Q: From your point of view, what is the role of sustainability as it relates to healthcare food services?  

 Schenk: Healthcare has a special interest in environmental stewardship for a few reasons, one of which is that healthcare is polluting. Healthcare in the United States is responsible for about eight-and-a-half percent of annual greenhouse gas emissions. Globally, it is about five percent. We’re taking that seriously because we don’t want to contribute to this problem which causes harm to health, environmental injustices, and harm to our whole planet, which is, as a Catholic health system, part of our commitment to care for our common home.  

So, how does that relate to food? Food has some significant contributions itself. When thinking about the variety of issues that we’re addressing, we use the mnemonic WE ACT: Waste, Energy and water, Agriculture and food, Chemicals, and Transportation. That is our framework for driving down greenhouse gas emissions. The “A” is where we’ve been focusing and working with Morrison quite a bit, as Morrison serves about 80% of hospitals across Providence. It’s important to think about this from the angle of green house gas emissions, waste reduction (because food waste is a big challenge in the U.S. particularly), packaging waste, and making sure we’re providing healthy, nourishing, comforting food to patients and caregivers.  

Q: Lisa, how do you help people like Beth achieve these goals? 

 Roberson: We help achieve goals for our sustainability leaders in three ways within foodservice operations. The first way is through mutual goal setting and aligning our programs; the second way is through governance and thought leadership; the third way is through measurement.  

When Beth and I started together, we first came together and mutually formed a group where we could better understand her mission and values for Providence Health. In that discovery session, we talked about carbon. Providence Health and their ministries have an aggressive platform: they can’t just stop at carbon neutral, they’re looking to leave the Earth better than how they found it.  

In order to execute those goals, it really takes governance. Governance is a huge success strategy for us, and through it we have the ability, in Morrison and Compass Group, to bring thought leadership. Chef Jeffrey Quasha and I are part of some sustainability workstreams within Compass Group, and by having this governance strategy we work together between our systems, and sometimes are able to bring practical solutions that have already been tested back to Providence Health to help them be successful. 

Last, but not least, is measurement. If we aren’t measuring what we’re doing, we can’t make change. Those are the three critical factors in helping Beth and Providence Health to achieve their goals.  

Q: What kind of role do data and analytics play in this goal?  

 Schenk: We have two catchphrases. One is, “Engagement is the secret sauce. Engaging people and using data are the backbone to our initiative. We have had the wonderful opportunity to work with the Providence Global Center, which is Providence’s tech development center in Hyderabad, India, and created the WE ACT scorecard. So,we’ve been able to track a particular use of a commodity like gallons of water, desflurane, nitrous oxideacross our whole range of environmental stewardship. We track the amount of it, the cost of it, and the carbon emissions for every month and hospital back to January 2019. We could not be making the decisions we need to make without that data. We can project cost savings, we can project carbon reduction, we can see it historically.  

For our food work, we spend a lot of time talking about data because we’re pulling in data that Morrison is able to get for us, for instance, percent local spend and percent sustainable spend. Those are both on our scorecard right now. What we’re working on next is the carbon intensity of meals served. We’re pulling in the purchasing data to calculate this, both through the Morrison product of carbon footprint and to our broader, national commitment of the Cool Food Pledge, which is offered by Healthcare Without Harm and the World Research Institute. 

Without access to data, without partnerships, we wouldn’t be able to stick to what we have decided is really important, which is data-driven, evidence-based application of improvement.  

 Roberson: I think Beth and Providence taking the lead on data is fantastic, because we know the data is so powerful. Data has the ability to make meaningful change, and if we don’t have data, we can’t make a pivot or know if we’re targeting and meeting our goals. As Beth mentioned, we provided detailed monthly reports on the food that Providence purchases and how it’s verified through specific claims, whether it’s growth hormone-free or no antibiotics ever, what are the different types of attributes and verifications. It’sa very detailed process, and I think it’sa game-changer when we can help inform our partners with this data, to bring them to a level where they can be resilient and make swift change. So,I think data is very powerful.  

Q: Chef, from a back of the house standpoint, how does the back of house play a role in the overall sustainability of health systems? 

