This guidance uses the “plan-do-check-act” cycle as a framework for developing and implementing a successful food program. While this guidance focuses primarily on food procurement, much of what you will find below can also be applied to other food-related program areas. It is meant to help you build and assess elements of your food program one step at a time while adapting to new experiences and lessons learned.
Develop a plan
Develop a plan based on high-impact opportunities, and set goals or objectives.
It is important for every hospital or health system to define short-term and long-term objectives while establishing expectations for staff. If any attempts have been previously made, this is also a good place to reflect and learn from past initiatives’ successes, roadblocks, or even failures.
Develop a plan for your food program and a phased approach to address contracts and products that meet the institution’s regulatory, environmental, health, and operational values, and have the best opportunity to improve social and environmental determinants of health and help build inclusive and sustainable local economies.
Consider these high-impact factors:
- Known environmental health concerns
- Internal organizational policies or directives
- High volume and cost savings
- Available alternatives or “easy wins”
- Environmental impact: greenhouse gas emissions, known polluter, waste or packaging reduction
- Social impact: worker safety, community or regional impact
All top-performing Practice Greenhealth partners have strategic sustainability plans and goals. A goal can be defined as what you are trying to achieve, while key performance indicators (KPIs) are quantifiable measures used to monitor and evaluate progress toward your goal. Goals should provide a focal point for internal and external stakeholders.
Facilities can consult Practice Greenhealth's annual sustainability benchmark reports to identify potential KPIs for each priority area identified. Or, if the facility takes advantage of the performance measurement tool Practice Greenhealth offers, then it should consult the customized performance analysis and opportunity report.
Identify key data to track
What information is necessary to show progress, and what is nice to have? Data tracking should be strong enough to capture necessary data, but simple enough to reduce staff barriers to entering data. Practice Greenhealth’s awards process can provide an annual data collection opportunity to ensure you are tracking all the data you need and allow you to benchmark your progress against your peers.
Create an implementation plan that clearly outlines what data is needed, from whom, and by when. Use regular communication (reminders, meetings) to encourage on-time reporting and gather stakeholder feedback about the data process
Gather data on key performance indicators (KPIs)
Local and community-based economies
- Percent spend local food purchases ($ spent local food purchases / total food spend)
- Percent local food from diverse suppliers ($ spent on food from diverse suppliers / total local food spend)
- Percent spend sustainable food purchases ($ spent sustainable food purchases / total food spend)
- Percent spend on sustainable seafood purchases ($ spent sustainable seafood purchases / total seafood spend)
- Percent reduction in GHG emissions from baseline – by animal product category
- Percent reduction in water usage from baseline – by animal product category
- Percent reduction in GHG emissions from baseline – by food waste reduction strategy
- Percent spend suppliers with valued workforce ($ spent on food from suppliers with valued workforce / total food spend)
- Percent spend on high animal welfare products ($ spent on high animal welfare products / total animal product category spend, where animal product categories are poultry, beef, pork, eggs, and dairy)
Community health and nutrition
- Percent spend on animal products produced without use of antibiotics ($ spend on animal products without antibiotics / total animal product spend)
Share relevant targets and performance indicators with internal and external stakeholders, including group purchasing organizations (GPOs) and vendors, and make regular reporting part of the cultural practice.
Include process indicators, such as stories about the data tracking process, to encourage further participation.
Secure resources for implementation
All sustainability change initiatives need to be properly resourced, food service initiatives included. To achieve goals related to local, sustainable, and equitable food purchasing, budget considerations should be made. Food is often treated as a commodity instead of an investment in employee health and community health and wealth.
Consider these resources and strategies that can address this common barrier:
- Discuss the True Cost of Food (and share this explainer video) to help leaders understand the compelling reasons to pay fair prices for local, sustainable, and equitable food products that cover the full cost of production and afford living wages for producers and processors.
- Engage staff from other departments outside of food service – including sustainability, community benefit, and procurement – to help implement the pricing model strategy and communicate within the institution the co-benefits of improved community health and increased community wealth and climate resilience, in supporting local producers and processors to build a strong food economy.
