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Farm to School and Healthy Hospitals Initiative: Change Agents in Food System Reform


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Farm to School and Healthy Hospitals Initiative: Change Agents in Food System Reform

Marydale DeBor JD,
Lecturer, Yale School of Medicine, Department of Psychiatry
Managing Director, Fresh Advantage™ LLC
New Haven, CT

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Farm to School and Healthy Hospitals Initiative: Change Agents in Food System Reform

  1. 1. Farm to Cafeteria Conference August 2-5, 2012 “Farm to School” and “Healthy Hospitals Initiative”: Change Agents in Food System Reform Marydale DeBor JD,Lecturer, Yale School of Medicine, Department of Psychiatry Managing Director, Fresh Advantage™ LLC New Haven, CT
  2. 2. Overview• Solving “Weight of the Nation” NEJM, August 2, 2012• Health Care Sector- Where are We?• One Model: Plow to Plate• National Hospital Initiative:• Partnership with Farm to School Movement• Key points of possible collaboration identified at this conference
  3. 3. We all know what the problemis……………starting withthose ubiquitous sugarybeverages .
  4. 4. 1 out of 3 children born in 2000 or after will develop Type 2 Diabetes
  5. 5. The Moral Dilemma• Given the evidence of harm done by consumption of food and beverages that contribute to obesity and related disease,How do we, as health care professionals….reconcile our mission, the oath that physicians take, with this:“Food served in childrens hospitals rated largely unhealthy” UCLA News December 1, 2001
  6. 6. Two Interdependent Systems:Food and Health Care are Broken• Illness (physical and mental), hunger, malnourishment, comprising ability to learn and function• Require leadership to be fixed• Health care sector should be leading, not absent..BUT• Farm to School is the true Pioneer
  7. 7. One Hospital’s ExperienceSee: “Plow to Plate: The Hospital as Change AgentSustainability: The Journal of Record, April, 2012
  8. 8. Caveat:• Plow to Plate is far from the norm. The model is premised upon the notion that hospitals (and physicians) must become public health practitioners---foreign to how system works now, but will be compelled by the economics of current situation and the implementation of reform policy and regulation. It will take generations of hard work and advocacy.• Fletcher Allen is the goal, but it is exceptional
  9. 9. Start with the Basics: Think…“[Local] Food is Primary Care™”
  10. 10. Use the resources available: Local,Regional Farms.. Supporting local economy
  11. 11. Physicians & Local/State Department of APRNs Policymakers Agriculture Social Service HospitalAgencies as(Youth & LEADERSeniors) Community CoalitionLocal MediaDepartmentof Health Farmland Preservation AdvocatesSchools Farmers FIRST! Parks and Farmers’ Recreation Markets Churches Copyright 2012 Marydale DeBor Restaurants / Chefs 11
  12. 12. RFP process, new vendor, community and hospital programs with health objectives• Make it a “food movement”• Make it fun, delicious, engaging• Don’t preach, don’t use the “N” word• Ingredient, calorie count and weight watcher data on all menus (nobody cared, or read them)• Make it taste good, and look beautiful, above all• Engage the media
  13. 13. FACULTY: Doctor, Chef andFisherman
  14. 14. New Milford Youth Agency Program: after
  15. 15. Consumer Supported Agriculture- Our Employees30 Shares Guaranteed by Hospital Sold Out in Less Than 1 Week
  16. 16. Healing/Learning Culinary Garden
  17. 17. Building a Food Learning Hub, Not Just a Food Service
  18. 18. Success Documented Widely• April, 2012 “Gold Award” Connecticut Quality Improvement Partnership• In May 2011: CHANGE COMES TO DINNER by Katie Gustafson• 2011 –Connecticut Magazine; NY Times• 2010 –Greening Food and Beverage Services, by Cheryl Baldwin, GREEN SEAL Guide to Transforming the Industry• 2009 Planetree Award for Nurturing Foods• 2009 Glynwood Center for Sustainability/Good Food for Health Award
