The next step towards environmentally sustainable hospital food: capturing the perspectives of those working at the forefront
By Stefanie Carino
We know that hospital foodservices have a long way to go to become truly environmentally sustainable. Those whose job it is to procure food, cook hospital meals, deliver food to patients, manage the waste, set policies and allocate funding, hold intricate and valuable knowledge of how things work. They also hold ideas about how things could be better, and are the people who will be responsible to bring about change. So what can we learn from them?
In our research we spoke with 46 individuals at operational and management levels responsible for policy, purchasing, production, onsite plating and delivery, and waste disposal at three hospitals in Victoria. We asked three questions – what are the current sustainable practices; what are their barriers and enablers; and what do they recommend for change?
This research is novel because the literature to date which has sought to capture the perspectives of staff working in foodservices has focused on specific areas, such as food waste or food procurement. (Read more about our systematic literature review via our blog here) Instead, we aimed to capture a whole food supply chain perspective, from food purchasing through to waste disposal.
So what did they tell us?
In terms of practices, there was effective equipment, technology and processes in place that were seen as sustainable. For example, there was little waste in food production due to the efficiency of ordering and production systems in place. However, there was a heavy focus on food waste, food left on patients’ trays, and poor waste segregation. This meant that food waste and packaging often all went to landfill together. There was little known about where food was sourced.
There were several facilitators for positive changes in foodservices such as committed individuals and working groups going against the grain and pioneering sustainable changes in the hospital. Audits raised awareness on food waste, and education efforts on recycling meant this was done well in kitchens. Quality improvement processes highlighted areas for change that had a financial benefit but also environmental benefit, such as ensuring oral nutrition supplements were ordered only when necessary and likely to be consumed. But barriers that were inhibiting change were the many competing priorities juggled by hospital workers, as well as insufficient communication, such as between wards and kitchen, and training opportunities for staff. The time between patients’ ordering their food and meal delivery meant that there were high rates of food waste. Although a desire for local food was apparent, this was restricted by the set contracts and guidelines in place for hospitals to operate under.
So what do they think is needed?
It was clear amongst those we interviewed that they desire change. As described by one participant:
“I think we need to change our attitude to what is acceptable and organic waste should not be going into the compactor and general waste (to landfill) due to the damage it does.”
They suggested an array of practice changes in how food is ordered, processed and delivered to patients. Many referred to the room service model as a way to provide patients with the food they want when they want it, to minimise waste, improve intake and satisfaction of patients. This has been rolled out in the Mater hospitals in Brisbane, which saw an increase in nutritional intake and satisfaction, and a reduction in plate waste and meal costs. Staff interviewed desire more audits, projects and training opportunities to increase knowledge on the issue, for those working on the ground as well as in leadership positions. Although they accepted responsibility for contributing to solutions, they highlighted the need for dedicated leadership and policy support to provide direction and guidance. There was a recommendation that hospitals reconsider how they market food to patients, and become more transparent in where food is sourced, prepared and how waste is managed, as a way to educate patients on sustainable food practices as well. As described by one participant,
“We’re a huge organisation who has a big impact and we also then demonstrate, well we have the opportunity to demonstrate, behaviours to a lot of people from different walks of life who come through and if we’re demonstrating that’s what we do here and if we can do it here on a big scale then other people can do it. It’s not just about the effect we’re having but it’s about the message we’re sending.”
Our next steps in the transition to a sustainable hospital foodservice must have a focus on effective leadership and policy, and must collaborate with those working in the system daily. If hospital foodservices were to become environmentally sustainable we would see an array of financial and social benefits, and hospitals would be able to reposition themselves as leaders in a sustainable food systems.
More information
Stefanie Carino is an Accredited Practising Dietitian and PhD candidate in the Department of Nutrition, Dietetics and Food at Monash University. Her research focuses on exploring the environmental sustainability of hospital food services. You can follow Stefanie on Twitter via @StefanieCarino.
Jorja Collins is an Advanced Accredited Practicing Dietitian who works in foodservice at Eastern Health and as a lecturer and researcher in the Department of Nutrition, Dietetics and Food at Monash University. She was awarded a Churchill Fellowship to explore environmentally sustainable hospital foodservice. You can follow Jorja on Twitter via @Jorja_Collins.
Shirin Malekpour is a Senior Lecturer at Monash Sustainable Development Institute. She develops and leads interdisciplinary research on planning and governance for sustainable development. You can follow Shirin’s team on Twitter at @MonashMSDI.
Judi Porter is a Professor in Dietetics at the Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University. You can follow Judi on Twitter via @JudiPorter_.
Stay up to date with the Monash University Department of Nutrition, Dietetics and Food on Twitter via @MonashNutrition.
Publication information
Reference: Carino S, Collins J, Malekpour S, Porter J. Environmentally sustainable hospital foodservices: drawing on staff perspectives to guide change. Sustainable Production and Consumption (2020), DOI: https://doi.org/10.1016/j.spc.2020.08.003
Click here to access the paper published in Sustainable Production and Consumption.
Sustainable Production and Consumption is a Q1 ranked journal, with an impact factor of 3.66.
All images sourced from Unsplash.
