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A Fresh Approach

From Canadian Healthcare Manager Dec 18, 2013

Hospitals and foodservice providers are making great strides in improving patients’ food experience by incorporating ingredients that are healthy, fresh and local


Cue the stereotype. Hospital food is notoriously bad.

Horror stories abound, as an Internet search quickly reveals. In one incident, a vegetarian was served a dinner of cold carrots—and nothing else. Another woman encountered overcooked, bland and mushy food so bad it was “beyond cliché.” Her husband, a former chef, began preparing food at home and bringing it to her bedside.

Hospitals, government, non-profit organizations and foodservice providers are working to improve patients’ culinary experience with healthier meal options incorporating local foods

But things are changing. Hospitals, government, non-profit organizations and foodservice providers are working to improve patients’ culinary experience with healthier meal options incorporating local foods. Result: Improved patient satisfaction and along with it, cost savings realized through reduced waste.

Local, fresh, sustainable

On the foodservice side, there’s Steamplicity. Developed by Compass Group in the U.K. and brought to Canada in 2009 by the company’s Canadian division, Steamplicity uses hospitals’ onsite microwave ovens to steam food using ingredients’ natural moisture. At the company’s Cuisine Centre, in Mississauga, Ont., entrees are prepared on a microwave-safe plate, sealed with a recyclable plastic polymer and chilled.

Ten hospitals in Ontario and B.C. use Steamplicity, according to Sharon McDonald, president of Compass Group Canada’s Morrison Healthcare division. The two B.C. hospitals, Royal Jubilee and Victoria General, prepare Steamplicity meals onsite in mini-Cuisine Centres.

Steamplicity offers 60 meal options—for example, wild Pacific salmon and steamed rice with fresh broccoli florets— developed by Morrison’s executive chef and dietitians. Wherever possible, Compass purchases ingredients that are local, fresh and sustainable, said McDonald.

Royal Jubilee and Victoria General introduced Steamplicity in January, 2012, and since then, patient satisfaction levels have risen dramatically, said Joe Murphy, vice-president, operations and support services at Vancouver Island Health Authority. Organic food waste has fallen to an average of 9,450 kg per month, down from an average of 15,400 kg per month, he said.

Providing healthy patient-menu options is The Fresh and Local Cookbook Developed for Healthcare Foodservices, published in mid-November by Burlodge Canada, a Brampton, Ont.-based manufacturer of retherm systems used to reheat chilled or frozen prepared foods. The cookbook features 79 retherm-friendly recipes for hot dishes and cold items such as salads, sandwiches and desserts tailored to hospitals’ nutritional requirements.

Ethnic flavour added

St. Michael’s Hospital, in Toronto, will be adding a Burlodge recipe—Mexican lasagna—to its patient menus. The lasagna is “unique” and will “add some ethnic flavour,” said Heather Fletcher, interim director of foodservice and patient transport at the 450-bed facility.

During the past two and a half years, the hospital has incorporated healthier foods and now, the “majority” of fruits and vegetables on patient menus are fresh, in-season “when we can get them” and sourced from Ontario, Fletcher said.

In addition, St. Michael’s offers healthier desserts such as fruit, yogurt, mixed-berry crisps and low-fat pudding. “We’ve seen a noted improvement in the amount of food consumed and in food waste,” said Fletcher.

Can order what they want

Also seeing increased patient satisfaction is Capital Health, which services 10 Nova Scotia hospitals.

The menu at Capital Health’s acute-care facilities offers up to eight options for each appetizer, salad, entrée and dessert category, said Jane Pryor, director of operations support. Everything is made from scratch and “all food contracts give preference to local suppliers, where available,” she said. Local foods include meats and in-season fruits, vegetables and lobster.

“There’s less waste because people can now order what they want,” she said.

Baked and grilled over fried

Out west, Alberta Health Services (AHS) has made great strides in recent years to patient menus at its 107 facilities, where food is made on-site.