  19. 19. Poster Presentation: Institute for Health Care Improvement National Convention-2011 Building and Sustaining a Healthy Dining Experience: A Quality Improvement Initiative to Implement a Healthful, Sustainable Food System with Exceptional Customer Service Team Members: Dan Amendola, Guest Service Representative / New Milford Hospital; Marydale DeBor JD, Cofounder Plow to Plate, Vice-President of External Affairs / New Milford Hospital; Beth Falder: Quality Data Analyst / New Milford Hospital; Wayne Frisbee, Guest Service Representative / New Milford Hospital; Kerry Gold, Dining Service Director Unidine Corporation / New Milford Hospital; William Hart, Cook / Unidine Corporation; Michele MacDonell, RD, CDN Clinical Nutrition Manager / Unidine Corporation / New Milford Hospital; Laura Olson, Guest Service Representative / New Milford Hospital; Noemi Rushton, Dining Service Administrative Assistant / New Milford Hospital; Bob Sommer, Vice-President of Human Resources / New Milford Hospital; Rafael Walters, Executive Chef / Unidine Corporation Introduction Results Methods Faced with low Press Ganey Developed a coalition with community Scores, complaints from leaders and local farmers to create the Plow employees, and increasing to Plate®program, promoting healthy foods concerns about the health and through a two track strategy of community well being in the communities and hospital-based programs. we serve, New Milford Hospital Signede Hal th Care Without Harm’s the decided to make food service a “Healthy Food i Health Care” pledge as a n top priority and use our food service program as a tool to statement of commitment to reforming the help prevent disease and hospital food system. improve public health. We Conducted a thorough assessment of the reevaluated our philosophy hospital food service, issued RFP based on and committed to the belief the results, and retained Unidine Corporation that a healthful, sustainable National Patient S atisfaction as the vendor-partner for the hospital. food system and exceptional ranking increased from the 51st Integrated the Plow to Plate®philosophy as customer service are integral to healthcare practice and the Percentile to the 93rd Percentile the foundation for te hospital’s food service h delivery system. Worked with several local patient experience. for Meals Overall, and from the farms and dairy co-op to provide 38th Percentile to the 95th “Connecticut grown” produce, dairy and Project Aims meats. Percentile for the Quality of Food. Eliminated all fried foods, soda machines, Target improvements to trans-fats and high fructose corn syrup. increase patient satisfaction Trained existing staff in culinary, customer and utilization of hospital café. service and communication skills. Initiative involved collaborating Instituted a room service model , obtaining with food service vendor and patient selections prior to each meal. creating a coalition with Renovated the kitchen to promote maximum community leaders to develop efficiencies and Á La Carte cooking, leading to a sustainable food system and improved temperatures and freshness of patient meals. patient education program. Instituted meal rounds to understand patient preferences. Reviewed and streamlined therapeutic diet orders to eliminate unnecessary restrictions while meeting patient needs.
  20. 20. What still needs work• Supply and Distribution• Knowledge deficit on part of physicians• Cardiologist insists we put soda back in cafe…….a matter of individual “choice” See NEJM article re : food industry messaging strategy• Vending machines; 24/7 healthy food service
  21. 21. Opportunities for Hospital- School Collaboration• Establish and Foster dialogue with local hospitals and physicians, nursing organizations: The Communication/Relationship Imperative! Saturday plenary• Tell your story: to physician groups in your states (state and local chapters of American Academy of Pediatrics, Family Medicine, Psychiatry, Internal Medicine….) Friday
  22. 22. FTS and Health Care Sector: Collaboration Opportunities• Supply/Distribution/Procurement – Include hospitals in • your purchasing coops (Friday sessions: Jeremy West, Greely CO) • Clean, cut, prep processing centers (Doug Davis, Burlington) • Long term storage facilities • Training of food service workers
  23. 23. Hospital-School Collaboration: Metrics• We don’t need (only)high tech interventions to fix this! – But let’s get distributors to adoptllicense Black River’s tracking methodologies! Saturday plenary – HHI has data collection system; join forces – Health care has resources: they have to measure everything! Maybe can help with metrics, esp if academic center
  24. 24. Collaboration Opportunities• Advocacy, Advocacy, Advocacy !!!!• Join New England Farmers Union—or your state chapter of National Farmers Union – Progressive policy platform – advocates at federal level for family farms and all of the policies and programs upon which Farm to School depends!
  25. 25. Our Future: Our ChildrenPlow to Plate Youth Chef Advocates, 2009
  26. 26. To learn more….• Contact: Marydale DeBor JD, Founder, Managing Director• 203-745-1796 Cell: 860-248-9854