‘It’s a constant changing environment, and we’re just playing catch up’: Hospital food services, food waste, and COVID-19 (2022 Jun)

(available for download at the bottom)

Cook N, Goodwin D,Collins J, Porter J.‘It’s a constant changingenvironment, and we’re just playing catch up’:Hospital food services, food waste, and COVID-19.Nutrition & Dietetics. 2022;1‐10. doi:10.1111/1747-0080.12762

Open access link to article: 


Relevant to: 

Foodservice dietitians


The research wanted to understand the impacts of COVID-19 on hospital foodservice practices. Specifically, how COVID-19 impacted the completion of food waste audits and the generation of food waste in hospital foodservice.

Bottom line for nutrition practice: 

  • Foodservice staff are a resilient workforce group
  • Forced changes in resource allocation and usage allowed foodservices to adapt and learn to work with COVID-19 restrictions, potentially beginning the path to post-pandemic services.
  • This stage of the ‘green recovery’ can be led by dietitians and may incorporate food waste audits as a higher priority.
  • The success of electronic menu management tools during this period to combat contact restrictions may see them remain as ‘standard procedure’ for food waste data collection and be selected for uptake in additional hospitals who do not have this technology currently.


  • Aims: Hospital food service operations have been affected by the COVID-19pandemic, particularly resulting in increased waste. The aim of this research was to explore the impact of the COVID-19 pandemic on hospital food ser-vices, particularly on food waste and the completion of food waste audits.
  • Methods: A qualitative interview research design was used. Semi-structured interviews were completed and recorded via Zoom, focusing on the barriers and enablers towards the completion of hospital food waste audits. Twenty-one participants were interviewed from 12 hospitals. No questions were related o the COVID-19 pandemic and its impact on hospital food services, however this issue frequently emerged during interviews. Data were coded following inductive thematic analysis.
  • Results: Five themes were generated from the interviews related to COVID-19and hospital food services; impacts on practice, labour, change, technology and post-pandemic expectations. Participants reported COVID-19 negatively affected food service operations. Changes included increased food waste, con-tact restrictions, and labour shortages. Nonetheless, hospitals embraced the challenge and created new positions, trialled different food waste data collection methods, and utilised technology to support food service operations around COVID-19 restrictions.
  • Conclusions: Despite the impact COVID-19 had on hospital food services, including their ability to audit food waste and increased food waste generation, the response from food services has demonstrated their adaptability to change. Sustainable healthcare, including the aggregate measuring and reduction of food waste in hospital food services, is an essential transition post-pandemic, and may be facilitated through the operational changes forced by COVID-19.

Details of results: 

Five themes were generated from the data after inductive coding was completed: these are below in dot point format with some of the dominant responses presented.

  1. Impacts on practice
    • Infection prevention led to increased pre-packaged single serve food, utensils, crockery and their waste
    • The re-use, storage, or donation of used items was prohibited
    • Waste disposed of in patient rooms
    • Forecasting was impacted by COVID peaks
  2. Change
    • Some changes occurred immediately, others took time
    • Reduction in hospital catering services
    • COVID-19 as an excuse to trialing new practice
    • Ingredients inaccessible and out of stock
  3. Technology
    • Room service was recommended to forecast meal numbers and support food service delivery
    • Electronic menu management systems with waste measurement capabilities were supportive in plate waste data collection but not available at all sites due to cost, equipment, and manual data collection still being part of standard practice
  4. Labour
    • Higher than usual sick leave
    • Failure to hire new staff (>300 interviews completed at one site)
    • Individuals forced to step in to new and unfamiliar roles (e.g. manager to chef)
    • Cumulative pressure on staff throughout COVID including vaccine mandate in Victoria which resulted in loss of staff
    • Nutrition students unavailable to hospitals for placement
  5. Post Pandemic expectations
    • Hope for practice to return to normal as soon as possible or when the pandemic is ‘over’
    • Planning for future emergencies already to counteract drastic changes in service and practice

Of additional interest: 

Editor’s comment:  

@nathan_cook includes the audit tool with descriptions for you available at this link in the side bar.

Conflict of interest/ Funding:  

One author of the research is an editor at the journal, however the journal undergoes a blinded peer review process. Funding was received by Nathan Cook in the form of a scholarship from the King and Amy O’Malley Trust Scholarship and the Department of Nutrition, Dietetics and Food at Monash University as part of his PhD.

External relevant links:  

A blog describing the research article – http://monashnutrition.blogspot.com/2022/09/hospitals-covid-food-waste-dilemma.html

Corresponding author: 

Nathan Cook, @nathan_cook, PhD candidate, nathan.cook@monash.edu

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