The sustainable hospital foodservice chain decreasing waste, improving energy efficiency, greening the food supply, improving patients food intake
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1 DCEA Sustainable food production: The sustainable hospital foodservice chain decreasing waste, improving energy efficiency, greening the food supply, improving patients food intake Bent Egberg Mikkelsen, Aalborg University Researchgroup: Meal Science & Public Health Nutrition (MENU) Søren Løkke, Associate Professor, PhD, M.Sc. (Eng.), DCEA Danish Centre for Environmental Assessment ABSTRACT: Danish hospital foodservice is responsible for the production of 200,000 meals that are served to patients, relatives and staff every day an activity with considerable environmental implications. Processing in the foodservice production units emits 200 tons of CO2/day and evidence shows that food waste in hospitals food service is 40 45% resulting in a total waste of 4*10 7 kg of food waste/year. The paper reports from the FoodServInSPIRe project part of the InSPIRe program and presents a environmental model that will be used for developing an intervention in the case of Aalborg Hospital. Data for environmental impact of processing in foodservice will be presented as well as results from a screening of the food service unit in the research case. The model will be used for the intervention improving the utilization of food, water, and energy resources. The intervention will contain a local food sourcing strategy that will contribute to increase patient perception. The intervention will use data on patient preferences and food data to predict and forecast demand precisely thereby contributing to decreasing waste and decrease the environmental impact. The intervention will integrate existing patient, food and processing data into one ICT system, through real time hospital food flow monitoring.
2 Challenges: Hospital Food service Six new super hospitals being built during next decade FAM acute 48 hour admission Move from traditional benchmarking approach (meals/employ or cost/employee) From trial & error to research based evidence
3 Undernutrition at hospital Approx 1/3 of the hospitalized patients in Danish hospitals are undernourished Approx 1/5 is at risk of developing malnutrition during hospitalization. Medical Technology Assessment (MTA, 2005) estimates that improving nutritional care can reduce hospital stays for medical patients by 3.4 days. Potential annual savings of million DKR by optimizing nutritional support National Board of Health/SSt
4 Climate & food activity Estimated CO 2 impact of DK citizens, public consumption not incl.(2t/y) Mobility Shopping Eating Accomodation Data from Jørgensen modified after Chrintz, One third of man made climate impact can me traced to food production or consumption = our FoodPrints. Denmark s National Inventory Report 2009 to UNFCCC; IDA 2009
5 Environmental key figures Processesing in Danish hospital CPU is estimated to emit over 200 tof CO 2 /day consume 1, Wh/day consume 8, litre of water/day Estimates based on Buhl, Frandsen & Mikkelsen, 1992 and Mikkelsen, All estimates based on production of daily meals
6 The greening of hospital foodservice
7 CPU environmental model Søren Løkke DCEA
8 Sustainable hospital food strategies Strategy Menu redesign (less meat, more veggies) Organic public procurement Local food policies Seasonal food policies Curtaling food waste (procurement planning, inventory management, monitoring, forecasting) CPU CleanTech, Energy effiency of CPU, (direct & indirect) CPU, Behavioural change (Energy effiency of CPU, direct & indirect)
9 Preferences, liking & waste
10 DK: Food waste all sectors retail, foodservice & domestic Edible: t/year 1 Total food waste t/year 1 Value 2 : 6,7 * 10 9 DKR. 1. Kjær &Werge, 2010, s. 53, table 18, Forundersøgelse af madspild i Danmark, Miljøministeriet, Miljøprojekt Nr ) 2. Jørgen Deigård, konferencen 'Det skjulte madspild. CONCITOs og Fødevareministeriets konference om det skjulte madspild d. 12. maj 2011
11 Food waste & convenienceness % convenienceness low high Illustrated with data from Kjær &Werge, 2010, s. 53, table 18, Forundersøgelse af madspild i Danmark, Miljøministeriet, Miljøprojekt Nr Edible foodwaste estimated at % of foodwaste depending on level of semi preparednes convenienceness. High convenienceness 9% of served amount/20% of procured amount. Low convenienceness : 20 38%
12 Food waste food service Foodservice incl. hospital: t/y. No distinction between edible and non edible due to lack of monitoring. 1 Min t/y % edible = t/y 2 Scientific litterature, hospitals % 2 : UK hospitals: % 4 DK Hospital: 55 % 5 Value: 750 mill/year (food service) Petersen og Kielland, 2003, Statistik for Madaffald 2001, Miljøstyrelsen 2. Lisbeth Mogensen, konferencen 'Det skjulte madspild. CONCITOs og Fødevareministeriets konference om det skjulte madspild d. 12. maj Jørgen Deigård, konferencen 'Det skjulte madspild. CONCITOs og Fødevareministeriets konference om det skjulte madspild d. 12. maj Edwards:& Nash. The nutritional implications of food wastage in hospital food service management Nutrition & Food Science, Number 2 March/April 1999 pp Effect of changed organisation of nutritional care of Danish medical inpatients. Karin O Lassen, Edvin Grinderslev 2 and Ruth Nyholm, BMC Health Services Research 2008, 8:168
13 FoodServInSPIReproject conceptual framework More local food more attraction more experience Increased energy and protein intake Better result of & decreased length of hospital stay Real time monitoring of food demand Precise forecasting of food demand ICT facilitated use of food & patient data Decreased food waste Clean CPU Tech Sustainable hospital food service (environment, cost wise & nutrition wise)
14 FoodServInSPIReproject the idea of Personas Reduce complexity through archetypes Originates from marketing (Ogilvy) & IT development Cooper: The Inmates are Running the Asylum. SAMS, Demographics (SES etc) Physocographics (preferences, personality, values, attitudes, interests, or lifestyles etc.) Health & nutrititional status
15 FoodServInSPIReproject workplan 1/2 Identification of sources of food waste in selected hospital foodservice environments Investigation on legal aspects of local food supply concepts Investigation on cooking routines in hospital catering production unit (HCPU) Development of local food supply concept in cooperation with FoodServInSPIRe Mapping of IKT routines in selected hospital foodservice environments Development project: Alternative use of by products Study: waste dependancy of convenienceness
16 FoodServInSPIReproject workplan 2/2 Development of model for realtime monitoring of food demand based on Food status: Remote food outlets at ward Patient status: Preferences & nutritional status on admission Development of intervention Baseline study (pre intervention) Follow up study (pre intervention)
17 Food waste sources Non edible (yet) peel, traditional by products Edible CPU Exeding shelf life More produced than ordered Distribution Ward Received not served or plated Eaten by others than intended Portioning Served not eaten plate waste
18 The location of food service in the hospital landscape 18
19 Scientific papers on catering Case of Public Health Nutrition Before 2007: 0 From 2007 and on:
20 Medical science Is foodservice a science? Nursing science Food science Your terms catering science do not have enough search volume to show graphs. 20 Your terms foodservice science do not have enough search volume to show graphs
21 Creating the idea of a local hospital foodscape
22 In conclusion Huge potential savings in waste reduction Need for environmental focused food science Focus on metaproduct features Need for holistic benchmarking Intelligent ICT Role of story telling experience economy Strengthening evidence driven innovation in food service
23 aau.dk Thanks for your attention Thanks to my co authors and co workers Sanne Sansolios Mia Brandhøj Sofie Husby Listelotte Hedegård Nadja Frederiksen Mette V Mikkelsen Lise Justesen Chen He Pernille Malberg Dyg Henriette Nicolaisen Camilla B Christensen Rikke Nygård Sascha Qvortrup Dwi Budiningsari Nadja Frederiksen Jeanette Friis Sofia Lourenço 23
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