this project. Talk about engagement what that looks like with patients and families. Annie, I’m going to go to you for this one.
Annie Thomas Bubel, Nemours Children’s Health (06:51):
Sure, absolutely. We want to be an educational resource, and we also really want to kind of function as place-making. We want this garden to be a special place and to use the programs as a gateway that kind of gets people outside into the garden, helps them feel ownership of the plants that they might see from their hospital room, and feel excited about spending time outdoors.
Patients can use the space as a special place for healing, both emotionally and physically. There was a case where I saw an occupational therapist using newly harvested eggplants instead of tennis balls to practice hand-eye coordination and catching skills, which was really amazing to see. We had a patient who spent the hour that she was nervously awaiting a study, a sleep study, to paint pollinators in the garden with her mother instead of sitting in a waiting room indoors, which hopefully helped to calm her anxieties and to help her and her mother spend some nice time together.
And I think one of the best things that happened last year was our fantastic harvest party that we held in September. So, for the first time since the onset of COVID-19, inpatients had a real opportunity and engaging experience of stepping outside, enjoying the beauty of the vegetable garden, and we were able to work with infection prevention and allow patients to dig in the beds and pull up potatoes and sweet potatoes and carrots and peppers and tomatoes and more.
And really, this is a group project. We could not have done this without all of the different stakeholders here. The Department of Child Life has been extremely instrumental. Sarah Narimanian, who was not able to be here, really helped to organize the party, helped to get the patients out of their rooms, and to be able to spend time there. And we saw patients spend hours in the garden, which was just lovely to see. The school program and the rehab program, whose windows actually overlook the gardens, have started to get really involved and invested as well. And we’re really hoping to continue all of that in the coming year.
Carol Vassar, podcast host/producer (09:08):
Community organizations are part of this, right? Talk about the community organization, community members who are coming to the fore and taking part in all of this.
Judy Lieberman, Nemours Children’s Health (09:19):
We’re really, I think, just building those connections right now. We are looking outside of the hospital and trying to connect with other organizations that are using food for the healthiest generation. The other day, our team met with a group of leaders from a school district that also has healthy food for healthy kids and seeing if there are ways for us to partner.
So this is just a way for us to begin to build as we are developing our programs here at the hospital. The other thing that we’re looking to do is creating a template. This is what Ken and his team are working on that we can extend this out to our practice sites and how can we provide this education because we’re a large system. How can we create this model that people can use elsewhere in the organization?
Carol Vassar, podcast host/producer (10:12):
Ken, talk about that a little bit. That sounds like there’s some growth in taking this to the practices, maybe even taking this to the Florida division. Talk about that.
Ken Darcey, Nemours Estate and Gardens (10:22):
Absolutely. I think that it was kind of a goal of ours at the very beginning of it, and going all the way back, we had to have those hard discussion of what we are and what we can do. To go back to Cindy’s point of addressing the food insecurity issue, we are not a hundred-acre farm, and we never will be. There are certain benefits that we are very unique. We’re pretty confident we’re the only organization, at least in the country if not the world, where we have a world-class public garden, a horticultural resource, and a world-class children’s hospital right on the same campus. So, to not take advantage of that it would be a shame, but then be able to say, well, what can we do, and how can we address the food insecurity issue in addition to all these other issues?
And what we’re trying to do is make it where it can be picked up and moved. And then, from that standpoint, we can impact way more people with our resources and our tools and our talents than if we were to just go to a farm and turn over a hundred acres of cropland. And to that point, once we made that decision and everything else kind of gelled, well, at that point, yes, we can move it to an offsite location, we can bring it to the Florida location, we can bring it to a third party.
And now, in addition to that and keeping it this flexible kind of program, therapeutic services can come in and take advantage of this space. We have learned that every division and department in the hospital is now thinking through new ways that they can engage with the space, which now, as you go out and move to all these different satellite locations, we can show them, “Well, this is how therapeutic services use the space. This is how a nutrition education use the space.” And then they can say, “Okay, well, that makes sense for our location. Let’s go ahead and move forward that.” And now that spreads much quicker than if we were just growing corn out in the middle of the field.
Carol Vassar, podcast host/producer (12:17):
Cindy Bo, Nemours Children’s Health (12:18):
So, one of the things that we started to think about when we did the planning originally is how to spread and scale the concept. Because one of the things that we are cognizant about is that it doesn’t necessarily have to be bound to this particular campus. So with the thoughtful planning, we had always wanted to spread and scale into other sites, whether they be our ambulatory sites, our primary care locations, or specialty care locations where we have a large site like at Deptford in New Jersey, we could possibly put a garden there. Or it could be at a partner site when we are talking to our partners where we have a good presence, whether it’s on the specialty care side, inpatient, or it could be even covering for, let’s say, the NICU.
