Diverting Food Waste From Landfill in Exemplar Hospital Foodservices: A Qualitative Study.

Background: The US Environmental Protection Agency Food Recovery Hierarchy suggests methods for diverting food waste from landfill. Knowledge of how hospital foodservices implement food waste management strategies could help modernize food waste practices.

Objective: The aim of this study was to explore hospital staff members' experiences of implementing a food waste management strategy to divert food waste from landfill in their hospital foodservice, including the journey, challenges, and facilitators of this practice change.

Applying the theoretical domains framework and behavior change wheel to inform interventions for food and food-related waste audits in hospital foodservices.

Background: Completing aggregate food and food-related waste audits in hospital foodservices is an intense practice, however they can demonstrate problem areas that require attention to reduce waste. Identifying interventions to facilitate and improve the implementation of these audits can be guided by behavior change science. The aims of this study were to use behavior change theories and frameworks to (1) describe the drivers of behavior to complete food and food-related waste audits and (2) identify possible interventions that support the implementation and uptake of these audits.

The role of policy in supporting environmentally sustainable foodservice in healthcare: lessons from exemplar hospitals.

Background: Foodservice in hospitals contributes to the environmental footprint of healthcare delivery. There is little known about the role of policy in supporting environmentally sustainable foodservices. The aim of the study was to explore policy in exemplar environmentally sustainable hospital foodservices from the perspective of hospital staff, toward what makes a policy effective, the limitations of policy, and the influential levels and types of policy.

Towards healthy food retail: An assessment of public health nutrition workforce capacity to work with stores.

Objective: This article aims to investigate the capacity of nutrition professionals to engage in food retail practice change to improve population diet.

Methods: Convergent mixed method design was used that includes pre-interview surveys, in-depth interviews, and retrospective mapping of service provision. The study was conducted in organisations that provide a nutrition professional service to food retail stores in remote Australia.

Local food procurement by hospitals: a scoping review.

Background: Local food procurement by hospitals is gaining traction as governments and advocacy groups seek to influence food systems and strengthen local communities, but there is little empirical evidence as to its practical application or efficacy. The aims of this review were to describe the extent, range and nature of local food procurement models in healthcare foodservices, and to understand the barriers and enablers to implementation, including from the perspective of stakeholders across the supply chain.

Method: A scoping review was conducted following the protocol published in the Open Science Framework Registration (DOI: 10.

The origins of hospital food: Where does it come from and what do staff, patients and suppliers think about local food?

Aims: To identify the origin of fresh and minimally processed foods served to hospital patients, and explore the challenges and enablers to local food procurement in hospitals.

Methods: A mixed methods study was conducted in a healthcare network in Victoria, Australia. Packaging labels and product information were used to audit fresh and minimally processed foods purchased in 1 week.

Packaged hospital food appears safe and feasible to reuse.

Aim: To determine the safety, operational feasibility and environmental impact of collecting unopened non-perishable packaged hospital food items for reuse.

Methods: This pilot study tested packaged foods from an Australian hospital for bacterial species, and compared this to acceptable safe limits. A waste management strategy was trialled (n = 10 days) where non-perishable packaged foods returning to the hospital kitchen were collected off trays, and the time taken to do this and the number and weight of packaged foods collected was measured.

Quantifying waste and its costs in hospital foodservices.

Aim: To measure the amount of different types of food and food packaging waste produced in hospital foodservice and estimate the cost associated with its disposal to landfill.

Method: A foodservice waste audit was conducted over 14 days in the kitchens of three hospitals (15 wards, 10 wards, 1 ward) operating a cook-chill or cook-freeze model with food made offsite. The amount (kg) of plate waste, trayline waste and packaging waste (rubbish and recycling) was weighed using scales and the number of spare trays and the food items on them were counted.

Factors influencing implementation of food and food-related waste audits in hospital foodservices.

Background: Designing a food waste audit tool for novel hospital foodservice practice does not guarantee uptake. Intended users must be consulted to understand the tool's feasibility and face validity. This study aimed to identify the perspectives of staff involved in the operation of hospital foodservices on (1) how an evidenced based consensus pathway food waste audit tool is perceived to translate into practice, and (2) to determine the factors that influence the completion of food and food-related waste audits within this setting.

Harnessing the pillars of institutions to drive environmentally sustainable hospital foodservices.

Background: The cultural-cognitive, normative and regulative pillars of institutions influence the ability of hospitals to change how they function at an organizational and operational level. As more hospitals and their foodservices instigate changes to address their environmental footprint and impact on food systems, they move through the "sustainability phase model" from no response through to high level action and leadership. The aim of this study was to describe and compare the pillars of institutions between hospitals in different stages of achieving environmentally sustainable foodservices (business-as-usual vs.

Food and food-related waste management strategies in hospital food services: A systematic review.

Aim: This review explored peer-reviewed and grey literature to describe the types and characteristics of food or food-related waste management strategies used in hospital food service settings; their financial, environmental and staffing outcomes; and the barriers and enablers associated with their implementation.

Methods: Six electronic databases, 17 Google Advanced searches, and 19 targeted websites were searched for peer-reviewed and grey literature. Literature reporting the financial, environmental, or staffing outcomes of food or food-related waste management strategies that reused, recovered energy from, or recycled waste instead of sending it to landfill were eligible.

'It's a constant changing environment, and we're just playing catch up': Hospital food services, food waste, and COVID-19.

Aims: Hospital food service operations have been affected by the COVID-19 pandemic, particularly resulting in increased waste. The aim of this research was to explore the impact of the COVID-19 pandemic on hospital food services, particularly on food waste and the completion of food waste audits.

