A Landmark Year for Washington - Physicians for Social Responsibility

A Landmark Year for Washington:
2011 was an important year for Washington’s
Healthy Food in Health Care Initiative. We welcomed good food proponents from around the
country to FoodMed, toured sustainable family
farms, and shared ideas on how Washington
hospitals can change the direction our national
food system is headed.
We welcomed two new Healthy Food in Health
Care Pledge signers, Washington’s first Balanced
Menus Challenge takers, and witnessed the
state’s first comprehensive sustainable food purchasing policy endorsed by foodservice and administration.
For those of us on the front lines of the good
food movement, it is an exciting time. The shift
toward fresh, local, humane, sustainable foods
in hospital cafeterias and patients meals is setting national standards for excellence that will
save both lives and livelihoods.
What will 2012 bring? I can’t wait to find out.
Thank you for another
inspiring year.
Kathy Pryor
Washington Healthy
Food in Health Care
Coordinator
Table of Contents
United General Hospital Wins National Award…...2
Overlake Hospital Launches Food Policy………...3-4
Swedish Medical Center Opens Café 1910………….5
UW Medical Center’s Nutrition Advisory Team…..6
WA Hospitals Take Balanced Menus Challenge…...7
Washington Welcomes New Healthy Food
Pledge Signers!
Swedish Edmonds
Swedish Issaquah
Washington Healthy Food in Health Care
Pledge Signers Now Include:
Seattle Children's Hospital
Group Health Cooperative
Island Hospital
MultiCare Health System:
Allenmore Hospital
Covington Outpatient Center
Good Samaritan Hospital
Mary Bridge Children's Hospital
Tacoma General Hospital
Northwest Hospital & Medical Center
Overlake Hospital Medical Center
Providence Sacred Heart Med. Ctr. &
Children's Hospital
Swedish Medical Center:
Swedish Cherry Hill
Swedish First Hill
Swedish Ballard
Swedish Edmonds
Swedish Issaquah
United General Hospital
University of Washington Medical Center
Group Health Commits to Cage Free Eggs…………..8
Jefferson Healthcare Hires New Chef………………...9
Northwest Hospital Creates Green Training……….10
Tacoma General Hospital Transforms Cafeteria…...11
FoodMed Visits Seattle………………………………..12
United General Hospital Wins National Food Award
United General Hospital in Sedro-Wooley won second place
in the nation in the first-ever
Sustainable Food Procurement
Awards from Health Care Without Harm.
United General Hospital was
selected for the diverse array of
sustainable products they are
buying, often directly from
farms. Executive Chef Chris
Johnson started purchasing directly from farmers through
Puget Sound Food Network’s
Wholesale Farmers Market, and
he continues to purchase produce, dairy, meat, and other
items directly from several
farmers throughout the year,
with an emphasis on local sustainable meats through the winter. He purchases Organic grassfed beef, wild Alaskan salmon,
local shellfish, and pastureraised poultry.
of people from other departments share in the pride of the
award—of being aligned with a
socially just foodservice.”
When asked about plans for
next year, Chris says humbly,
United General Hospital also
“We’re just going to keep doing
buys Fair Trade, Rainforest Alli- what we’re doing. We’re always
ance Certified coffee and 95%
looking to expand the amount
rBGH-free dairy in all categoof local & Organic products we
ries. Chris estimates that 25% of serve. I never really had this as
the meat they purchase is raised a goal—I just keep doing what
without non-therapeutic antibi- feels right.”
otics.
