To explore strategies to improve the environmental sustainability of hospital foodservice

Aims

This Churchill Fellowship explored strategies to improve the environmental sustainability of hospital foodservices. Over eight weeks (Feb – Mar 2020, pre-covid19) I travelled through the United States (US) and visited hospitals leading the way in environmentally sustainable hospital foodservices and healthcare. The aims were to:

• Identify current and planned environmentally sustainable practices in hospital foodservices and describe how they work.

• Explore barriers and enablers to successful uptake, implementation and maintenance of environmentally sustainable practices in hospital foodservices.

• Identify common features of healthcare organisations that are leaders in sustainable healthcare.

Findings

Twenty four case studies were produced that showcase specific environmentally sustainable hospital foodservice initiatives. These describe what they are, how they work, the resources required, the benefits, limitations and lessons about implementation. They relate to:

• Waste management strategies

• Local food supply

• Energy and water

• Foodservice system design

• The menu

Eleven themes were identified, which describe factors that enable sustainable practices in foodservices and healthcare in the US:

1. The scope of ‘hospital foodservice’ includes patient feeding and retail foodservice, providing the scale and flexibility required for sustainability initiatives to occur.

2. Hospitals view themselves as powerful players in food systems and public health.

3. Foodservice and nutrition departments were closely connected and well-staffed, enhancing capacity for sustainable practices.

4. Funding from multiple sources was available for sustainability initiatives in hospital foodservice.

5. State and local legislation and regulation promote sustainable practices in hospital foodservice.

6. Identity and culture were drivers of change.

7. It takes a team of people to make environmentally sustainable changes happen in a hospital.

8. Sustainable practices were communicated widely, serving as a teaching tool and a marketing tool at the same time.

9. Sustainable hospital foodservice and sustainable healthcare were not framed using an environmental and climate change lens.

10. Networks of communication allowed for information sharing of best practices across organisations.

11. A competitive awards program for environmental sustainability led to goal setting, action, reflection and evaluation.

Recommendations

Waste management practices and food procurement approaches are priority areas for change, and specific actions are proposed for divert waste from landfill and increasing procurement of local food.

Suggestions for optimising cultures, practices and structures to support the implementation and maintenance of environmentally sustainable foodservice initiatives in Australian hospitals include: 

1. A sustainability committee exists in every hospital, and foodservice and nutrition has a seat at the table.

2. Hospitals and healthcare organisations sign up to Global Green and Healthy Hospitals.

3. Healthcare and foodservice standards extend their scope to include environmental sustainability.

4. A new narrative begins that values hospital food and hospital foodservice and gives public health nutrition a place in hospitals.

5. Information about the outcomes and feasibility of environmentally sustainable hospital foodservice strategies and foodservice models is measured and shared, to inform smarter decision making.

Now is the time to advocate and create change locally within healthcare organisations in Victoria, Australia, and more broadly across foodservice, healthcare and food systems across the country.