Healthy Hospital Food Environment:Policy & Programs in Practice

CDCWeight of the NationMay 2012

Scottie GaskinsSenior AdministratorVidant Wellness,Home Health & Hospice

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Overview of Vidant Health

• Healthcare system serving 29 counties (1/3 of North Carolina) with a population of 1.4 million people. – 1,500 beds

– Ten owned, leased or managed hospitals

– physician practices

– home health and hospice

– wellness centers

• Largest NC employer east of I-95 with over 11,000 employees

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MISSION

VISION

VALUES

To enhance the quality of life for the peopleand communities we serve, touch and support

Where incredible people provide incredible care… every day

Excellence… our standardCompassion… our distinctionTeamwork… our advantageEducation… our investmentInnovation… our future

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Wellness Culture• Strategic Framework – People Pillar• Leader & Board driven & supported• Robust Wellness Benefits:

– Three Wellness Centers– Employee Wellness Program– Disease Management & Health Coaching– Employee Health Clinic– Occupational Health Clinic– Employee Assistance Program– Employee Pharmacy– Incentives- premium credits, medications & other– Medical Plan Design

• Environment & Policies to support healthy behaviors

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Employee Engagement

91%

employee participation in

Wellscreen!

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State of Weight at Vidant Health

• 74% employees are overweight or obese; > local, state & national

• Obese employees averaged 9.4 more sick hours than healthy weight participants at a cost of $197 per person per year. Cost reduction opportunity of $809,572 to reduce the 46% of employees who are obese.

• Employees who were overweight or obese incurred 4.58 times more lost work hours tied to workerscompensation than workers withBMI less than 25.

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Weight Reduction Programs

• Drop-A-Ton / Wellness Challenges

• Weight Watchers at Work

• Eat Smart, Move More, Weigh Less

• Group Training/ Weight Path

• Medical Weight Loss / Optifast

• Medical Nutrition Therapy

• Bariatric Surgery

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Healthy Food Environment

Our Commitment:

• Make delicious, healthy foods:– Accessible– Affordable– Visible with calorie/portion size

information so consumers can make informed choice

• Create an environment that supports the practice of healthy behaviors

• Still provide choice

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Policy Effective January 2012

Healthy Food Environment is the Norm, not the Exception

• 75% of food & beverage options at onsite food venues (eateries and vending) meet healthy criteria

• 60% of food & beverage options at company-sponsored events meet healthy criteria

• Price leverage healthy options in eateries and vending

• Label calories on all foods and beverages

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What is Healthy?

Per serving calorie criteria as outlined below:

Main dish <500 caloriesSide item <250 caloriesMeal <800 caloriesSoup (8 oz.) <225 caloriesDesserts/breads <200 caloriesSnacks <200 caloriesCondiments < 75 caloriesBeverages -water, sports drinks, diet sodas, juice drinks <50 cal/ 8oz -milks and coffee drinks <100 cal/ 8oz -100% juice no cal limit; 12oz max

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Spirit of HealthyOffer fruits, vegetables, whole grains, lean meats and fish, and vegetarian options; and use health-promoting food preparation techniques.

The impression should be that healthy foods and beverages predominate.

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Calorie Labeling

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Price Leveraging

25% average variance

Healthy Entree         $2.54Less Healthy Entree $3.44

Fried Chicken Breast   $2.47Baked Chicken Breast $1.83

Regular Bottle Soda $1.71Diet Bottle Soda  $1.39

Side Dishes reduced from $.99 to $.84(94% healthy)

Fish Entree reduced from $3.29 to $2.80

Salad Bar reduced from $.32 to $.26/ounce

Whole Fruits reduced from $.70 to $.60

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Communication

• Cascaded by leadership

• Toolkits & Webinars– Vendors– Event Planners

• System communication channels

• Early adoptors & demonstration from board meetings to employee forums

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Keys to Success

• Leadership engagement & buy-in• System-wide steering committee• Specialty work groups – Finance, RD’s• Written into policy• Cascaded by leadership• Communication• Early engagement of vendors• Baseline data captured to monitor impact• Linkage to resources such as NC Prevention Partners• Shameless plagiarism of other’s best practices

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Next Steps

• Consumer education

• Monitoring compliance until hard-wired into the culture

• Monitor impact– Sales– BMI

Acknowledgement

• Vidant Nutrition Initiative Healthy Food Environment Steering Committee

• Kathryn Kolasa PhD, RD, LDN, Vidant Nutrition Consultant

• May 2012

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Questions