“The people in the community have always
been supportive,” Chris
says. “We’ve had a lot
2011 National Healthy Food in Health
Care Award Winners
The inaugural Healthy Food in Health Care Awards
were announced at FoodMed 2011 (see page 12)
and included hospitals from around the country:
United General Hospital Chef and Food Services
Director Chris Johnson and Washington Healthy
Food in Health Care Coordinator Kathy Pryor
Sustainable Food Procurement Awards:
Fletcher Allen Healthcare, Vermont
United General Hospital, Washington
John Muir Medical Center (Concord), California
Public Policy & Advocacy Awards:
Fletcher Allen Healthcare, Vermont
Sparrow Hospital, Michigan
Oregon Health & Science University, Oregon
Food Climate Health Connection Awards:
Carroll Hospital Center, Maryland
John Muir Medical Center (Concord), California
Oregon Health & Science University, Oregon
Clinical Engagement Awards:
Lisa McDowell, RD, Michigan
Tim Goltz, MD, Maine
Amy Collins, MD, Massachusetts
Overlake Hospital Medical Center Launches Sustainable Food Purchasing Policy
Since signing the Healthy Food in Health Care
Pledge in 2007, Overlake Hospital has become a
leader in Washington’s sustainable procurement
efforts. They have worked diligently to make sustainable and humanely-raised products available
to hospitals throughout the region, and share
their practices and strategies publically.
Highlights Include:
 Document will be shared with all existing
and potential new vendors
 Prioritizes local, antibiotic-free, hormonefree, and third-party certified products
 Provides alternatives to beverages including
high fructose corn syrup
 Reduces meat purchases 20%
In November 2011, Overlake Hospital received
 Aligns recipes and menu items for inpatient
approval for a comprehensive sustainable food
and retail services with “2010 Dietary Guidepurchasing policy created by Executive Chef
lines for Americans”
Chris Linaman. Portions are being published here
 Promotes the humane treatment of animals
verbatim with permission.
 Promotes the health & safety of farmworkers
Many thanks to the staff of Overlake Hospital for  Requests readily available way to identify
creating and sharing this visionary document.
region of origin & sustainability criteria
individual and environmental health, the procureOHMC Comprehensive Food Policy to ment staff within Hospitality Dining Services is committed to the above principles. These
Promote Individual & Environmental principles will be applied to all major purchasing deciHealth
sions. Departmental leadership will evaluate the
health and environmental impacts of both current and
potential food products in an effort to select healthy
Purpose
and safe products that are also environmentally
Overlake Hospital Medical Center seeks to improve
sound. Procurement staff will also expect our current
the health of our patients, employees, our communiand future suppliers to continuously develop price
ties and the environment by increasing access to
competitive products that conform to those principles
fresh, healthy food in the hospital environs. We will
outlined above.
do so in conjunction with "Healthy Food in Health
We recognize explicit and ordered priorities in OverCare" pledge signed in 2007 and in a manner that
lake's comprehensive policy. First, we seek to inpromotes agricultural practices that are ecologically
crease the availability and consumption of fresh fruits
sound, fiscally viable, culturally appropriate, and so& vegetables. Second, to purchase food that is free
cially responsible.
from pesticides, hormones, and non-therapeutic antibiotics. Third, to increase the proportion of locallyFood Purchasing Guidelines
sourced foods. Fourth, to reduce procurement of any
ingredient or ready-to-eat food that contains any
In support of Overlake Hospital's policy to promote
GMO.
Sustainable Food Policy at Overlake Hospital:
An Interview with Executive Chef Chris Linaman
Why did Overlake create this policy?
[We have] been working on "sustainable" initiatives for last 5 years, but had no formal policy just lofty ideals. After the FoodMed 2011 conference, I realized that official policy was needed to
help focus and sustain efforts and to provide accountability. Also [we] knew that we would
have the support of great organizations like
Health Care Without Harm, Washington Physicians for Social Responsibility, & WA Healthy
Food in Health Care Initiative to help carry policy to full fruition.
them as to what products they might try to bring
in to not only our account, but also to those other
accounts within their customer base that have
similar interest and passion for REAL food.
How has Overlake's administration supported this
policy?
Both Marketing VP and Professional Services VP
have voiced their approvals - highlighting the
economic responsibility language.
What do you anticipate will be your largest hurdle?
