Representatives from various health authorities gathered on World Food Day to share advances they are making in providing healthier, more culturally appropriate, and more environmentally friendly meals to patients in hospital and other health-care settings. Attendees heard from Dr. Annie Lalande, a surgical resident at VGH and PhD student in resources, environment, and sustainability at UBC, who has been spearheading major food system changes at VCH, Dr. Eileen Wong, a family physician at Providence Health Care, who is committed to enhancing food quality for older adults in long-term care, Jose Morais, a registered dietician and Red Seal chef, who is the director of Patient Food Services with the Provincial Health Services Authority, and Elaine Chu, a registered dietician and director of Fraser Health’s Food Service Transformation and Strategic Projects.

Dr. Lalande kicked off the presentations, detailing the VGH Planetary Health Menu program that ran for eight months beginning last October to evaluate a novel planetary health menu. She emphasized that food is a form of medicine, but that in hospitals it is often treated instead as a service. Dr. Lalande outlined the environmental impacts of the food industry and the benefits of choosing more plant-forward meals. She reviewed the menu development for the pilot project and patient feedback. The 54 recipes tested offered more protein and cultural diversity and there was no significant difference in their nutritional adequacy compared to traditional hospital meals. These recipes were also substantially better aligned with a planetary health diet. The program is now starting to be introduced at Richmond Hospital and is expected to be implemented across other VCH sites gradually.

Dr. Wong spoke next, addressing the need to balance patient eating habits with planetary health. She has been involved with two quality improvement projects; the first on food in a long-term care setting and another in a rehabilitation centre. The goal for the first project was to reduce food complaints by 20 per cent. The study found that there was a disconnect between what residents wanted from their meals and what staff assumed they wanted. The project tested two ideas: switching the size of lunch and dinner portions and providing lipped plates. Although there was a significant decrease in dinner wastage in cognitively intact residents (from 48 to 24 per cent) over a year, there was no significant difference in the cognitively impaired. The aim of the second project, which is summarized in this poster was to reduce food waste by 10 per cent within six months of the first PDSA. From a trial of a Vegetarian Week, lessons learned included that patients need to be at the centre of food changes.

Mr. Morais recently worked at PHSA’s Forensic Psychiatric Hospital and is now in charge of food services at BC Children’s and Women’s Hospital. He talks with patients and families about the food on offer and also solicited feedback from staff who ate the same food as patients at the Forensic Psychiatric Hospital. His goal is to provide comfort foods that are visually appealing and culturally sensitive. This is achieved by engaging patients, researching cultural backgrounds, training staff in cultural competency and recipe development, and having ongoing feedback and evaluation processes. Mr. Morais advocates for values-based procurement that emphasizes integrating ethical, social, and environmental considerations. Effective menu planning, inventory management, proper handling and quality control, recycling and composting, creative repurposing, feedback mechanisms, and patient, staff and community engagement are the variables he takes into consideration for reducing waste.

Ms. Chu began her presentation by recalling the aha! moment she had during the 2021 heat dome that was followed a few months later by massive flooding in the Fraser canyon and valley. These events brought climate issues home for her, and she resolved that it is better to try to do something rather than giving up. She then reviewed the six pillars Fraser Health has created for its food strategy for people and the planet. These include serving a menu that is delicious, nutritious, appealing and culturally appropriate and that lowers the carbon footprint and reduces waste. Patient satisfaction with meals is the overarching goal as waste will not be reduced if patients do not like the food being offered. Procurement, engagement and measurement are the strategy’s other goals. Ms. Chu outlined ways different Fraser Health facilities are working towards these goals.

All the presenters emphasized that the work they are doing requires team effort. They also acknowledged the power of sharing information as different health authorities work towards a common goal. Dr. Lalande, Dr. Wong, Mr. Morais, Ms. Chu, and others have been collaborating for over a year. They share their successes and their challenges, and our health-care facilities and our planet are benefiting from their co-operation.

This World Food Day special event was made possible by the collaboration of VPSA, Providence Health Care MSA-PASS, and the BC Children’s Hospital MSA and is an example of the way your medical staff associations are working together for the benefit of all members.

Post-event feedback

Seventeen of the 51 people attending the presentation completed a post-event survey.

A strong majority indicated that the session met its stated objectives of (1) demonstrating the therapeutic benefits of food in health care, emphasizing its impact on patient outcomes and overall well-being and (2) empowering health-care professionals with strategies for fostering positive conversations about food, enhancing patient perceptions of hospital food.

Most also strongly agreed that they will apply content from this session to their work.

Responses to the question about what resonated most with them from the session included:

• Passion from the speakers for change.
• We can make a difference one plate at a time, starting with our own food choices.
• The significance and importance of purchasing local nutrient-dense whole foods. Indigenous and cultural comfort foods.
• Stories shared by diverse clinicians and staff across multiple health authorities. Truly appreciated the range of examples and the strong community of practice around food in our region.
• Efforts to troubleshoot waste reduction and measures for cost savings without impacting nutritional value.
• Amazing collaboration on planetary health food work is happening across Metro Vancouver health authorities.

Photo credit: Leila Kwok