Hospital Foodservice Makeover — Addressing Portion Sizes but Allowing Choice
By Lindsey Getz
When a hospital physician tells his patient at discharge to begin eating healthfully and then walks downstairs to a cafeteria featuring fried foods, sugar-sweetened beverages, and salty snacks, the patient will quickly realize there’s a contradiction. Hospitals should set the tone for healthful living, which is why many are revamping their foodservice policies.
Vidant Health, a system of 10 hospitals in rural eastern North Carolina, has done just that. The organization has adopted a corporate policy that addresses portion size while advocating personal choice. It’s an effort that’s been going on for years and continues to evolve.
The fact that many hospital staff members weren’t leading healthful lifestyles, even though patients perceived them as role models, sparked the new policy’s development. “Data from our annual wellness assessment indicated our employees reported sedentary lifestyles and not getting enough fruits and vegetables,” says Rose Ann Simmons, MPH, director of corporate wellness for Vidant Health. “So over the years, our wellness effort has continued to focus on improving the environment and helping people live healthier lifestyles. We knew our cafeterias played a big role in that.”
Foodservice Program Unveiled
Revamping cafeteria choices was no small undertaking but was done in small increments over time. The corporate policy consists of the following four key components:
1. Seventy-five percent of food and beverage options at on-site food venues must meet healthful criteria based on calories and portion size.
2. Sixty percent of foods and beverages at all company-sponsored events must meet healthful criteria.
3. Healthful items will be price leveraged, meaning they’ll be more affordable than their unhealthful counterparts.
4. Calories and serving sizes must be labeled on all food and beverage choices at the point of service (purchase or provided).
Putting all of these pieces together created a comprehensive policy that touched on many different areas. While many hospitals have found that finances can become a roadblock to making healthful changes, Vidant Health has used price leveraging to push the healthier choice. “We’ve made it more attractive for customers to choose the healthful option,” Simmons explains.
Impacting Employee Events
What’s also unique about Vidant Health’s policy is that it impacts the type of food and beverages served at hospital-sponsored events. Most hospitals have looked at making changes only in their cafeterias.
Vidant Health’s previous policy required that water and at least one healthful food option be made available at company-sponsored events, but in January 2012, the organization changed the requirements, stipulating that 60% of all foods and beverages meet set calorie goals. This affected executive, staff, and board member lunches as well as events such as the employee picnic, community fund-raisers, and open houses.
“Taking a comprehensive approach that really looks at everything our organization is involved with certainly brings on challenges, but it’s also been fun,” Simmons says. “The challenge lies in the fact that we’re bringing in vendors to cater our events, and we need to be sure they’re doing their part. They’re required to do food labeling if they want to be on our preferred vendor list.”
One way Vidant Health has achieved its goals was by creating two toolkits—one for vendors and one for event planners—that provide guidelines for serving healthful foods and beverages at company-sponsored events. Vendors also were invited to attend an online training session. Some of the vendors created special menus for Vidant Health to make it easy for event planners to select an appropriate menu.
To date, anecdotal evidence shows that the changes are having a positive effect. “I think what’s helped everyone to accept the policy without a lot of complaint has been that we still allow choice,” Simmons says. “We aren’t banning any items; we’re just helping to encourage people to make the healthier choice. Recently, one hospital decided to stop frying foods. That’s been successful so far largely because of a lot of planning and preparing employees. We’re not making changes without educating staff on why we’ve made them. And I think the fact that our effort is comprehensive and touches on a lot of areas also helps make it successful. This wasn’t an overnight project but has been a long, ongoing effort that continues to evolve.”
— Lindsey Getz is a freelance writer based in Royersford, Pennsylvania.