Restraining my excitement to do the right thing
I realized that official
NOW - not trying
to tackle all at
policy was needed to
once, but rather
help focus and sustain
sustaining what
efforts and to provide
we have already
been doing,
accountability.
while steadily
taking on new
What has been your reaction from vendors?
initiatives in
phases. This will
[I] have been sharing draft versions with all cur- increase the oprent vendors as we meet on a regular basis - the portunity for sucvast majority already knew where we stood, so
cess, and help
no real surprises but appreciated the formality of prevent flamethe plan. New vendors have been very suppor- out.
tive - mostly because I am only talking to those
that I believe have a real chance to meet our standards. I have asked for feedback from both curChef Chris Linaman speaking at the
rent and new vendors, and all agree that this pol2011 Obesity Prevention Summit
icy is thorough and provides good direction to
Tukwila, WA
Swedish Medical Center Opens “Café 1910” in Issaquah
was founded: 1910. One hundred years later, the
health system is obviously still thinking up new
ways to promote health for its patients.
There are no fryers in the hospital, and Swedish
Issaquah is pioneering a “no soda” pilot—the
first in Washington state. There was one compromise: one soda vending machine in the staff
lounge, out of public view. “It’s how we’re keeping everyone happy,” says Candi.
Washington’s newest Healthy Food in Health
Care Pledge-signer—Swedish Issaquah—opened
its doors in July 2011. This newly constructed
hospital bills itself as a re-visioning of what
healthcare looks like, and this is certainly true of
its foodservice—particularly Café 1910.
“It is not designed to be a cafeteria,” says Candi
Johnson, Swedish’s Director of Nutrition Services. “It’s much more interactive.”
One truly notable feature of Swedish Issaquah is
the kitchen, which Executive Chef Eric Eisenberg
designed with consultant Jean Michel Boulot.
Candi offered input on the one-piece flow of the
room service line. “We basically sat down with
the consulting firm and designed this kitchen
based on years of experience.”
The plans they came up are designed to save
time, space, and heavy lifting. The room service
line is continuous, and allows hot and cold items
There are themed stations throughout the café,
to be plated simultaneously. The floors are soft,
each staffed by a chef. Each station will eventuso there is no need for mats. There is ample dish
ally have cameras to showcase chef demos on the room space, complete with water-saving features.
café’s message screens. Meals are plated on
They are currently setting up composting of all
china, and everything is prepared from scratch,
food waste.
down to the wood-fired pizzas.
“It’s our dream kitchen,” says Candi.
“We’ve really prioritized local foods,” Candi
says, pointing to the menu, which features Washington beef, chicken, and vegetables. They have
even partnered with Sol to Seed, a small farm in
Carnation, WA to create the “Sol to Seed Pizza”
featuring seasonal vegetables from the farm.
They offer “dessert bites” from Theo Chocolate, a
Fair Trade chocolate maker in Seattle, rather than
full size desserts.
The name “Café 1910” refers to the year Swedish
Corbin Sears demonstrates the new pizza oven at Café 1910
University of Washington Medical Center
Brings Back Nutrition Advisory Committee
As the University of Washington Medical Center
works to dramatically increase its offering of Organic and whole foods, the nutrition team has
decided to bring back a tradition many thought
was left in the past—a multi-disciplinary Nutrition Advisory Committee.
The committee will consist of stakeholders
throughout the hospital, including a pharmacist,
physicians, nurses, speech therapist, the head of
outpatient services, and several dietitians.
“We’re doing this to help create ambassadors to
departments throughout the hospital,” says
Chuck Zielinski, Director of Food & Nutrition.
“We also want to communicate the evidence that
drives the changes we’re making—why we’re
doing what we’re doing.”
says. They see the room service menu as an arena
to educate patients about healthy eating habits,
and are actively seeking ways to use their room
service trays as educational tools.
Other proposed changes include creating their
own line of Organic grab-n-go foods in-house,
increasing vegetarian and legume options, reducing sugar-sweetened beverages, and ensuring all
dairy products are rBGH-free.
Ultimately, Chuck dreams of pairing the hospital
Nutrition Advisory Committee with researchers
at the University of Washington to study patient
outcomes in connection with food. “We’re right
next door to a world-class university with topnotch researchers,” Chuck says. “We should be
working together.”
The committee will serve two primary purposes:
1. To identify areas where early nutrition intervention can improve patient outcomes,
and integrate those into the hospital’s
foodservice.
2. To make sure the food being served promotes wellness and health, and meets the
mission of the hospital.