AHS removed deep fryers in favour of baked and grilled foods, said Heather Truber, director, food safety, menu and supply, nutrition and foodservices. In 2012, AHS introduced Closer to Home, a program allowing facilities to make site-specific changes to dishes to satisfy patients’ tastes, while still adhering to master menus and dietary restrictions, said Truber. AHS is continually working to enhance their menu items by, for example, introducing lemon-dill sauce for fish and offering dried cranberries, which patients can add to hot or cold cereals.

During the past year, AHS has focused on sourcing more Alberta products, which now account for 29 per cent of its food offering (not including produce), up from 24 per cent in 2012, said Truber. Alberta producers supply greenhouse and field peppers, tomatoes, cucumbers and potatoes, grains, in-season fruits and all of AHS’s eggs and beef as part of the organization’s $55-million annual food buy. Truber said the new menu items are generating “positive patient feedback.”

Local product percentage boost

Local products have become a bigger part of the food buy in the St. Joseph’s Health System Group Purchasing Organization following a $65,000 pilot project, bankrolled by the Green Belt Fund, a privately and publicly funded non-profit organization working to increase the amount of Ontario foods in hospitals.

Undertaken between January 2011 and March 2012, the pilot project invited local food vendors to participate in the request for proposal (RFP) process. Now, Ontario products account for $1.5-million of the group purchasing organization’s annual food buy, up from “well under $1-million before the project,” said Wendy Smith, material management analyst in the MEALsource division, which aggregates volumes and facilitates the contract process for its 26 member patient-foodservice operations.

“Our success would not have been possible without the hard work of our partners for this project at My Sustainable Canada.” Smith added. “They first determined the origin of the products originally on contract, aided with reaching out to local vendors who could meet these needs and made the appropriate introductions so that MEALsource could proceed with the necessary vendor education to enable these folks to begin bidding on our business.

“We found that the RFP process was very daunting for local vendors and many did not know that it existed.  As well, there was much work involved in ensuring that the products quoted met the safety and inspection standards necessary for healthcare procurement.  This project has done much to increase the level of competition in our contract process and through that, everyone wins.”

Chef-driven, right from scratch

In 2010, foodservice provider Sodexo Canada, headquartered in Burlington, Ont., introduced chef-driven, scratch-made food at 491-bed Mackenzie Health hospital, in Richmond Hill, Ont., north of Toronto. Making everything from scratch gives the 10-chef team flexibility to alter recipes “literally overnight” to meet dietitians’ requests, says Gay Magrath, a Sodexo employee who works onsite at Mackenzie Health as director of foodservices.

Complementing the food is “high-touch” customer service whereby a Mackenzie Health staff member visits patients right before mealtimes to display the menu on a hand-held device. Patients then make their choices, restaurant-style.

Magrath said that since 2010, food waste has decreased “significantly” and fell by more than 8 per cent during the past year.

Healthy Food in Health Care Pledge

More healthy and local food initiatives are underway. In late 2012, the Coalition for Green Health Care, comprising some of Canada’s largest healthcare associations and environmental groups, introduced its Healthy Food in Health Care Pledge, a framework that outlines steps the healthcare industry can take to improve the health of patients, communities and the environment.

In March, 2013, the Greenbelt Fund launched the Local Food Challenge, which helps eight public institutions (including four hospitals) buy more local food for their menus. They will create new recipes, work with local farmers on education and liaise with distributors on local food suppliers. Supporting the program is the Ontario Ministry of Agriculture and Food and Ministry of Rural Affairs.

Those two provincial ministries, as part of their New Directions Research Program, are funding a three-year, $200,000 pilot project exploring the possibility of growing food on publicly owned institutional land. Developed in partnership with the Coalition for Green Health Care and My Sustainable Canada, a national non-profit group dedicated to helping organizations make sustainable choices, the project launched in September, 2013, at two healthcare facilities, Homewood Health Centre, in Guelph, Ont., and Glengarry Memorial Hospital, in Alexandria, Ont.

