Hospital’s Covid food waste dilemma
By Nathan Cook APD
Currently Australia is experiencing its 4th wave of COVID-19 and cases are rising. In hospitals, higher level contact restrictions and COVID-19 protocols are being reinstated to support patient care. During the last two years of COVID-19 hospital foodservice systems have been pressured to continue their delivery of a streamlined food service. However, like any hospital department, the foodservice have also experienced interruptions to ‘normal’ operations. One of these impacts has been the increase in hospital food and food-related waste. Hospitals already experience large amounts of food waste, some reaching 2.57kg per bed per day, and the pandemic has only exacerbated this problem further.
For example:
- Increase use of single use items
- Forecasting challenges with unexpected patient
numbers leading to overproduction
- Surplus perishable food prohibited from
reuse/donation
- Reduced food waste monitoring if no electronic menu system is installed due to infection prevention protocols
With the implementation of contact
restrictions and COVID-19 protocols what can we expect food waste to be in
hospital food service systems?
Monash Nutrition’s PhD Candidate Nathan Cook explored the impact of the COVID-19 pandemic on hospital food services, particularly on food waste and the completion of food waste audits. Aggregate food waste audits, which measure waste during food preparation, food plating and after food service, are important in reducing food waste. They guide foodservice systems to monitor waste amounts over time by quantifying waste amounts, standardising data collection techniques, highlighting problem areas or products within the foodservice and obtaining a baseline data point. This quality improvement practice is essential to hospitals who are aiming to reduce their food waste. Without measurement there is no way to understand if they are managing or improving their waste numbers.
In this study Nathan interviewed 20 employees from public hospitals in Victoria, Australia via Zoom who worked directly in, or close to, their hospital's foodservice. The interviews aimed to understand perceived barriers and enablers to conduct routine food and food-related waste audits and gain perspectives on Cook’s previously developed evidenced-based consensus pathway food waste audit tool. All interviews were analysed to locate recurring themes.
Five themes were identified from the interviews:
Impacts on practice
New infection prevention protocols led to the increase of single serve pre-packaged food items and disposable crockery and cutlery. These items, including all leftover food waste in isolation rooms, could not be measured because waste was disposed of in patient rooms. The overproduction of food to cater for family members of COVID-19 positive patients and community members arriving for testing also led to increased food waste.
Labour
Shortages in labour due to high amounts of sick leave and limited student opportunities to be allowed at hospital sites for placements impacted food services’ capabilities to prioritise tasks such as food waste audits. Current staff also quit their role due to the vaccine mandate laws and one hospital reported completing over 300 interviews but not being able hire any applicants due to COVID-19 disruptions. In these instances the lack of manpower increased remaining staff workload and this appeared to magnify the pressure on food service staff.
Change
Due to the COVID-19 pandemic hospital food service practices were forced to adapt and change. For example, temporary pausing of the introduction or continuation of surplus food charity collections, elimination of catering services and ingredient suppliers being out of stock. A positive example to come out of one hospital was the creation of a new role, the ‘ward host’, whose responsibilities were to collect patient orders on the wards and notify the kitchen of changes to patient menu choices. This role had a significant impact on reducing food waste and generated time savings for the food service.
Technology
Technology was viewed as an obvious solution to the contact restrictions and food service delays presented by COVID-19. Implementation of an electronic plate waste measurement strategy was being trialled at one hospital, whereby students used visual estimation to estimate and enter patient food waste percentages into a device attached to the collection trolley before it reached the kitchen. Participants described how the benefits of electronic menu systems were supportive in managing and collecting data that streamlined food service operations, however this technology was not available at all health services interviewed.
Post covid expectations
Some participants were looking forward to the ‘end’ of the pandemic so operations could return to normal, while others were already planning for an expected increased workload in sustainability projects post pandemic and aiming to hire for additional roles in this area.
Regardless of the impact COVID-19 has
had on hospital food services ability to complete food waste audits, food
service staff demonstrated resilience during this time and were able to adapt
to change. Moving forward, seeing the success of
electronic menu management technologies during this time may see them remain as
‘standard procedure’ in food services post-pandemic; future projects may see a
reallocation of resources such as students to implement other food waste
projects rather than standard manual plate waste audits.
Although food waste audits are
disrupted during times of COVID-19 peaks the importance of this task should not
be undermined and is an important project that can be led by hospital
dietitians to power the green recovery post pandemic and support the transition
to sustainable healthcare.
Read more about this research here: https://onlinelibrary.wiley.com/doi/10.1111/1747-0080.12762
By Nathan Cook
Nathan Cook is a PhD student from
Monash University investigating strategies to measure and manage food waste in
hospital food services. His career ambition is to apply a research approach
within hospital food services to reduce hospital food waste. Nathan is an
Accredited Practising Dietitian, Accredited Sports Dietitian, and secretary for
the Dietitians Australia Food and Environment Interest Group.
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