The University of Washington Medical Center
food and nutrition team is very interested in
serving evidence-based foods with proven track
records, but wants to make sure they’re communicating why those changes are important.
“If we’re serving fresh Organic blueberries in our
room service meals, we want to communicate
why we’re serving Organic blueberries,” Chuck
UWMC Dietitian Beth Adamsen Marcondes serves
up quinoa salad and healthy lunch samples for
National Nutrition Month.
Two Washington Hospitals Take Balanced Menus Challenge
Overlake Hospital & Medical Center and
the University of Washington Medical
Center are the first hospitals in Washington state to sign the Balanced Menu Challenge.
The Balanced Menus Challenge is a voluntary commitment to reduce meat procurement by 20% over a one-year period. By
reducing the amount of meat a hospital
serves, the hospital is able to reduce its carbon footprint, offer serving sizes in alignment with USDA dietary guidelines, and
use the cost savings to invest in sustainable
Beth Adamsen Marcondes, RD, and UW Medical Center Food Services meat purchasing.
Director Chuck Zielinski signing the Balanced Menus Challenge.
Both hospitals plan to meet their goals by
implementing Meatless Mondays in their cafeterias. The University of Washington Medical Center
also plans to increase legume protein sources, and reduce the size of their hamburgers from 5 oz. to
4 oz.
The U.S. produces about 8.7 ounces of red meat and chicken per
person per day, while federal dietary guidelines recommend consuming 5.5 ounces of protein each day (including meat, poultry,
nuts, beans, and eggs). That means Americans consume 33%
more meat on average than is recommended.
U.S. beef cattle are responsible for 160 million metric tons of
greenhouse gas emissions every year -- equivalent to the annual
emissions from 24 million cars and light trucks. Beef has largest
carbon footprint, followed by pork, then poultry. In a Johns Hopkins study of four California hospitals who piloted the Balanced
Menus Challenge in 2008, the authors found that the hospitals
were able to reduce their meat-related CO2-equivalent GHG
emissions from 2,637 annually to 1,648 tons annually—the savings equivalent to CO2 emissions from burning 102,454 gallons of
gasoline or sequestering carbon by growing 23,354 tree seedlings
over 10 years.
Group Health Commits to Cage-Free Eggs
Group Health Cooperative’s Capitol Hill campus has made a commitment to using cage-free liquid
and shell eggs. The hospital will be purchasing Wilcox liquid eggs and Davidson’s shell eggs.“We've
used pasteurized shell eggs for years to avoid having to have a physician
order to use shell eggs, and now Davidson's pasteurized shell eggs are
available as cage free so we've changed over,” says Mary Hanson, Manager
of Nutrition Services.
Wilcox Farms is a Food Alliance-certified, 100-year old family farm located
in Roy, Washington. Davidson’s is a national company based in Illinois.
Their cage-free eggs are Certified Humane.
Group Health began purchasing the Washington-produced Wilcox cage-free
liquid eggs when they became available through US Foods. “We made the
change to Wilcox liquid eggs because they were a local producer.”
For the last two years, The Humane Society of the United States has sustained
a massive effort asking hospitals and other major foodservice sectors to purchase cage-free eggs. In
July 2011, the Humane Society of the United States and The United Egg Producers (the egg industry’s trade group) announced an historic agreement whereby both organizations will support—and
work toward enactment of—federal legislation to improve the lives of the 280 million hens used in
the U.S. egg industry each year. Many thanks to the hospitals and businesses whose support made
this possible!
The Washington Association for Healthcare Foodservice tours Wilcox Farm in
Roy, WA
Jefferson Healthcare Hires Chef Arran Stark
Jefferson Healthcare’s new Chef and Food
Services Director Arran Stark
Port Townsend’s Jefferson Healthcare has set a lofty goal for itself—a complete re-visioning of what
their foodservice looks and tastes like. This summer, the hospital hired Chef Arran Stark to revamp
the hospital menu. Although he was initially called in as a consultant, the hospital soon offered him
the position of Food Services Director.
