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Title : Demonstrating Evidence Informed Food Procurement Can Improve Quality of and Satisfaction with Hospital Foods Without Significant Cost Increases- Results from Northwell Health's Healthy Food Initiative Jeffrey Jacobs and Sven Gierlinger

Background : While foods available in most hospital settings are typically of suboptimal nutritional quality and receive low patient/consumer satisfaction scores, it may be possible to improve the quality and concomitant satisfaction scores of hospital foods through the implementation of procurement and food preparation policies which follow state of the science nutritional and public health recommendations. We sought to attempt this in a financially responsible manner.

Method : In July, 2016 new food procurement policies were introduced. These policies aim to implement the scientific recommendations and messages of the “Healthy Kitchens, Healthy Lives” conferences (www.healthykitchens.org) , including: eating more fresh fruits and vegetables; eating less processed, and convenience foods; more sustainable fish; etc. These policies were applied across Northwell’s 22 hospitals and 62,000 employees in the NY area.


  • Fresh vegetable purchases rose $100K per month (100% increase) from January to July.
  • Utilization of deep fryers was reduced by 75% (eliminating fryers in 13 of 17 kitchens).
  • Fresh Anti-biotic-Free (ABF) chicken purchases increased $220K/month (from Jan-July). These accounted for 15% of chicken in January and 85% of chicken by July.
  • Fresh seafood increased by $35K/month and now all hospitals use 100% ABF or organic fish only.
  • ABF chopped meat purchases followed a similar pattern and currently all hospitals use 100% ABF 4 oz burgers only.
  • Fresh, rain forest certified coffee replaced previously purchased “liquid coffee” and saved $250K/year.
  • Total food purchases were $29 million and rose by only 2% during the implementation.
  • Press Gainey Scores relating to the question: “quality of food” rose 121% during this period.
  • During this same time, we engaged >5,500 employees in Northwell Health’s Teaching Kitchens.
  • Conclusion: It is possible to apply evidence based food procurement policies to improve the quality of and satisfaction with hospital based foods without a significant increase in overall food expenditures.

    Title : Demonstrating that novel food procurement guidelines can result in (novel hospital food offerings) which meet nutritional guidelines while increasing guest satisfaction; and without significant increases in overall food procurement costs. Results from Northwell Health's Healthy Food Initiative.

    Background : Most hospital foods lack quality presentation, possess suboptimal nutritional quality, taste poor, and receive low patient/consumer satisfaction scores. It is possible to improve these characteristics through the implementation of innovative, health promoting, environment protecting food procurement and preparation policies, which follow evidence based nutritional and public health recommendations.

    Method : New methods were developed to ensure compliance and adherence to Northwell Health’s new “healthy quality food initiatives”. These methods included requiring all hospitals to sign a pledge to purchase local produce during the local growing season. We found that our vendors lacked availability of the restaurant quality food products we desired. As a result, healthy quality items and freshly cooked and prepared items had to be continuously created to meet the newly developed hospital’s health and nutritional criteria, as outlined by the NYC Healthy Hospital Initiative. In addition to improving food quality, 10 hospitals have implemented an upgraded bone china plate program utilizing 10 ½ inch entrée plates, to better highlight a “restaurant style” presentation of higher quality food offerings.


    Press Gainey Scores relating to the question: “how would you rate the quality of food” rose from 9% top box in June 2016, the start of the program, to 56% in November of 2019, an increase of 47% over 36 months. Total food purchases of $35 million at baseline, rose by only 3 % during the implementation year (2019???) This h correlates with the documented federal cost of living increase in this same year. Many new food offerings were developed to meet the system’s new nutritional guidelines. For example, a “never fried” potato which is not pre-fried, pre-breaded or pre-oiled; healthy desserts; artisanal (whole grain) breads, and many more.

    Conclusion: It is possible to apply evidence-based food procurement policies to improve the nutritional value and quality of hospital-based foods while increasing customer patient satisfaction without a significant increase in overall food expenditures.

    Title : It is possible that an evidence-based hospital-managed food insecurity program can have a significant impact on the health of patients at Northwell Hospitals by addressing and improving the targeted community’s social determinants of health via access to affordable healthy food.

    Background : Northwell Health developed the pilot program, “Food as Health” at Long Island Jewish Valley Stream Hospital, the first hospital-based initiative in New York State to comprehensively address food insecurity among its patients

    Method : The “Food as Health” model utilizes the strengths of the area’s food system, local organizations and community partners. To begin, the program will screen patients either in the hospital or at local community centers with the 2-question Hunger Vital Signs Survey. Individuals who screen positive will be referred to their “Food As Health” center to receive fresh fruits and vegetables, counseling from a community dietitian, assessment and application assistance for SNAP and WIC, insight on eating for their condition, culturally appropriate and SNAP- friendly recipes, as well as connections to long-term food resources available locally. The food will be dispensed like medicine, providing a three-day supply of nutritious food. For patients who cannot travel to the “Food as Health” center, partner organizations will provide home delivered meals or raw produce. The program aims to utilize teaching kitchens, conduct outreach and provide food resources in libraries, workplaces, and community centers. Partnerships with local community organizations will ensure that the provided recipes, guidance, and resources will be culturally appropriate, and ideally increase the likelihood of adoption of healthier habits. The program hopes to provide these services and resources in local, readily accessible locations, in order to decrease the burden of travel and increase the likelihood of utilization.


    First 16 months of program (July 2018 – October 10, 2019)
    Category # of Patients Screened: 2,452
    Positive for food insecurity: 676
    Referred to onsite FAH center: 308
    Seen at FAH center for initial visit: 142

    After visiting the pilot program at Long Island Jewish Valley Stream Hospital, over 70% of screened patients reported increased food security on follow-up.