Quasha: I think it actually starts with purchasing for us, making sure the product that is coming through our door is cross-utilized at least five times through multiple applications. We’re flipping the script on proteins. I think there’s a big push going on right now, as less people are using alternative proteins, so for us leading with plants is a huge opportunity for driving down those carbon emissions.  

Every day, we’re talking about tracking when it comes to food waste reduction, and I think that’s one of the biggest opportunities we have, understanding where the food waste is coming from and taking on the question of, “How do we stop it?” For us, is it a pre-production meeting, or—a new term which really isn’t in the culinary industry—a post-production meeting? We’re hash-tagging the phrase “de-prepping.”  

When you’re thinking about post-production, it’s just as important as pre-production, because with pre-production you have forecasting, and you’re forecasting how much food you’re going to produce to make sure you’re not overproducing and generating waste. But if you’re post-producing and having that conversation as food is coming off the line with your cooks and saying, “Now, what are we going to do with it?” There’s an opportunity to de-prep it, upcycle it, or align it with food recovery. Preventing food from ever hitting the waste bucket is one of our biggest opportunities.  

Q: What about menuing? How does that play into a more sustainable operations model, and how important is it to more sustainability overall?  

Quasha: Everything starts with the menu. When you talk about menu engineering, I think that’s one of the biggest keys. We talk about menuing with intention, putting the right food in the right months. You shouldn’t serve a tomato salad in December, when tomatoes are not in season in the U.S. If you’re buying fruits and vegetables from outside the country, you’re only increasing carbon emissions by transporting that food.  

Understanding your local spend is key as well. Having the combination of products across the U.S. and sourcing from local farms and local purveyors, you’re supporting diversity in local spend but also decreasing carbon emissions. Like I mentioned, the rule of five. I think it’s a huge opportunity for us to continue to drive that.  

Our new patient menu that we recently launched last month has 525 ingredients. So, if you think about 63 different diets, four different menu styles, and we only have 525 ingredients across the menu, that’s us putting the rule of five into play, which is exciting. But if we can minimize the amount of ingredients, then we’re having harder conversations with our supplier partners to make sure that every single ingredient they’re producing on our behalf is aligning with our strategic sustainability goals.  

Q: Can you expand a bit on the rule of five? 

Quasha: For example, coleslaw mix. If you deconstruct it to the simplest form of red cabbage, green cabbage, onions, and julienne carrots, and put it on top of a pulled pork sandwich, hypothetically, you’d have a pulled pork sandwich. But if you take that mix and add a little bit of pickled ginger and a vinaigrette and put it on top of some jasmine rice with the same pulled pork, you now have a bowl build. If you take that same pulled pork and you put it on a baguette with pickled jalapenos and add the coleslaw mix with the pickled ginger and vinaigrette, hypothetically you now have a banh mi.  

So, it’s just taking basic culinary principles and applying it to a larger audience. My team is doing that every day, looking at the ingredients that are on our managed order guide and figuring out new and innovative ways to stay on trend and excite our guests with amazing flavors. Of course, everything has to start with “delicious.”  

Q: How important is engagement as part of a stewardship program?  

Schenk: As I said originally, our phrase “WE ACT” means “we,” it doesn’t mean just “our team” or “you”, it means everyone. And we have 120,000 caregivers, or employees, in Providence. We consider that that’s who gets this work done. Everybody from the kitchen to the janitorial staff, to the physicians and nurses, to the engineers. And if they don’t know or don’t care about the program, it’s not going to get done. So, engagement, or getting people involved, invited, included, and informed with instructions and data as necessary—that’s what I mean when I say engagement is the secret sauce. It’s the fuel, and a necessary and unavoidable challenge as well, with so many people and constant turnover. But it’s super important.  

Roberson: Working in this field, in sustainability, a lot of the time the term is very nebulous. Maybe there’s a certain percentage of the population who really understand it and educate themselves. But for the most part, when we make change, we have this saying: “Let’s meet customers, caregivers, and communities where they are,” and that’s important when you start out. But engagement is about bringing them along the journey and helping make it meaningful to them.  