The decision to hire Arran was a radical departure from the hospital’s status quo, and required a
major remodel of the kitchen. “We went from a reheat kitchen to a space you can cook in,” Arran
says. They have had to add additional cook and prep spaces, and train long-time staff members in
new techniques.
Arran teaches community cooking classes in his spare time at his commercial kitchen, Cultivated
Palette. Arran believes that getting people cooking is one of the best ways to reverse negative health
trends in the U.S. To that end, he plans to offer internships to teenagers and seniors in the hospital
kitchen, where they can learn how to prepare and season fresh meals from scratch.
Arran is a proponent of seasonal, local menus, and uses organic ingredients whenever he can. “I call
up Nash’s [Farm] and ask them what they have a lot of—what can I get a lot of for a good price.” He
builds menus around availability and local flavors.
“We want to be a destination in the community,” says Arran. “We want people to choose to eat in
our cafeteria.”
Northwest Hospital & Medical Center to Offer Sustainability Trainings
To Foodservice Employees
In January of 2012, Northwest Hospital & Medical Center will begin the first of six sustainability
trainings for its approximately 50 foodservice staff.
The program is based on a Green Grant developed in 2010 by Northwest Hospital, Swedish Medical
Center, and SEIU, which was designed to train EVS workers on sustainability issues. The 2012 version will focus on foodservice staff, and address issues like overproduction of food, composting, water, energy, chemicals, and food sustainability criteria.
“All the staff compost and measure waste but they don’t necessarily understand how important
their efforts are,” says Mary Porter, Northwest Hospital Food & Nutrition Services Manager.
Northwest Hospital is working with North Seattle Community College to develop the curriculum
for six 90-minute courses, and the grant will pay for interested foodservice staff members to attend a
5-credit course at NSCC titled “Environmental Sustainability in Healthcare.” The community college
will provide English as a Second Language (ESL) and Adult Basic Education (ABE) support—which the hospital recognizes as vital to employees
who may have limited English skills or experience with higher education.
Northwest Hospital will also be recruiting standout students from this
program who can take part in a “Train the Trainer” class, to make sure
there is a continuity of sustainability messaging when training new hires.
They are optimistic that this program can lead to promoting sustainability
leaders from within, and help staff work toward common goals.
Tacoma General Hospital Transforms the Cafeteria
For Earth Day 2011, MultiCare’s Tacoma General Hospital did something unusual to celebrate—
they shut down the cafeteria hot bar and brought in a farmer.
They brought in Fred Fleming, one of the founding farmers of the Shepherd’s Grain cooperative,
and Carla Berst of Pink’s Original Bakery, which uses Shepherd’s Grain flour, to talk about the farm
to fork process. They also introduced a market where the hot bar had been, selling fresh vegetables
and fruit, local cheeses, crackers, and teas.
“It’s really been a big hit,” says Pam Theimann, Manager of Food
Operations and Retail Nutrition Services. “We did chef demos of
the products we brought in, which people loved. We wanted to
promote cooking with whole foods, which is the direction we’re
going.”
Tacoma General maintained the cafeteria market all summer
Michelle Gessner, Mutlicare Director Nu- long, Monday through Friday, into September. They have since
trion Services; Patricia Franco, Allenmore brought the hot bar back, but there is a new emphasis. They have
Hospital Nutrition Supervisor; Pam Thie- changed some of the entrees, and there is no more fried food.
mann, Tacoma General Manager of Food
There is a curry bar, a pasta bar, and changes to the recipes in the
Operations and Retail Nutrition Services
old standbys, like the taco bar. “We’ve added turkey,” Pam says,
“So people don’t have beef as the only option. Really, the key is fresh, made-to-order food.”
Pam and her team have also been working hard to make sure there are sustainable options available.
They’ve brought in Wilcox eggs and Draper Valley chicken, which is raised without antibiotics. (See
sidebar.) Pam remains passionate about supporting
Do you want antibiotic-free chicken?
Washington farms whenever she can. Although the products were slightly more expensive, they have been able to Pam Thiemann is interested in talking to
other hospital foodservice managers who
offset the costs by offering more vegetarian options, and
are looking for antibiotic-free chicken. She is
selling entrees a la carte.
