In 2016, Brigham and Women’s Hospital redesigned its cafeteria to put healthy food front and center.
The Massachusetts hospital, part of the Mass General Brigham healthcare system, prides itself on serving great food with sound nutrition, and the team wanted to make it easier for customers to make nutritious decisions.
So it leaned on the principles of choice architecture in the redesign, putting healthier options right where diners can see them and placing more indulgent items in the back.
The goal was to encourage diners to eat healthier in a stealth way, said Susan Langill, general manager of the food and nutrition department at the hospital.
“The product placement of different items was thoughtfully planned out, so that when you walk into the Garden Cafe, you see all the healthy foods first—the large salad bar and the soups and all healthier drinks and things,” she said.
Langill, who also oversees foodservice at the hospital’s Faulkner campus, said the teams at both hospitals continue seeking to be ahead of the curve when it comes to nutrition, sustainability and social responsibility.
“I think what's unique for us is, we really take pride in trying to be ahead of the curve, bringing in new concepts and ideas to the employees, the customers and our patients,” she said.
From cutting greenhouse gas emissions to developing a diverse menu, here’s a look at how the hospitals are doing just that.
Sustainability and corporate responsibility
The two Brigham and Women’s campuses were among the first handful of U.S. hospitals to sign the World Resource Institute’s Cool Food Pledge, noted Langill, cementing their commitment to eco-friendlier cuisine.
The main sustainability goal the teams are working toward now is cutting greenhouse gas emissions associated with their food by 25% by 2025, an aim in line with the Cool Food Pledge.
One way they’re doing this is by tracking and addressing food waste—they donate leftovers to a nonprofit called Food for Free, which repurposes the food into frozen meals that are served to food-insecure populations.
They also try to repurpose food scraps. “So, like broccoli stalks aren’t appealing to a lot of people, or cauliflower stalks and things, and so we'll turn that into a coleslaw and be able to use that as opposed to throwing it away,” Langill said.
Brigham and Women’s Faulkner has about 170 beds, and serves food out of one main cafeteria and a Starbucks cafe.
Meanwhile, the main campus operates four kitchens in different buildings, and the foodservice team operates the main cafeteria as well as two cafes. There is also a 24-hour, self-serve micromarket for employees and two franchised restaurants.
At the pair of hospitals, social responsibility doesn’t end with caring for the environment. The teams also seek to bolster equity in the kitchen, Langill noted. One way they’ve done so is by eliminating the high school diploma requirement for kitchen staff.
“Why do we need to have a high school diploma to be working in the kitchen? It's not really necessary,” she said. “And that's a barrier to especially people who might have [immigrated] from another country and don't have that documentation.”
Embodying inclusion through a diverse menu
In addition, staff seek to create an inclusive and welcoming environment for all cultures.
Prior to COVID, the hospitals took part in a global chef exchange program through Sodexo, where a chef from another country visited the hospitals and prepare some of their favorite dishes. Langill said the teams decided to launch their own chef exchange program after the pandemic, where cooks from other hospitals visit and share recipes.
“We sell the food in the caf, and it increases exposure for employees to try new foods. And I think helps with our whole DEI program to make all the employees feel more included,” said Langill.
When developing the menu, supporting diverse local vendors is also an important consideration.
The two hospitals have teamed up with Commonwealth Kitchen, a Boston-based food incubator that helps startups lacking the resources to produce food in a commercial kitchen.
The incubator has developed a program that allows these startups to use its kitchen facilities to scale up their businesses. The hospitals will then incorporate items from these local producers onto their menus or sell them in retail.
Marketing plant-forward fare
Today, the two hospitals offer a diverse range of plant-forward fare, but Langill said it has taken years to get this far.
At Brigham and Women’s main campus, the hot entree menu at its Garden Cafe is 35% plant based, with a range of vegetable-forward dishes, including jackfruit and lentil jambalaya, curry sesame tofu and portobello stroganoff. Its soup and action entree station is 63% plant based.
The two hospitals have also made efforts to menu foods from the World Wildlife Fund’s Future 50 Foods list, which highlights ingredients with high nutritional value and relatively low environmental impact. During Biodiversity Month in May, for example, several Future 50 foods were featured on the salad bar.
In addition, they've increased the prominence of plant-based taste tests for guests. “We upped our game in terms of the frequency of how often we're having these taste testings,” Langill said. “We usually do them in a visible part, highly trafficked area of the hospital to get more exposure."
Last summer, the teams participated in Practice Greenhealth’s Plant Powered 30 challenge, where they encouraged diners to make one meal per day plant-forward. Those who did were entered into raffles to earn prizes.
They’ve also focused messaging less on physical health and more on the health of the environment, aiming to appeal to the younger generation, which “is much more climate friendly,” she noted.
Langill said that when Brigham and Women’s first introduced plant-forward fare about 15 years ago, it didn’t seem to take off.
“When you market something as vegetarian or vegan, that only appeals to the vegetarians and vegans. It doesn't entice anybody else. And so, we weren't that successful,” she said.
To make the menu more approachable, the team workshopped the names of certain items. For instance, rather than calling a product vegetarian chili, they might name it Cuban black bean chili.
“It’s still the same thing, but instead … focusing more on what's in the food and flavor and the culture of the food and celebrating that, as opposed to focusing on what's not in it,” said Langill.