Think Global Act Local: Churchill Fellow Dr Jorja Collins is working to make hospital foodservices green and healthy.

By Dr Jorja Collins

The Churchill Fellowship is an internationally recognised award that empowers Australians to explore international best practice and innovation that can be applied in Australia. 

We are proud of Monash Nutrition Senior Lecturer Dr Jorja Collins who was awarded the 2019 Churchill Fellowship.

Working as a foodservice dietitian at Eastern Health and a Monash University lecturer and researcher in foodservice and sustainability, Jorja is aware of how ‘usual care’ in foodservice and healthcare is contributing to the planetary health crisis. Jorja is working towards creating change within her sphere of influence. The motto of the Winston Churchill Memorial Trust, which awards and funds these prestigious fellowships in memory of Sir Winston Churchill, is ‘travel globally, inspire locally’.

Today, we sit down with Jorja who shares her experience travelling to the United States to explore strategies to improve the environmental sustainability of hospital foodservices.

What did you find?

Over eight weeks (Feb – Mar 2020, pre-COVID-19) I visited 12 hospitals across the US that had won awards for environmental excellence to learn about: 

• How their sustainable foodservice practices worked
• Barriers and enablers to successful uptake, implementation and maintenance 
• The features making these hospitals leaders in sustainability

I toured hospital kitchens, dish rooms, wards, waste areas in the loading docks, onsite food gardens, teaching kitchens, ‘pantries’ providing food relief and power plants. I saw the ‘room service’ model of foodservice, where people call up to order their food and it is cooked fresh on demand, and even robots delivering food. I saw food waste being donated, composted and dried out, and learnt about methods and tools for measuring food waste. I visited local farms and food companies that supplied food to hospitals and heard about how having a contract with a hospital provided secure and significant income to improve the livelihoods of these businesses.

Visiting a poultry farm that supplies
chicken and eggs to the hospital down the road.

I met with people in senior roles who explained how hospital values and leadership were critical for success. These hospitals believed they have a responsibility to the community to invest in public health, health promotion and sustainable food systems and healthcare. This differs from the lens of healthcare in Australia, which largely focuses on acute clinical service delivery. All of the hospitals employed someone whose full-time job was hospital sustainability and there were clear policies, KPIs, governance structures and working groups of ‘green champions’. Hospitals were members of Health Care Without Harm, an organisation that runs programs to support hospitals to be more sustainable. This gave hospitals access to case studies and toolkits, networks for information sharing, while the annual awards system generated the incentive to set goals, capture data and carry out continuous improvement. I observed cultural factors and legislation that were instrumental in shifting behaviours to be more sustainable. For example, sending food waste to landfill is against the law in the state of Washington which means composting is second nature and infrastructure exists to enable it.

Waste segregation was common throughout
hospital wards, cafeterias and foodservices

What can we learn? 

In my full report, I documented over 20 case studies of sustainable practices occuring in foodservice that we can learn from. Waste management practices and food procurement approaches are priority areas for change due to their scale and impact.. We can optimise cultures, practices and structures to support the implementation and maintenance of environmentally sustainable foodservice initiatives in Australian hospitals by:  

1. Having a sustainability committee in every hospital, with foodservice and nutrition having a seat at the table.
2. Hospitals and healthcare organisations signing up to Global Green and Healthy Hospitals.
3. Healthcare and foodservice standards extending their scope to include environmental sustainability.
4. Beginning a new narrative that values hospital food and hospital foodservice, and gives public health nutrition a place in hospitals.
5. Measuring and sharing information about the outcomes and feasibility of environmentally sustainable hospital foodservice strategies and foodservice models, to inform smarter decision making.

What happened next? 

The impact I have been able to make in my work as a foodservice dietitian, a lecturer and a researcher has undoubtedly been influenced by the findings of this fellowship and the status that comes from being a Churchill Fellow. At Eastern Health we have installed a new waste machine at Box Hill hospital to turn food waste into energy, we have created a new position for a ‘Sustainable Food Systems Dietitian’ - the first of its kind in Australia - and we are working towards signing up to be a member of Global Green and Healthy Hospitals. The research my team and I are conducting helps us to understand what best practice looks like and how we can achieve it. We have explored staff and patient perspectives, the pillars of institutions that support change, captured how hospitals are diverting their foodwaste from landfill, developed a consensus based tool to measure food waste (figure 1) and audited where hospital food comes from. I have published 12 research papers with 6 more underway and have presented at conferences to dietitians, nurses and midwives and the Department of Health. Our work is influencing policy. The Victorian Government has cited our research to support their recommendations for action on food waste and we are liaising with government departments to ensure our research on where hospital food comes from is factored into new policy on local food procurement.

There is still plenty more work to do, but I am proud of the progress I am making! 

Figure 1: Consensus based food waste audit tool

Read more about Dr Jorja Collins’ fellowship here.

Dr Jorja Collins is a leading researcher in Australia on environmentally sustainable foodservice in healthcare. Her team's research considers food waste, the origin of food, plant based menus and environmental sustainability across the supply chain as a whole. Jorja received a prestigious Churchill Fellowship and she spent 2 months in the US in 2020 visiting hospitals who have won awards for environmental excellence to learn about the green strategies they have implemented in foodservice and how these lessons can be applied in Australia. She is an advanced accredited practicing dietitian, and has 10 years of experience working as a clinical dietitian, a foodservice dietitian and an educator. Jorja was awarded the Dietitians Australia Young Achiever award in 2019 which recognises her leadership in the dietetics profession.

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