So, Tommy, if I said to you, “We’re doing some great work here, all three of us are working to reduce scope three emissions,” are you excited about that? What does that mean? But, if I told you, “We partner with growers and foodservice companies to make change, and we’re using strategies in healthcare because we have so many hospitals which are greenhouse gas emitters. All of us are working together to make change, so that your grandchildren will be able to eat a banana or an avocado, rice, chocolate, honey—things that we take for granted which could actually be gone with global warming. It’s getting too hot to produce these items. So, the work that we’re doing is reducing the impact of global warming so that your grandkids, our families, one day can continue to enjoy the things that we’ve all grown up with and loved.” That’s engagement.  

Quasha: For me, everything starts at the back door with the food that’s coming in. But a lot of the work that Lisa and Beth have been doing with, “good, better, and best,” is the ideology that we’re taking forward with Morrison Healthcare and Compass Group on a global scale. Instead of taking a top-down approach to sustainability, we really need to take a bottom-up approach, empowering our chefs, our culinarians, and our cooks every single day to be more sustainable. So, we’re working together with Lisa and the North American Culinary Consult to develop a bunch of micro-lessons relating to sustainability on a “good, better, best,” mentality.  

Thinking about empowering a cook, if they can make one change every couple of months—if we could eliminate tasting spoons from our kitchen and move to metal spoons, if we could get rid of condiment PCs in our retail space and move to pumps, if we can eliminate single-use plastic like plastic wrap—those are the changes that inspire our chefs so they feel like they are part of something bigger. When you start getting more and more buy-in, and you take 700-1000 accounts across the country, you start this tidal wave of sustainability that’s happening. We also think about putting sustainability out front. Like with a safety moment, could we have a daily sustainability moment where we’re speaking about sustainability? The more we speak it, the more we do it, the more we’re going to create change.  

Schenk: I would add, particularly with food, the two areas we get the most comments about in relation to healthcare are waste and food. Because everyone touches waste, and everyone eats every day. But especially with food, since it is more joyful, it’s a wonderful way to connect with people, and a way to explain why we’re moving more towards a plant-forward menu and why beef is an issue. We also work with Morrison Communications, and every other week we share a recipe to show how food that would be wasted can be used in another way, and it gets a lot of hits from our caregivers. It’s a really great way to connect with people and move this all forward.  

Q: How optimistic are you about the ability to drive sustainability practices in healthcare? What do you see in the near future and down the road with driving sustainability in healthcare?  

Roberson: What makes me most optimistic about driving sustainable change is partnerships. We cannot make change alone, and when we have the ability to partner with forward-thinking thought leaders such as Beth and Providence Health, we have the ability to grow together, to empower each other to succeed, and we basically make each other better. I think about what we’re trying to accomplish—reducing carbon emissions is a team sport, not an “alone” sport—we all have to cross the finish line together. We just can’t do it alone, so partnerships are key.  

Quasha: Taking what Lisa said, using that power of partnership and leveraging our partnerships with our suppliers, we are finally aligning in terms of sustainability in culinary. Culinary backing sustainability has taken a little while, but now it’s really full speed ahead. And on the healthcare side, not only are we healing people, but we’re healing the planet at the same time. That is the power of every plate we’re putting out, and it’s an amazing message.  

Schenk: I get asked this question a lot, and it’s a great question because a lot of people are overwhelmed by our planetary challenge. And I spend so much time thinking about solutions, the problem, and how we define and talk about it.  

So, in the end, yes, I’m optimistic. I’m optimistic that we can do it, and I’m optimistic that we have the solutions. We live in a world of solutions; we see it all the time. I think, though, that whether we do it or not is basically up to us, all of us who are alive right now. That’s what I say to every adult who’s alive right now: this is up to us. And what we’ve learned from the climate trends and the warming trends is that this decade right now, the 2020s, is critical for the next decades and the next centuries. So, this is something that I’m really proud of Providence for doing, saying that we will do all we can by 2030, we’re doing all we can right now, and this is something I take very seriously. So that success and progress gives me great optimism.  

Kane: Thank you all so much for being on our podcast today. This was very informative and very inspiring for what the future of healthcare holds for sustainability, so thank you all for being a part of this today.