Toronto Rehab Institute, Lyndhurst (University Health Network) | Cornwall Community Hospital | Hôpital Glengarry Memorial Hospital | Hanover District Hospital | The Ottawa Hospital
Figure 9: The HGMH Horticultural Therapy Garden
Hôpital Glengarry Memorial Hospital (HGMH) is situated on a 23-acre property in the heart of eastern Ontario. The garden was established as an extension of the Stroke Rehabilitation department, and is open for use by anyone who visits the hospital.
HGMG has been involved with Project SOIL since 2013. Through its pilot phase it has grown from a small therapeutic garden to a production site three times its original size (see http://projectsoil.ca/project-overview/pilots/hopital-glengarry-memorial-hospital/). Over the three-year project, HGMH has developed a business plan for the garden at the request of hospital administration. The administration has warmed to the project, which has generated positive press and provided tangible results that can be shared with other hospital administrators including a case study and a report on the health benefits of gardens (http://projectsoil.ca/project-partners/harvesting-health-investigating-the-therapeutic-effects-of-gardens/), along with tools to measure these benefits (http://projectsoil.ca/harvesting-health/). The latter, produced by students in Carleton University’s Health: Science, Technology and Policy program, provided the backdrop for the visioning session held at HGMH on April 18, 2016.
The core visioning team included members of staff and the hospital board, the HGMH CEO, and the pilot project’s lead gardener, as well as the head of physio /rehab.
Members at the visioning session on April 16 2016 were:
- Jaquline Fraser – Past chair, HGMH Board
- Frank Wettering – HGMH Board
- Louise Quenneville Emergency Preparedness Coordinator & Project Management, HGMH
- Chantal Mageau Pinard – HGMH Physical therapy and rehab
- Linda Morrow – CEO, HGMH
- Sarah Good – Past gardener/researcher at HGMH
- Phil Mount – Project SOIL lead
- Sue Aitken – Carleton University
- Irena Knezevic – Project SOIL co-lead, Carleton University
3.2 Interest and Incentives
Glengarry Memorial Hospital has many incentives for a hospital garden and the idea received positive feedback from many staff members.
3.2.1 Patient impact
The therapeutic garden offers a variety of benefits to the hospital and community, including incorporating fresh food into patient and staff meals and improving patient experience. While there has been no systematic evaluation of the garden’s outcomes, patient surveys and staff observations suggest that the garden has contributed health improvements from physical activity and socialization, to memory and concentration (particularly important for stroke recovery), motor skills, mood, and disposition to the overall program of treatment.
3.2.2 Community Impact
The garden may provide a place for high school students completing community service hours to volunteer. The garden aims to encourage the development of local healthy eating and physical activity policies within the community.
3.2.3 Brand Impact
By using sustainable farming methods, the hospital will establish itself as a leader in green health care while maintaining fiscal responsibility and becoming a key player in the “buy local” movement.
3.3 Site Description
HGMH is located on an expansive 23 acre piece of property with large areas of mowed lawn, forest, long grassy bog, and water access from the adjacent pond.
There is room for an expansion to the south side of the existing garden which could likely double or triple the amount of growing space. The area is mostly in full sun, and although there are some weeds and gravel-filled soil, the land is quite well-suited to growing. There is some wiring that runs underground through that area of the garden, so caution must be exercised when digging any new beds. The water used to irrigate the garden comes from a well located on site, and is complemented by the use of rain barrels next to the shed. At the visioning session, team members expressed that they are not ready to expand the garden further at this time because they feel the need to ensure sustainability of the current endeavour. They would prefer to first enlarge the team and secure funding for the next few years.
Figure 10: Overhead view, HGMH site (source: googlemaps)
See Appendix 2 for annual growth of total growing area at this site.
3.3.2 Competing land uses
HGMH is situated on a 23-acre property that contains a significant amount of unused land. The potential of the idle land held great interest to the SOIL team from the outset.
However, hospital administration has made it clear that some of this land is slated for future building sites, and that they did not want the garden project to expand beyond the project’s capacities and resources.
3.4 Description of the Proposed Project
The proposed project uses Small Plot Intensive (SPIn) farming methods to provide hospital-grown produce for staff and patients.
3.4.1 Purpose of gardens / production
By incorporating SPIn farming methods, the long term goal for the garden is to provide sustainable produce to the hospital kitchen and establish itself a leader in green health care, while maintaining fiscal responsibility and becoming a key player in the “buy local” movement. In 2015, the garden produced over fifty varieties of fruits, vegetables, herbs and edible flowers.
