When trying to change the culture in a healthcare cafeteria—or patient trayline—foodservice teams at individual hospital systems might feel a bit isolated and alone in their efforts, if not for organizations like the Humane Society of the United States (HSUS), Oldways, the Physicians Committee for Responsible Medicine, Health Care Without Harm and Meatless Monday.
Those nonprofit organizations provide resources for foodservice leaders and their teams—hands-on training, recipes, menus, programs and more—to individual hospitals or hospital systems, in an effort to bring plant-based eating into the forefront in healthcare dining. This year, those same organizations have formed a new coalition, working together to essentially help hospitals offer more plant-based menu items.
While the coalition can provide a lot of backup, it’s up to individuals who are working in the trenches to make it work in the busy day-to-day setting of a hospital kitchen dedicated to providing the best for patients, visitors and staff while keeping a constant eye on sales, labor and operating costs.
One of those people is Natalie Castro, MS, RD, LDN, a registered dietitian who oversees the food policy for Baptist Health South Florida’s 11 hospitals that span from the Boca-West Palm Beach area all the way down to the Florida Keys.
Castro is familiar with HSUS and has partnered with them for a couple of years prior to the new coalition. Even before that, Castro has focused on what she calls the “food environment.”
“I was challenged with keeping our employees healthy, but I can’t do that if we don’t have a healthy food environment,” Castro says. “When you step outside you have McDonald’s and all these marketing messages coming at you. [Within the hospital] we have to look at the food we offer in our dining rooms, our vending machines, our celebrations and meetings…we can’t have a double message. We can’t say you have to feed people healthy food and then give people horrible food.”
When developing menus, Castro often asks herself: “What does that food environment look like when you’re trying to change the culture for good?”
At first, Castro found that healthy menus can mean higher food costs: For example, fresh fish isn’t sustainable from a budget standpoint, especially at the low prices the hospital cafés pride themselves on, a value-add that’s a resource to the community, especially in smaller Florida towns.
“It’s the cheapest meal in town. You can’t get a great meal and a bottled water for $4 anywhere else,” Castro says. “It’s something we’re leveraging, and we invite the community, including Miami-Dade police officers to come in. It’s affordable. What drives a customer to make a healthy choice? If it’s convenient and affordable.”
Plant-based eating has turned out to be a ticket to healthier—and cost-effective—menu items, Castro says.
“We were like, ‘It only makes sense. What if we changed our better-for-you meal and made that completely plant-based?” she says. “All the stars aligned. We were running into issues trying to be economical and produce a meal of high quality for such a low price.”
The answer came in the form of one of the hospital system’s most popular menu items, a Chipotle-style Mexican bowl with beans as the protein. Another selling point for plant-based menu items, Castro says, “Beans are much cheaper.”
The familiarity factor also comes into play in creating successful plant-based menu items. “Our Mexican bowl is popular, because who doesn’t like tacos?” Castro says, adding that a Cuban bowl is also a top seller. “People are familiar with that, so we connect with the cultural familiarity versus something like tofu. We’ve adapted the menu based on sales and the cost variance speaks for itself by being able to have a lower food cost.”
Other familiar-but-better-for-you menu items have included and udan noodle bowl with mushrooms, grilled tofu and edamame and also a lot of lentils; patties from a local vendor; replacing ground beef in picallilo and a pasta Bolognese also made with lentils.
Sophisticated plant-based cooking—not just throwing raw tofu on the salad bar—is the intersection where training from HSUS and other organizations in the coalition comes in clutch.
Training in plant-based cuisine—along with a higher-caliber work force entering the healthcare market—has helped the stars align further.
“We have chefs with years of restaurant experience who are changing what hospital food is,” Castro says. “We’re changing the idea that if it’s healthy it means bland.”
The numbers show that culture change is happening. Baptist Health has seen an increase of 93% in plant-based sales since starting work with HSUS, with an average of 40% of customers choosing the plant-based options daily.
One factor she’s had to watch out for, Castro says, is the sophisticated marketing not just of fast food chains, but of manufacturers of plant-based processed foods that may be full of unhealthy additives.
“Our whole philosophy is to use fresh ingredients,” she says. “We emphasize our meals as being the most nutritious options you can put in your body.”
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