Healthcare institutions across Canada are exploring how they can shift their food spend and put more local foods on patient menus. As opposed to framing food as something to purchase based only on lowest cost, the strategic choices made around food can be considered an opportunity to invest in the longer term by supporting local economies, and generating the immediate returns of improved patient satisfaction and well-being.
However, getting more local food into hospitals can be surprisingly challenging. For example, order lists often do not provide information about where a food was produced, menus don’t offer flexibility to use seasonally available ingredients, and tight budgets limit the ability for hospital kitchens to cook from whole ingredients.
Also, what do we mean when we say local? The values that define local food vary amongst purchasers - some prioritize purchasing from producers in their immediate vicinity, where others define local as being produced in their province. Several provinces, like British Columbia and Ontario, have definitions for value-added products as well, which provide guidance on what processed and prepared foods can be considered local.
Two Nourish leaders — Marianne Katusin in Ontario and Donna Koenig in British Columbia — are innovating with their menus, purchasing and supply chains to get more local food on the patient tray. Both are working in provinces that are making local food promotion a priority through supportive policy environments that enable local purchasing. For example, Ontario proclaimed the Local Food Act in 2013, although they have yet to enact the pillar setting targets for local food purchasing by institutions. In the 2017 mandate letter, Feed BC was one of the Minister of Agriculture’s mandate letter commitments: “to increase the use of British Columbia grown and processed foods in hospitals, schools and other government facilities.”
Local food is a way for people to connect with and express their personal values and beliefs about the importance of supporting food producers in their regions to build stronger economies, while gaining better access to fresh, delicious ingredients. Marianne and Donna show how having ingredients on a patient plate that are locally produced can connect not only the patient, but also the hospital staff and facilities, to their broader community.
Community Soup: Halton Healthcare in Ontario
Marianne Katusin started making local food a priority when the Local Food Act was proclaimed in Ontario in 2013. It was not clear what reporting would be required with the new Act, but Halton Healthcare made the decision to become leaders in providing innovative meal delivery service using local food items. Maintaining and growing the local and regional food systems requires a collaborative approach that includes working with various partners. Promoting local foods has become part of their day-to-day work. When the Food Services team was engaged to develop a departmental mission and vision statement, it became apparent that local and sustainable purchasing was important to the food services staff, many of whom come from rural farming communities.
Marianne’s desire to build a community around her local food advocacy has taken her food service team out of the kitchen, thus collaborating with other clinical teams and interacting with patients. Clinical dietitians have been invited to taste panels to participate in recipe testing, and are directly involved in recipe development and analysis of nutrients of new menu items. At Halton Healthcare, nutrient-rich and delicious go hand-in-hand in the recipes the food service team has developed.
Rather than seeing local food as an increase in expense, Marianne has found ways to strategically leverage existing staff and menu-planning design to justify sourcing higher quality local ingredients, ultimately leading to significant cost savings by buying local and creating meals in house. Since then, she has been successfully combating the stigma of terrible hospital food through delicious and nourishing meals being served at Halton Healthcare, with menu items cooked in-house and 30% of food items locally sourced from Ontario.
Through the collaborative Nourish project “Food in Health is Part of Healing: Enactment of the Local Food Act in Ontario Food as Quality Indicator”, Marianne wants health care institutions to break out of a budget-centric mindset that limits change to the status quo. There is widespread evidence about the benefits of purchasing and eating local but elevating the accountability to local purchasing in policy takes it to the next level.
Where does it come from?: Interior Health in BC
When Donna Koenig started investigating the food provenance of the British Columbia Interior Health facilities, she wanted to know how much of her ingredients were being sourced locally from British Columbia (BC). The Interior Health Authority serves a population in the Okanagan region, a vibrant agricultural area filled with fresh fruit trees. And yet, products like the processed fruit cups served in hospitals are purchased from China.
IIn the 2017 mandate letter, Feed BC was one of the Minister of Agriculture’s mandate letter commitments: “to increase the use of British Columbia grown and processed foods in hospitals, schools and other government facilities.”. This mandate has enabled facilities to start figuring out where their food was coming from through collaboration with suppliers and distributors. For example, Donna wanted to know why the eggs being served to patients seemed to becoming from Ontario and not from within the province. However, it can be challenging to find the origin of a food, and it requires institutions to collaborate with distributors and suppliers who are willing to be transparent. By working closely with her Group Purchasing Organization, Donna was thrilled to discover that the eggs did in fact come from BC, but went through a complex supply chain that required them to be processed elsewhere.
Donna wants to find more ways to source locally for her facilities, but she also knows that there needs to be adequate demand in order to grow food processing capacity in the province. Articulating her need for local food as a healthcare client can lead to the kind of investments into local industry that lead to job creation and community wealth.
Donna, Marianne and many others including regional and provincial governments know that purchasing locally might initially seem more expensive, but that it depends on how the costs are framed. If people look at the value of local purchasing from a perspective of full cost accounting, what does the choice to purchase a processed product shipped from thousands of miles away ultimately cost? And on the other hand, what are the benefits for local economies, social cohesion, food literacy and the environment to choosing a local product?
Nourish has been working with healthcare innovators to encourage strategic and values-based decision-making around how to purchase local, sustainable, culturally-appropriate and delicious foods at their institutions. You can learn more about best practices and resources here and read the report Purchasing Power: 10 Lessons on Getting More Local, Sustainable, and Delicious Food in Schools, Hospitals and Campuses.