- Request dedicated staff time within the food service department or a food value chain consultant from the community to assist with the work all the way through to the contracts being signed. This may include coordinating the ongoing relationship-building and conversations with local producers and processors, identification of products and producers, working out the logistics of distribution and delivery schedules, and data tracking. This is work that requires focused, consistent attention and cannot be simply added to a food service director’s plate or left to producers and processors.
Creating policies that communicate your hospital or health system’s values and procedures for integrating your values into relevant processes is an important next step. This includes how you communicate with suppliers and engage them as partners.
Develop internal policy
Your food policies should communicate your organization’s commitment to its values, which may include engaging community, transparency, racial equity, local economies, environmental sustainability, valued workforce, animal welfare, and community health and nutrition.
For purchasing-specific examples, review these sustainable procurement policies from peer organizations.
A food procurement policy that aligns with your values will:
- Signal commitment from the highest levels of the organization
- Provide a consistent approach and common language, which will be appreciated by procurers, users, and suppliers
- Link food procurement to other organizational goals and policies, as well as important national or local priorities and policies
- Ensure procurement is monitored regularly and continuously improved
An effective food procurement policy will include:
- The reasons for the policy and links to the organization’s mission and values
- The process the organization is committed to and expected outcomes
- Identification of departments and leaders responsible for implementing the policy, including duties and authority to carry out the policy
- Evaluation and monitoring requirements
- Instructions for communicating about the policy and its progress, including public transparency and accountability, and opportunities to regularly review and update the policy
Embed your values in food procurement processes
Review the contract work plan to identify when relevant contracts will be due for negotiation or solicitation. Build policy implementation around these opportunities.
Include discussion of your purchasing values during your annual budget review and planning. While costs for some items may be higher, budgeting can reveal opportunities for cost savings, trade-offs, and investments in long-term success. For example, committing to a dependable local supplier, even if their prices are a little higher, may circumvent national supply chain disruptions.
Review existing menus against high-impact opportunities and other “easy wins” to modify menus to meet your purchasing goals. We offer many resources including tips, strategies, and tools for incorporating local, sustainable, and equitable foods into menus.
Include product and vendor requirements in solicitations for bids
Your vendor qualification language could include a requirement that suppliers can provide purchasing data required to evaluate progress toward values-based food goals outlined in the policy. Data reporting requirements may include the types of data required (product type, brand, location of manufacture, units, product weight or volume, purchase volume, third party certifications, etc.) and method and frequency of data reporting.
You may wish to rewrite product specifications to require products that meet your food purchasing goals. Consider these recommendations to help communicate your values and encourage transparency. Focus on high-impact opportunity products first. Review supplier catalogs or other organizations’ solicitations for guidance.
If working with a food service management company, review the request for proposal for food service management services, and add a data-sharing requirement. Though not a standard practice for food service management companies, product purchase data is critical to measuring progress toward your goals.
Engage vendors and suppliers
Talk with current vendors and suppliers early and often in developing and implementing a values-based purchasing policy. Ask them what they can offer to support your goals and what information you can supply them with to ensure they can provide what you need.
Recognize that your suppliers may be less familiar with values-aligned product attributes you are looking for and that you may need to play a role in educating them.
For broadline distributors, request a tutorial on their data tools, and share the criteria your institution seeks to track. Work with the broadliner’s business development team to develop reports that supply needed information and a process for gathering information that is currently unavailable.
This is also a good time to:
- Make clear and specific requests from vendors about needed data, including data fields (e.g., product information, manufacturing information, units of measurement), required frequency of reporting, and data formats (e.g., Excel spreadsheet, not PDF).
- Add data-sharing requirements and criteria as part of new bids and requests for proposal for food service management companies (FSMCs) and suppliers. Request a sample dataset showing all required fields in the correct format as a criterion of the solicitation process. If you utilize a vendor performance management system or regular performance check-ins, consider adding a success metric related to data tracking and sharing to ensure it remains a priority.