3.4.2 Program model and governance
The program will consider arrangements with farmers and will but need to proceed cautiously; previous programs have been developed as a separate enterprise but then offloaded to the hospital. Union rules regarding who is employed and how will also need to be observed.
3.4.3 Cost of Production
Funding required is projected to be around $15,000 a year. The project’s start-up funds came from Ontario’s Healthy Communities Fund, which aims to encourage the development of “local healthy eating and physical activity policies.”
The amount of funding the foundation can commit needs to be evaluated. Grant programs such as summer student employment, Trillium, or Ontario Ministry of Agriculture Food and Rural Affairs (OMAFRA) could potentially match partial funding.
3.4.4 Primary and secondary uses for food
The produce harvested from the garden is used primarily in the hospital kitchen, but is also used in the rehabilitation activity room, and some is sold in small markets on the property, as well as to a local cafe, The Quirky Carrot.
Suggested partners from the community include
- Martintown and Maxville (have a horticulture association)
- Cornwall culinary program (though it is probably too far)
- High-school students completing community service hours
- Dietetic interns
- Local green food box program
As well, it was recognized that there may be people who have not joined the auxiliary because they do not want to spend time in hospitals, but if they could volunteer in the garden this may grow auxiliary membership. Auxiliary could commit to providing guidance to student assistants. Materials will be circulated at an upcoming volunteer appreciation event to investigate this.
3.4.6 Resource sharing
Community Living has committed to share equipment expenses (see detail at 3.5).
3.4.7 Responsible Staff
With the support of the Senior Management team at HGMH and collaboration with the Auxiliary, the Project Manager has led a team of volunteers in planting and garden maintenance from 2011 until 2013, when a summer student was secured for a Garden Coordinator position. The Auxiliary volunteers continue to participate in the startup and teardown of the garden as well as assisting patients to the garden, as the rehab schedule and weather permits. According to the 2014 HGMH Garden Business Plan, the intention was to have ten hours per week time-commitment from the auxiliary volunteers. The garden is working towards securing that commitment, but as is often the case with organizations that offer multiple services, the garden is not the only area of HGMH’s work in need of volunteer support.
Figure 11: Site Map, HGMH
The position of Garden Coordinator, which has been subsidized through Service Canada, increased from 120 hours in 2013, to approximately 200 hours for the following two years. University or college students working from May through August have filled this position. In 2015, through Project SOIL, a research student was provided to plan and maintain the garden and create the case study for the project.
This increased the amount of labour by 300 hours, including time allowed for planning, research, and writing. The addition of an extra person made the management of a larger area much more feasible and allowed for work to continue into October.
Maintenance staff were a critical support for the 2015 expansion, and the occupational therapist has also been crucial in engaging the patients with the garden and finding tasks that both contribute to the garden and assist with the patient rehabilitation. The kitchen staff have overall been very receptive to the introduction garden produce to their repertoire.
3.5 Moving Forward
In 2016, despite a late start and extreme heat, the garden had a stellar year for produce. Students, a critical piece of the HGMH gardens, started work on June 23rd—one month after prime planting season. Reasons attributing to the late start included delay in confirmation of funding from Service Canada, and the internal date for general orientation.
In 2016, HGMH initiated a collaboration with Community Living. Community Living clients participated in the garden—along with HGMH patients—with great success. The partnership will continue in 2017. This year’s collaboration benefited hospital patients and Community Living clients, and allowed both organizations to share the expenses needed to run and maintain the garden, with an additional two weeks added to students’ original eight weeks.
Figure 12: HGMH garden expansion
The area of the garden that had been increased in 2015 was managed by two individuals new to gardening, but who produced the most food in one year since the onset of the garden. With the extreme heat in the summer of 2016, soaker hoses were well worth the expense. In late October, tomatoes were still being included in cooking, with the remainder boiled and skinned and frozen in the last week of October: the kitchen could not keep up with the tomatoes!
At the garden wrap up meeting, eyes were on next year to have an April start. An additional focus on fundraising and marketing of the garden will commence in the first quarter of 2017. With positive feedback and support from a dedicated team of volunteers, HGMH is endeavouring to more forward, connecting food to health and being sustainable while doing so.
Figure 13: Experiencing the sensory garden