How to improve food waste management in hospitals through focussing on the four most common measures for reducing plate waste

Identifying solutions to minimize meal tray waste: A mixed-method approach

BACKGROUND & AIMS

Over $150,000 are lost annually due to meal tray waste in a large hospital in the United States. This study aims to explore the root causes of meal tray waste within a decentralized foodservice model and strategies to mitigate waste.

METHODS

A mixed methods sequential explanatory design was used by first identifying hospital units high and low in meal tray waste using recorded food management data from January 2021 through September 2022, then conducting observations, mobile-interviews (n = 16), and in-depth interviews with hospital foodservice staff (n = 6) and nurses (n = 6) in each unit. Lastly, hospital and topic experts (n = 10) were engaged in strategizing solutions to reduce meal tray waste.

RESULTS

Findings indicate meal tray waste is increased when patients discharge and when standard trays (i.e., also known as house trays, which include items not requested by patients) are provided. Meal tray waste points to the unpredictability in a hospital that often arises due to patient circumstances, lack of coordination between nursing and foodservice staff, patients' food preferences, and the need for system and workflow improvements in a decentralized foodservice model.

CONCLUSIONS

Findings highlight considerations that may be applicable across diverse medical institutions seeking to reduce meal tray waste. Hospitals should choose the best foodservice model that suits their institution to manage operations efficiently, focusing on reducing waste, cost optimization, patient satisfaction, and sustainability.

Sustainability initiatives in inpatient psychiatry: tackling food waste

Background

Food plays a dual role in promoting human health and environmental sustainability. Yet, current food systems jeopardize both. Food waste poses a major global challenge due to its significant economic, social, and environmental impacts. Healthcare facilities generate the largest amounts of food waste compared to other forms of catering provision. Food waste correlates with environmental unsustainability and diminished patient satisfaction, compounding the prevalent challenge of hospital malnutrition and contributing to suboptimal patient outcomes.

Materials and methods

In a three-year interventional study (2020-2022) at a psychiatric tertiary care center, we assessed and mitigated food waste using evidence-based measures. We conducted systematic food wastage audits over three years (2020-2022) in May and June, each lasting four weeks. Costs were analyzed comprehensively, covering food, staff, infrastructure, and disposal. Environmental impact was assessed using Umweltbelastungspunkte (UBP) and CO2e/kg emissions, alongside water usage (H2O - l/kg).

Results

Economic losses due to food wastage were substantial, primarily from untouched plates and partially consumed dinners, prompting meal planning adjustments. Despite a >3% increase in meals served, both food waste mass and costs decreased by nearly 6%. Environmental impact indicators showed a reduction >20%. Vegetables, salad, and fruits constituted a significant portion of waste. Overproduction minimally contributed to waste, validating portion control efficacy.

Conclusion

Our study highlights significant economic and environmental losses due to hospital food waste, emphasizing the importance of resource efficiency. The strategies outlined offer promising avenues for enhanced efficiency. The decrease in food waste observed over the three-year period underscores the potential for improvement.

Implementation of sustainable food service systems in hospitals to achieve current sustainability goals: A scoping review

BACKGROUND

Food waste is a pivotal contributor to environmental degradation in the modern world. Vast amounts of food are wasted and many individual efforts and collective initiatives being underway to deal with this challenge. Hospitals are institutions that produce and provide food, but at the same time contribute greatly to food waste. The objective of this scoping review is to present available data regarding quantity of food waste generated in public hospitals and summarizes studies that assess and quantify the greenhouse gas emissions (carbon footprint) associated to food service management in hospitals.

METHODS

A systematic literature research was conducted by two qualified researchers in PubMed, Scopus, ISI Web of Science and Science Direct. The publication date was set to the last ten years, i.e., 2013-2023. All the abstracts retrieved were screened, and the eligible articles were selected after a two-step process. Abstracts from the retrieved full papers' references were also screened for eligibility. The selected papers were included in the final scoping review.

RESULTS

Overall, 2870 studies were identified and 69 were included in the review. Most of the studies (n = 33) assessed the causes and quantified the amount of food waste generated in hospitals. A small number of studies (5) estimated carbon dioxide equivalent (CO2-eq) produced by food waste. Although several studies suggested strategies and measures to reduce the environmental impact of foodservice operations, none of them implemented a comprehensive foodservice management system.

CONCLUSION

This scoping review suggests that hospital diets contribute to food waste and may have a negative environmental impact. There are several internal and external factors and practices that influence positively or negatively the sustainability of hospital food service systems. Systematic efforts are needed to identify and enhance parameters that could improve the environmental footprint of hospitals in terms of more effective management of food waste.

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.

DESIGN

A qualitative study was conducted in 2022-2023 using semi-structured interviews.

PARTICIPANTS/SETTING

Eighteen participants were staff members with knowledge of the food waste management strategy from 14 exemplar hospitals in United States, Spain, Scotland, and Australia using strategies to divert food waste from landfill within the last 10 years.

ANALYSES PERFORMED

Mapping and thematic analysis were undertaken to code and identify themes from the interviews that described staff members' experiences of the journey to implement the strategy.

RESULTS

Six hospitals donated food, 1 transferred food waste for animal feed, 4 used an industrial solution, and 3 sent food waste for composting. A common journey pathway for successful implementation was identified from participants' experiences. It features the following 6 phases: idea, preparation, roll out, maintenance, established practice, and evolution. Facilitators included legislation, enthusiastic staff members, executive support, and "luck." Challenges were smells, occasions when food waste was not collected, equipment breakage, and funding depletion.

CONCLUSIONS

This study identified a common journey pathway for implementing a food waste management strategy in hospital foodservices that can be used to anticipate and prepare for the steps in the implementation process.

Effective waste management in service industry: Fuzzy-based modelling approach for strategic decision-making

Hospitals need to identify issues of greater importance on waste management because the implementation of many different strategies may lead to an unconscious increase in costs. Accordingly, the purpose of this study is to define the most effective waste management strategies in the service industry. For this purpose, a novel fuzzy decision-making model is proposed that has two different stages. In this context, six JCI-based indicators are weighted by using sine trigonometric fuzzy Decision Making Trial and Evaluation Laboratory (DEMATEL) methodology. Additionally, a comparative evaluation has also been conducted with sine trigonometric fuzzy Criteria Importance Through Intercriteria Correlation (CRITIC) technique to check the reliability of the findings. On the other hand, five different strategy alternatives are selected by considering the principles of the integrated waste management hierarchy approach. These items are evaluated by considering sine trigonometric fuzzy Technique for Order Preference by Similarity (TOPSIS). On the other side, these factors are also ranked with the help of sine trigonometric fuzzy Additive Ratio Assessment (ARAS) to test the consistency of the results. The main contribution is that prior strategies can be presented to the hospitals to have appropriate waste management process by defining the most important factors. Criteria weighting and alternative ranking results are the same in all combinations. Therefore, it is seen that the proposed model creates coherent and consistent results. It is defined that efficient storage of waste is the key issue to have effective waste management process. Moreover, 'reduce' is found as the most critical stage of this process.