Although they won’t have a daily market next year,
Tacoma General’s foodservice team will work with
MultiCare’s Center for Healthy Living to create recipes
and work on the educational side of changing eating habits. Pam credits MultiCare’s administration for pushing
the cafeteria to make healthy changes. “They’re very concerned with obesity, diabetes, and high cholesterol in the
workplace….We’re looking at food as preventative medicine.”
currently buying Draper Valley chicken
through US Foods, but it has limited availability due to low sales. “I’d like to get more
hospitals buying it so the price goes down,
and more people can carry it. We’d like to
offer it in our patient meals, but right now,
it’s not even a possibility.”
If you would like to talk about buying antibiotic-free chicken for your cafeteria, please
contact Kathy Pryor at [email protected].
FoodMed Visits Seattle
FoodMed 2011, held at the Hyatt at Olive 8 Hotel in downtown Seattle, drew approximately 200 attendees from across the United States, Canada, and Switzerland. The 2-day conference focused exclusively on the Healthy Food in Health Care Initiative, and ways hospitals can work to shift our regional, national, and global food systems to support health and the environment. The preconference sessions included a tour of Dog Mountain Farm, tours of Overlake Hospital and Seattle
Children’s Hospital, and a Nurses Workgroup session on food and health.
Workshops included case studies in direct farm purchasing, healthy beverage policy, buying sustainable meat and seafood, strategies for hosting farmers markets on hospital grounds, hospital
cooking demonstrations, waste reduction, the overuse of antibiotics in animal agriculture, creating
hospital leadership teams, working with distributors and foodservice companies to increase sustainable food options, the importance of Fair Trade coffee, and the frightening truth about GMOs.
Washington presenters included:
Chris Johnson (United General Hospital) and Chris Linaman (Overlake
Hospital) spoke on the role chefs can play in training their staff to prepare
fresh ingredients and create seasonal menus, and the positive impact their
sustainable food purchasing has had on morale and community support.
Pam Thiemann (Tacoma General Hospital) spoke with Kathryn Gardow,
Cathy Buller, Lucy Norris, and Karen Mauden on how hospitals can support local farmers in an effort to preserve Washington farmland.
Cindy Krepky (Dog Mountain Farm) spoke about her experiences holding
farmers markets at multiple hospitals in Seattle, and was joined by speakers
from Baltimore and Boston hospitals in an effort to share best practices from
around the country.
Keith Edgerton (Providence Southwest Washington) and Andrew Meyers
(Providence Centralia) spoke about how they have implemented waste reduction strategies at Providence hospitals, including eliminating Styrofoam
and launching recycling and composting programs.
Daniel Shewmaker (Caffe Vita) spoke about the global implications of the
coffee trade, and explained how to understand sustainability criteria for the
world’s second most traded commodity.
FoodMed is held every other year in a new region of the country, and is hosted
by Health Care Without Harm. Previous locations have included Oakland,
Boston, and Detroit. Stay tuned for information on FoodMed 2013!
Want to get involved?
Over 360 hospitals across the country
have signed the Healthy Food in
Health Care Pledge
“As a responsible provider of health care services, we are committed to the health of our
patients, our staff and the local and global
com-munity. We are aware that food production and distribution methods can have adverse impacts on public environmental
health. As a result, we recognize that for the
consumers who eat it, the workers who produce it and the ecosystems that sustain us,
healthy food must be defined not only by nutritional quality, but equally by a food system that is economically viable, environmentally sustainable, and supportive of human
Health Care Without Harm provides
dignity and justice. We are committed to the
free resources for improving
goal of providing local, nutritious and susthe health and sustainability of your
tainable food.”
Additional Resources:
hospital:
Healthy Food in Health Care:
www.healthyfoodinhealthcare.org
www.noharm.org
FoodMed:
www.foodmed.org
Questions?
Please contact Kathy Pryor,
WA Healthy Food in Health Care
Program Manager:
[email protected]
(206) 714-0813
Practice Greenhealth:
www.practicegreenhealth.org
Washington Physicians for Social
Responsibility:
www.wpsr.org