So I think it’s important for us to recognize that when we’re thinking about spreading and scaling the concept, it could be anywhere with the thought process that we can reach as many associates, patients, and families.
One of the other things I wanted to mention is that originally, when we think about what this is, while we will not be a hundred-acre farm, not yet, at least, the concept of the FARM, actually the acronym is used in our planning. So that’s incorporation of our families, agriculture, research, and medicine. Those principles, using that acronym FARM, allow us to really be thoughtful about no matter where we are physically, we can still apply those guiding principles to expanding and developing a small garden, large garden or to be able to reach those purposes that I just talked about.
Carol Vassar, podcast host/producer (13:58):
I’m glad you mentioned the word research because I’m curious as to what kinds of research you see or maybe are conducting already in association with this project. Annie, I’m going to go to you for this one.
Annie Thomas Bubel, Nemours Children’s Health (14:11):
So, on the estate side, we’ve actually started research that we think could absolutely apply to the Can Grow space as well. So, we are starting down a research journey in collaboration with a researcher at the University of Manchester Metropolitan in the UK. Basically, this research is trying to answer a really complex question. Can we prove that visiting a garden really affects health-related outcomes?
So I think we all know anecdotally that when we go to a garden like the one at Nemours Estate or the beautiful vegetable garden, Can Grow Garden, it makes us feel better. But to be able to quantify that feeling and to kind of get a real data sense of what that means can really help us to communicate with the medical side of the fence to say, “Yes, this proves that we are affecting the feelings of people after they visit.” That it’s maybe reducing stress, maybe helping them emotionally, all those sorts of things. So Nemours Estate is part of a pilot study with a few select prominent properties, including Chatsworth House in the UK, Biltmore Estate in Asheville, North Carolina, and I believe Fallingwater as well, in Pennsylvania.
We are hoping to gain more research on that and kind of apply that same mentality to the Can Grow Garden. Our preliminary report proved that visitors’ emotional well-being, positive functioning, vitality, and social well-being were improved, and we’re continuing to gather research on that. We’ve only done one year of that so far.
Carol Vassar, podcast host/producer (16:01):
One of the major benefits is the food that actually comes from all of this. I’m wondering, A, how much food you’ve been able to produce so far, if this is the first year, if you have any sense of how many pounds? And then B, where is this food going, ultimately?
Ken Darcey, Nemours Estate and Gardens (16:20):
I can address that. So, there’s a two-prong output for the program. The first is not quite food per se, but we grow anywhere between a thousand to 1,500 tomato plants that actually just get handed out to patients and families as they leave the hospital. Free of charge, a little bit of information on how to take care of them. It was one of those early solutions we came up with. We were trying to struggle with the legalities of handing food, and the workaround there was like, “Okay, let’s just hand out a tomato plant, and they’re going to grow their own food.” And that was massively successful. So that is the first prong of the program that is this really great output that we get really great feedback on, and we know is paying off down the line, not only with the knowledge and the education of growing food but also the food output that they come themselves.
The garden output itself has varied. Four hundred pounds a year, a thousand pounds a year. It hasn’t been a huge amount. We don’t label ourselves a production garden. We really are using it as a template for all of these other activities for education, interpretation, and engagement. But the food that we do produce goes to the same outlet at the hospital entrance, where patients and families are just welcome to grab it as they go. Every once in a while, we’ll run into a larger output. We have worked with the food bank in the past for big harvests of things. However, we have some new channels being laid in place right now to get it to some of our more satellite locations.
Carol Vassar, podcast host/producer(17:55):
One of the things that we talk about here at Nemours is going well beyond medicine. This is clearly an example of that. Dive deep into why this is an example of that. Judy, I’m going to start with you.
Judy Lieberman, Nemours Children’s Health (18:10):
Each person that is on this call does a tremendous amount of work. I see the garden as a way of being able to pull together that information. Nutrition Services has created all these videos, so we’re now using the garden as a way to be able to promote nutrition services. The estate has a tremendous amount of information on gardening, and so again, we’re using the Can Grow Garden as the tool to be able to communicate educationally how to take this at home, whether it’s your personal home or at a practice site. There’s a tremendous amount of information. If I remember an anecdote from being involved with the garden, I think there’s somebody on this call who created a beautiful garden in her own home as a result of being part of this committee. I think that this is an amazing opportunity to really highlight the work of our associates that have an impact on the greatest generation in keeping kids healthy.