- If using a third-party data company, discuss data needs as described in the food waste solutions toolkit.
- If using menu development and ordering software systems, consider adapting them to track preferred product attributes.
Work through existing group purchasing organizations (GPOs) that manage food supply contracts
Hospitals and health systems can influence product availability through their GPO contracts. It is important to start slow and buy what the GPO is able to offer to demonstrate follow-through. This GPO engagement resource outlines opportunities to advocate for more products that align with your values from preferred GPO suppliers.
Engage the broader supplier community
Attend food shows sponsored by business development agencies, ask for supplier recommendations from other regional institutions, and offer events like supplier speed dating to share your purchasing needs with the supplier community. Many hospitals expand staff time to focus on building relationships with local and alternative suppliers that work with local or regional producers (e.g., local food hubs).
Build procurement culture that aligns with your values
Train staff on procurement principles, including policies, procedures, and how procurement can be a tool for community engagement. Consider including staff from multiple departments – food service, community benefit, sustainability, and clinical – as well as community members.
Nonprofit hospitals may also refer to their community health needs assessment (CHNA) to identify and refine strategies for engaging the community in the hospital’s procurement culture and needs. For example, consider developing questions in your CHNA survey addressing cultural preferences and food traditions.
Engage community members through public relations events such as health fairs, tabling, sponsorship, and co-branded events to help the institution share its values with the community. Speak with the institution’s public relations team about creating these opportunities.
Share food initiatives and celebrate successes widely through the use of cafeteria spaces (e.g., table tents, TVs, and signage). Include information on patient menus and trays, and identify staff from different departments to represent your purchasing values when speaking at conferences and events.
It is critical to review progress against the initial plans or objectives and gather data points from any relevant previous initiatives or annual or quarterly data collection process for comparison.
Adapt tracking systems to measure progress
Work with procurement staff to understand what they track already, and identify opportunities to use existing purchasing and inventory systems to track relevant data. This might include modifying out-of-the-box or custom software. Engage relevant IT personnel to incorporate outcome indicators, like fields for criteria, into data management workflows.
Review collected data, and decide how best to combine it to measure against goals. Note any areas where data is missing, incomplete, or overly broad.
Consider third-party tools to measure progress toward outcomes. For example, the Cool Food Calculator is a tool that can be utilized to measure carbon reduction for organizations who take the Cool Food Pledge.
Evaluation helps determine if your procurement program is benefiting your organization and beyond. In this phase, you can reflect on your hospital or health system’s impact, report on your results, and refresh your plan and approach as needed.
Bring internal and external stakeholders together to evaluate the impacts of the initiative or primary objectives you have set out to test. Use a SWOT (strengths, weaknesses, opportunities, and threats) analysis to discuss how the process went for stakeholders and how they interpret the outcomes. Discuss what worked well, what needs improvement, and how to achieve greater impact in both products (increasing purchasing of foods that meet your criteria) and process (stakeholder participation in meeting goals).
Convene the advisory committee or key stakeholders quarterly to provide strong oversight. Report your purchasing program results to leadership through an annual report. Provide case studies illustrating successes, and make report summaries widely available for staff and patients.
Recognize and appreciate key champions: Celebrate small wins and recognize key stakeholders for their efforts at annual celebrations, in newsletters, or at public recognition events. Share success stories with peers through professional networks, conferences, and awards. These opportunities will reward the hard work of staff through recognition and celebration. Hospitals and health systems can also participate in Practice Greenhealth’s Environmental Excellence Awards to compare their progress and achievements against other organizations.
Revise objectives, targets and plans as needed
Use your impact evaluation to determine whether the objectives or targets need reframing, revisions, or expansion.
Consider adding or modifying objectives or high-impact products or opportunities. Practice Greenhealth’s 10 elements for sustainable procurement programs can serve as your quick reference guide to determine opportunities for improvements to the organization’s procedures. This is also the time to refer back to the baseline or other assessment and organizational strategies and priorities to align interests across departments for greater impact.