KETCHUM, Idaho—For the past 18 months, the foodservice department at 28-bed St. Luke’s Wood River Medical Center has been transforming the department’s offerings to include healthier, local and more environmentally conscious choices. The result of these changes is a program called Green Cuisine.
Green Cuisine is the new menu and menu development strategy for both the cafeteria and patient services. Instead of having one menu for patient services and a different menu for the cafeteria, St. Luke’s is now running the same menu for both customer bases.
“We try to serve local, healthy, antibiotic-free, hormone-free foods,” said Sherrie Pond, dietary manager. “We have food produced by people who are close to home, so the foods are fresher, and the food is produced by people with good practices and values. They care not only for us as human beings but also for the Earth and the animals. We’ve reduced our carbon footprint.”
Most produce, meats, dairy products and bakery items are purchased from local farmers and locations. “When we say local, we try first to be within 150 miles of our facility,” Pond said. “Second is within the state of Idaho and third is within the Northwest. We know that there are some things such as pineapples, avocados and bananas that you cannot meet that criterion with.”
Pond said the changes occurred during a three-month period. One of the first steps in the Green Cuisine program was switching to local dairy products, including milk, creamers and ice cream. The second change was purchasing all local produce for the salad bars and steam tables in the cafeteria. Local produce is now used in all aspects of patient and cafeteria dining. Pond also found a local organic bakery from which to purchase breads and other bakery items. Switching to hormone-free and antibiotic-free meats was one of the last steps.
Environmental changes: Many of the changes in Green Cuisine have been made because of their environmental impact, Pond said. “We looked at the economy, the environment and social, nutritional well-being of everything that is involved in our sustainable food program. We looked at what is compostable and recyclable. We try to reduce the amount of items going into the landfills. We can treat our Earth much better than it has been in the past. If we treat it well it will still be here for our grandchildren and great grandchildren.”
Pond hopes to partner with a local farmer to start a composting program to reduce the amount of food waste going into landfills. Packaging has also been a major concern for Pond. “We’ve eliminated close to 95% of our individually packaged items like ketchup, mustard and creamers,” she said. “People pour their own juice and milk. Some juice we have to keep in an individualized container for some patient care. The fewer containers we have, the more we like things.”
To eliminate individual milk containers, Pond started a self-service milk station in the cafeteria. Milk is delivered from Clover Leaf Dairies in half-gallon glass bottles. The dairy provides Pond with a plastic pouring spout, which is inserted in the opening of the bottle so that customers can pour their own milk.
“We looked at the menu and what we could do first that would be the easiest,” Pond said about starting the Green Cuisine program. “Changing the milk over was very simple. People at first asked, ‘where is the milk?’ You show them where they can pour it. They taste it and it’s fresh because it’s local. They liked the idea that they could pour their own.”
Other beverage changes in the cafeteria include removing the soda machine, for health reasons, and putting in a self-serve juice dispenser to eliminate individual juice containers.
Menu matters: The Green Cuisine program was started not only because of its environmental impact, Pond said. With the program, healthy dining has been taken to a new level at the hospital. All “junk” food has been removed and replaced with healthier versions, including “lite bites,” which are grab-and-go healthy snacks like celery sticks, almonds or grapes.
One of the program’s first initiatives was eliminating all partially hydrogenated fats. Pond is in the process of removing all high-fructose corn syrup, and she wants to be MSG-free in the near future.
“We are a hospital,” Pond said. “Our dietitian, Becky McCarver, would teach patients healthier ways to eat. She would teach them one thing and we would serve them something different. She did research and found out that we could do a healthier program. We were looking at what was going out in our waste, and I thought, this isn’t good. We wanted to make a difference in our community, our patients and their family members. Becky has two children and she wanted healthier options for them. So the question became, ‘why can’t we be the first to get it started in our community?’ We are a hospital and we teach it so why not do it ourselves?”
Pond said menu development was a large component of the Green Cuisine program. “We had to create menus that we could use in the cafeteria that would also be in sync with our patient meals,” she said. “Instead of having a patient menu separate from the cafeteria menu, we worked on getting it all put together. That meant adjusting and modifying a lot of recipes that could be used for therapeutic diets.”
This meant changing cooking techniques or products in certain menu items. One example is the lasagna. High-fat cheese was swapped out for low-fat cheeses and meat was eliminated. The lasagna is now fresh tomato basil lasagna. Pond said customers were nervous about the change at first. “They said, ‘A lasagna without meat?’, but now it is a very popular item.” Another change was replacing the bread stuffing in the stuffed chicken breasts with a spinach, cheese and onion stuffing. “We’re being creative with common foods that you can create a healthier recipe for,” Pond says. “We are teaching a different eating style and introducing people to stuff that tastes good and is healthy.”
Up to the challenge: Pond admitted the change to Green Cuisine has been a challenge, but she says having tastings to let people get used to the new items was an important step toward customer acceptance. “The biggest challenge was the change. People weren’t sure they were going to like the change. Originally, the cafeteria was designed to service the staff of the hospital and patient families. Now, we are noticing that we are getting a lot of outside people coming in just to eat.”
The Green Cuisine program has been a complete turnaround. Before the program, most produce was pre-packaged, prewashed and precut. “We were just taking it out of bags and dumping it in bowls,” Pond said. “Many of the items came premade and we were making soups from stocks.”
Now, all produce is delivered in its natural state and foodservice employees clean, cut and portion the fruits and vegetables for service. Entrées are now made from scratch and soups are made from housemade stocks. Pond said the hospital’s location has made getting fresh produce a challenge. “We have snow six months of the year,” she said. “We’ve been very successful in utilizing local people. It was a challenge at first, but the more we did it the more the word got out and the more farmers surfaced who were willing to work with us.”
Changing from pre-packaged, premade items to made from scratch required additional training on things like knife skills and safety, Pond said. She also added one FTE to cover the additional labor involved with the Green Cuisine program.
Pond said she has been able to offset the higher food and labor costs by reducing waste. “When you buy it fresh and locally in bulk, it offsets the cost of when you were buying precut, washed produce,” she said. “When you are ordering soup bases versus making your own, there is a cost difference there. We learned that a lot of our waste that was produce could go into making our own soup bases. That really saved us a lot because we were throwing away less. We had all the stuff here, but we weren’t utilizing it.”
Cafeteria sales have increased between 25% and 35% since starting the Green Cuisine program, Pond said.
At first, cafeteria prices did not increase. Nine months after starting the program, prices increased by 6%. “Every two years we do a price increase and we hadn’t done one in two years,” she said.
Pond said the program is still evolving. “We recently went to all cage-free farms from local farmers. We want to be MSG-free. We want to be a totally healthy kitchen. We want everything that we serve to help people and not damage in any way. Our mission is to provide highly satisfying food that sustains the health of ourselves, our community and the Earth.”