Carol Vassar, podcast host/producer(19:12):
Cindy Bo, Nemours Children’s Health (19:13):
One thing I would add is that there’s an aspect of giving back and knowing how you can go upstream to plant your own food, to produce something beautiful from your own home, from your own space, and then be able to harvest that either for your own family or for others. I think there’s so much to be said around going well beyond medicine when it comes to giving back. Those social lessons that we impart in our kids and children go a long way. The other example is just from my own inspiration, having seen this in my own backyard, literally and figuratively. To be able to build a garden for the neighborhood kids in my area, the 10 or 12 homes with about 18, 20 kids. Having seen that, being exposed to it, knowing that the process itself is a continuous one that gives back to nature and to others, is an important lesson.
And when we think about well beyond medicine, it’s going beyond the walls to serve our communities. And that’s a small way to engage our children to start thinking about that concept. And like I said, the lessons that will manifest themselves over the next couple of years as they grow up are yet to be seen. But if we don’t plant the seed figuratively and literally now, we won’t be able to impart that wisdom in our kids. So for all of the reasons that my colleagues had talked about, in addition to this one, are really the reasons why we want to go well beyond medicine.
Carol Vassar, podcast host/producer (20:43):
Judy Lieberman, Nemours Children’s Health (20:44):
Yeah, I think that truly the Can Grow Garden is an exciting destination. Each year, we’ve built on it by adding different beds. This last year, we added ADA beds and worked with our rehab department with kiddos coming out to actually plant and have their own experience in being able to stand up at something at their level so they could get their hands in soil. And that, I think, brought tears to my eyes to watch that. But it truly is well beyond medicine in so many different kinds of capacities, and seeing anecdotally the people that come out and enjoy the space. Whether they’re visitors or associates or our patients, it truly has become a spot for people to go well beyond medicine.
Carol Vassar, podcast host/producer (21:32):
Cindy Bo, Nemours Children’s Health (21:33):
For our associates, when we ask them to use this opportunity for volunteerism or just for respite, there has been a very well-received emotion and reaction to this. Oftentimes, we’re very busy, especially as you’ve heard nationwide around the surges that have been happening. For our clinical frontline team members, it’s hard to volunteer, maybe off campus. If they’re here on site, they may just walk through the garden, take an hour, create a team activity, what have you, and it allows there to be that reset. That is so important to be able to find small ways to recharge, to feel invigorated, and have that connect to purpose that was originally set when we envisioned the Can Grow Garden. So that’s another aspect that I think we shouldn’t forget about as it relates to our patients and families and our caretakers.
Carol Vassar, podcast host/producer (22:26):
Ken Darcey, Nemours Estate and Gardens (22:28):
And I’ll just even go another step further on that, Cindy. So for the associates in the organization who are kind of maybe hearing this and saying, “Well, oh, I wish we were involved somehow, but oh, it seems like they have it all locked down.” 1000% not the case. If there’s any way your department, no matter how non-tangential you think this might fit with our program, set that to the side and reach out to Judy because we have been surprised and excited at every turn of how we have seen different departments engage with this space in new and exciting ways to improve the lives of the patients and families.
Cindy Bo, Nemours Children’s Health (23:04):
We hope our listeners are actively wanting to participate after this podcast because we can use everybody’s help. It really takes a village to be able to grow something like this together, and we all feel, then, a social responsibility and accountability to one another to be able to serve and really make this flourish.
Carol Vassar, podcast host/producer (23:26):
Thanks for listening to our conversation about The Can Grow Garden with me, Carol Vassar, and our guests, Judy Lieberman, Ken Darcey, Annie Thomas Bubel, and Cindy Bo. The idea of Well Beyond Medicine manifests in myriad ways. How do you see it in your world? Patients, caregivers, and healthcare professionals, let’s hear from you. Leave us a voicemail at nemourswellbeyond.org. That’s nemourswellbeyond.org. While you’re there, check out our other episodes, subscribe to the podcast, and leave a review. Thanks to Che Parker, Cheryl Munn, and Susan Masucci for their help with producing today’s podcast episode. Join us next time as we visit Nemours Children’s Hospital Orlando to speak directly with Nemours Associates on what Well Beyond Medicine means to them. Until then, remember, together, we can change children’s health for good, Well Beyond Medicine.