So much for stereotypes.

Don Douloff is a freelance writer living in Toronto.

Ontario’s Farmland Crisis

High costs make it hard for young farmers hoping to get into the business (CBC News)

“According to StatsCan data, about 50 per cent of our land assets will be transferred in the next five years. And of the retiring farmers, 75 per cent of them don’t have successors. It’s a transition we’ve never seen before in agriculture. And it’s one we are wholly and completely unprepared for.”  – Christie Young, executive director of FarmStart

FarmStart has two incubator farms in southern Ontario to bring new farmers into the business, but at current prices, Young says there is no way those starting out could earn enough from their farms to make a living and pay their mortgage.

Read more

Hospital Food in the UK

( … don’t know what i want, but i know how to get it)

Good hospital food needn’t cost more – Soil Association

“Catering Mark-accredited hospitals also champion British and local food producers, with the result that for every £1 spent on a Food for Life Catering Mark menu there is a social return on investment of more than £3 to the local community, mostly in the form of new jobs and contracts for local food producers.”

The Soil Association in the UK is well known for its certification of organic farming, food and drink production, but the certifier also has an international forest management branch(!?!), and a Food for Life catering mark.

“The Catering Mark provides an independent endorsement that food providers are taking steps to improve the food they serve, using fresh ingredients which are free from undesirable additives and GM, and better for animal welfare.”

Where applied to hospital and care settings, they offer this set of rationales:

“There is a growing awareness of the connection between good food, and health and wellbeing. Obesity and diet related ill health is already costing the NHS £10 billion a year, and this has been estimated to rise to £50 billion by 2050.
In 2010, our survey revealed that nearly two thirds of people have brought in food from outside hospital because the meals on offer were so unappetising.”

Some Examples

After Hinchingbrooke Hospital was awarded a Bronze Catering Mark, they stated that “Patient satisfaction jumped to 92 per cent just two months after the new menus were introduced”.  Unfortunately they don’t provide details on that claim: however, they do offer completely transparent patient feedback results!

Whitgift House was the first care home to receive the Bronze Catering Mark. “Not only are our residents benefitting from a healthier diet, they are also enjoying their food more.”

Sustain Campaign

And check out Sustain (UK)’s Campaign for Better Hospital Food Facebook page, which has been very active, and includes some frightening photos and stories, as well as a survey of the attitudes of hospital catering staff.

Feasibility Study of On-site, Institutional Food Production

Led by postdoctoral researchers Phil Mount and Irena Knezevic, this three-year project will look at the viability of on-site  food production at public institutions, through collaborative arrangements with local food producers.

New Directions Research ProgramProject SOIL is funded by the New Directions Research Program of the Ontario Ministries of Agriculture and Food and Rural Affairs.

The project builds on emerging production models that can flexibly adapt to  institutional resources (including SPIn or Small Plot Intensive farming), as well as land tenure models that could contribute to community food production, health and well-being –  such as Lakehead Psychiatric Hospital’s donation of land to a social-purpose business (GreenWerks) that grows food for the hospital, local markets, and food bank.

The feasibility of alternatives will be explored by:

  1. surveying public institutions to identify capacity to support food production;
  2. interviewing institutional key informants to understand opportunities/constraints; and
  3. performing in-depth site analyses to explore food production models and cooperative opportunities with existing local food networks.

Case studies and cost/revenue flows will help to guide three innovative and groundbreaking food production pilot projects. These pilots will test the therapeutic benefits at gardens on the properties of Hôpital Glengarry Memorial Hospital -which focuses on post acute stroke rehabilitation- and Homewood Health Centre, a leading addiction and mental health treatment facility. The multiple values of the food and synergistic benefits produced from the soil on these properties will be explored at these health facilities, and also at the Food School Farm, Centre Wellington District High School’s radical participatory agroecological education program that looks to produce “critical and confident food growers and consumers”.

Return often; this site will expand organically, reflecting the growth of the project.