3 Tips for Transforming Hospital Food Into Something More Sustainable

The University of California, San Francisco (UCSF) is world renowned for its cutting-edge research and medical care. It is also a leader in sustainability, modeling healthy, sustainable food choices for patients, staff and visitors. In the recent 2014 townhall (see minute 21.20), an attendee asked University of California Office of the President (UCOP) President Janet Napolitano about UCOP’s sustainable food initiative, advocating for a move away from an animal-based diet. She responded that while UC is not moving toward a total vegetation approach, campuses are adjusting their procurement process to buy food from smaller, organic growers. Napolitano commended UCSF for its sustainable food efforts, notably efforts to eliminate antibiotics from the meat it serves at UCSF Medical Center.

I had the opportunity to speak with Dan Henroid, the medical center's director of nutrition and food services, to reflect on UCSF’s successes and challenges as it moves the needle on sustainable food. Based on our discussion, I offer the following three tips for other hospitals and institutions seeking to improve the sustainability of the food they serve:

1. Reduce conventional meat consumption in order to purchase more sustainable meat;


2. Collaborate to promote sustainable food practices; and


3. Get your local team on board.

What is driving sustainability in health care?

UCOP policy requires all UC campuses to procure at least 20 percent of their food from sustainable sources by 2020. UCSF has already reached this goal, yet continues to push the envelope on serving healthy and sustainable food. According to Janet Howard, director of facility engagement for Practice Greenhealth, three forces are driving sustainability in hospital food: health, climate and antibiotic resistance.

According to Henroid, “From our perspective, a heightened emphasis on personal health is driving this trend from our customers and patients. We are seeing a convergence where customers want both healthy food and sustainable food."

Using the word “customers” might seem odd for a medical center. However, according to the UCSF Sustainable Foodservice Annual Report, in addition to feeding 1,500 patients a day, the Department of Nutrition and Food Services at UCSF Medical Center is responsible for several retail food outlets and a very busy and successful catering department, with combined annual sales of over $9.5 million.

1. Reduce conventional meat consumption in order to purchase more sustainable meat

Nontherapeutic antibiotics in meat is a hot topic in the mainstream press right now: Recent pieces by the Huffington Post, Consumer Reports and Environmental Working Group all stress concerns over the use of antibiotics by the United States meat industry.

“There is overwhelming scientific consensus that overuse of antibiotics in livestock is a health hazard to people. It’s time for hospitals, universities and other consumers to stop buying meat raised with nontherapeutic antibiotics,” said Dr. Thomas Newman, the chair of the Academic Senate Sustainability Task Force at UCSF that originally spearheaded the resolution, and a member of the faculty at the School of Medicine at UCSF.

With an Academic Senate resolution to phase out meat raised with nontherapeutic antibiotics, the medical center recently announced that it will now serve only antibiotic-free chicken breasts on its patient and retail menus. UCSF now also offers a $4.50 grass-fed, antibiotic-free hamburger. In order to offer more sustainable meats, UCSF trimmed conventional meat purchases with offerings such as “Meatless Mondays” and other strategies for reducing waste. A new program recently put in place, offering hotel-style room service to patients, provides patients more control over food choices. Henroid expects this “on-demand” system will reduce waste and incur cost savings.

2. Collaborate to promote sustainable food practices

As reported in Civil Eats, hospitals attempting to purchase sustainable food face serious supply chain challenges. In the case of meat produced with nontherapeutic antibiotics, the market to date has been small in the U.S and the products costly. Even large institutions such as UCSF, not to mention individual food vendors, have problems getting the actual products they want in the quantity they need. No one hospital is big enough alone to shift the food production supply chain.  UCSF has partnered with colleagues at SF General, UCLA, Stanford, Kaiser, John Muir Health, Washington Hospital and USF to work together to promote sustainable meat practices.

At an unprecedented gathering last year,  80 participants gathered at the UCSF Sustainable Meat Summit, including sixth generation cattlemen, chicken farmers, and physicians, to explore how to benefit from small and medium livestock producers who offer alternatives to intensive farming practices that boost production through antibiotic use. At the Summit, each sector involved in meat production was able to meet and converse with the others in the business.

Estancia Beef attended the meeting and connected with UCSF, explaining that it was able to provide the necessary beef products consistently, in the volumes needed. While the cows come from Uruguay, which has carbon footprint implications, according to Estancia, grass fed, pasture-raised beef means a smaller carbon footprint, no concentration of waste in a small area (a hallmark of all feedlot operations), and no contamination (waste, antibiotics and/or growth hormones) from run-off into the local water system. As described by Health Care Without Harm, “Estancia Beef’s cattle are grass-fed, raised without antibiotics and hormones, certified by Animal Welfare Approved, and affordable. However, the company’s products were not available for hospitals to purchase through the major food distributors that they rely on, like US Foods and Sysco.”

UCSF reached out to hospitals statewide through Health Care Without Harm’s network, leveraging the combined purchasing power of multiple health facilities. With perseverance and collaboration, US Foods now offers Estancia products. UCSF’s work paved the way for other US Foods’ customers. The University of California at Los Angeles (UCLA) Medical Center is also now serving Estancia hamburgers and ground beef. “As more California hospitals join this initiative, pushing the total purchasing volume to 80,000 pounds and beyond, each facility that is purchasing meat from Estancia will receive a discount from the company, thanks to the combined demand,” explained Health Care Without Harm.

Yet, except for UCLA, other campuses and medical centers have not been able to make the switch. Henroid responded, “The primary barrier to other institutions incorporating antibiotic-free meat is cost.  At the end of the day, we still don't have enough operators who are committing to this effort. 
If we had more institutions demanding it, the costs would go down.”

By pooling purchase power, large institutions can improve their ability to access new products. Collective demand can lower costs by creating economies of scale and provide institutions access to new products. As detailed in the Farm Fresh Healthcare Project 2014 How-To Guide, “If everyone is independent, no one is going to be able to drive this huge system forward, but if we have three or four hospitals working together, that’s a game changer,” explained Luis Vargas, Procurement Manager, UCSF Nutrition and Food Services.

3. Get your local team on board

Henroid attributes his success to his team and recommends one of the first steps is to get your local team in order. According to Henroid, you need your local team members to be committed to your sustainability effort. “It takes a whole lot of constant effort and commitment to go through all of the different options and stay on top of the market. If I was the only one in my department committed to this, we still wouldn't be making progress,” he stressed. One way he incorporates sustainability into his department’s culture is by talking about sustainability during the interview process.

Image credit: Food and Environment Reporting Network (FERN)