Methods: A qualitative interview research design was used.

Nutritional intake and foodservice satisfaction of adults receiving specialist inpatient mental health services.

Aim: Meeting the nutritional needs and foodservice expectations of hospital inpatients is challenging. This study aimed to determine whether adults receiving specialist inpatient mental health services meet their energy and protein requirements and are satisfied with the foodservice.

Methods: An observational study of adults admitted to three specialist inpatient mental health services within a large health service.

Daily Relations Between Stress and Electroencephalography-Assessed Sleep: A 15-Day Intensive Longitudinal Design With Ecological Momentary Assessments.

Background: Recent studies have found bi-directional relations between stress and sleep. However, few studies have examined the daily associations between stress and electroencephalography (EEG) measured sleep.

Purpose: This study examined the temporal associations between repeated ecological momentary assessments of stress and EEG-estimated sleep.

The Origins of Food Supplied to an Australian Public Hospital.

Local food procurement by public institutions such as hospitals offers multiple benefits including stimulating the local economy, creating jobs, and building resilience within the food supply. Yet no published study has attempted to quantify the local food purchase by hospitals. This baseline is needed to identify gaps, set targets, and monitor change.

Effectiveness of Strategies to Decrease Animal-Sourced Protein and/or Increase Plant-Sourced Protein in Foodservice Settings: A Systematic Literature Review.

Background: Effective population-based strategies are required to move toward healthy sustainable diets that replace a proportion of animal- with plant-based protein. Food service can support this using a variety of strategies across the food supply chain.

Objective: This systematic review aimed to evaluate the effectiveness of strategies to decrease animal protein and/or increase plant protein in foodservice settings on uptake, satisfaction, financial, environmental, and dietary intake outcomes.

The Drivers of Environmentally Sustainable Hospital Foodservices.

Hospital foodservices have the potential to positively contribute to the local food system and planetary healthcare. Understanding the factors contributing to the success of "exemplar hospitals" with environmentally sustainable foodservices gives an opportunity to reimagine foodservices and guide strategic planning. The aim of this study was to identify the drivers of sustainable hospital foodservices.

A systematic review of food waste audit methods in hospital foodservices: development of a consensus pathway food waste audit tool.

Background: To understand, monitor and compare the scope of food waste in hospital foodservices, it is essential to measure food waste using a standardised method. The aims of this systematic review were to: (i) describe and critique the methodological features of waste audits used in hospital foodservice settings that measure aggregate food and food-related waste and (ii) develop a consensus tool for conducting a food waste audit in a hospital foodservice setting.

Methods: Seven electronic databases were searched for peer reviewed literature, and 17 Google Advanced searches located grey literature that described food waste audit methods previously used or developed for hospital foodservices.

The Value of Programmatic Assessment in Supporting Educators and Students to Succeed: A Qualitative Evaluation.

Background: Programmatic assessment has been proposed as the way forward for competency-based assessment, yet there is a dearth of literature describing the implementation and evaluation of programmatic assessment approaches.

Objective: To evaluate the implementation of a programmatic assessment and explore its ability to support students and assessors.

Design: A qualitative evaluation of programmatic assessment was employed.

A Qualitative Study Exploring Hospital Food Waste From the Patient Perspective.

Objective: To study the perceptions, beliefs, and expectations of patients related to food waste during their hospital stay.

Design: A qualitative study using semistructured interviews and thematic analysis of transcripts.

Setting: Four hospital wards across 3 hospitals in 1 large health care network in Melbourne, Australia.

"I teach it because it is the biggest threat to health": Integrating sustainable healthcare into health professions education.

Background: Steering planetary and human health towards a more sustainable future demands educated and prepared health professionals.

Aim: This research aimed: to explore health professions educators' sustainable healthcare education (SHE) knowledge, attitudes, self-efficacy and teaching practices across 13 health professions courses in one Australian university.

Methods: Utilising a sequential mixed-methods design: Phase one (understanding) involved an online survey to ascertain educators' SHE knowledge, attitudes, self-efficacy and teaching practices to inform phase two (solution generation), 'Teach Green' Hackathon.

Environmental Sustainability of Hospital Foodservices across the Food Supply Chain: A Systematic Review.

Background: Hospitals have a responsibility to support human health, and given the link between human and environmental health, hospitals should consider their environmental impacts. Hospital foodservices can negatively affect the environment at every stage of the food supply chain (production/procurement, distribution, preparation, consumption, and waste management/disposal).

Objective: To systematically identify and synthesize the following across the hospital patient food/nutrition supply chain: environmental and associated economic impacts of foodservice; outcomes of strategies that aim to improve the environmental sustainability of foodservice; and perspectives of patients, staff, and stakeholders on environmental impacts of foodservice and strategies that aim to improve the environmental sustainability of foodservice.

Total energy expenditure measured using doubly labeled water compared with estimated energy requirements in older adults (≥65 y): analysis of primary data.

Background: Contemporary energy expenditure data are crucial to inform and guide nutrition policy in older adults to optimize nutrition and health.

Objective: The aim was to determine the optimal method of estimating total energy expenditure (TEE) in adults (aged ≥65 y) through 1) establishing which published predictive equations have the closest agreement between measured resting metabolic rate (RMR) and predicted RMR and 2) utilizing the RMR equations with the best agreement to predict TEE against the reference method of doubly labeled water (DLW).

Methods: A database consisting of international participant-level TEE data from DLW studies was developed to enable comparison with energy requirements estimated by 17 commonly used predictive equations.