Healthier Drinks for Healthcare

Initiative Type
Service Improvement
Status
Deliver
Added
04 July 2019
Last updated
09 July 2019

Summary

Food and drink outlets are often the first thing you see when you walk into a hospital, making them an ideal place to showcase a commitment to healthy living. As part of the Rapid Results Program, healthy food and drink supply in Queensland Health facilities became a Minister’s Priority in 2019. Prevention Division has been working with Hospital and Health Services (HHS’s) since 2016 to enable and drive a reduction in sugary drinks in our hospitals benefitting patients, families, and staff.

Achievements made through voluntary incremental change have laid the groundwork for a bold new policy requiring complete removal of sugary drinks from Queensland Health facilities: Health Service Directive: Healthier Drinks at Healthcare Facilities.

Key dates
Jun 2016
Dec 2019
Implementation sites
All HHSs are engaged in the Healthier drinks initiative.
Partnerships
Partnerships have been crucial to the delivery of the Healthier drinks initiative. A partnership between PHB and HHSs in the first instance, followed by local HHS partnerships with key stakeholders affected by the changes.

Aim

Creating environments that support patients, staff and visitors to make the healthy choice, the easy choice at Queensland Public Hospitals.

Benefits

  • Improve the availability of healthy choices and ensure they are available at all times.
  • Reduce the availability of less healthy choices.

Background

The Preventive Health Branch (PHB) within the Queensland Department of Health provides leadership and expertise to enhance and support prevention focused policy, systems and services in hospital and health services (HHSs).  There has been a growing readiness in HHSs to look beyond acute services and to engage in prevention. A strengthening partnership between PHB and hospital and health services including funding support, has enabled the acute healthcare sector to develop and deliver sustainable and integrated prevention policies and programs, including activity around healthier food and drink supply for patients, families, and staff.

Solutions Implemented

By August 2018, six HHSs had voluntarily committed to removing sugary drinks from sale, including CHQ, DD, NW, SW, WB and WM. In 2019, healthy food and drink supply in Queensland Health facilities became a Minister’s Priority. To fully deliver on this priority, a Health Service Directive was developed in consultation with HHSs, effective from 1 July 2019. The purpose of the Directive is to ensure that any drinks sold, provided, promoted and advertised in Queensland Health facilities are only healthier drinks.

Evaluation and Results

Evaluation data provided from HHSs at the end of 2018 demonstrated a significant reduction and in some cases, complete removal of sugary drinks. In addition, stakeholder surveys have revealed consumer and staff support for healthy changes to food and drink supply in health care facilities. Compliance with the mandatory requirements of the Directive will be measured via an online monitoring and reporting system and results will be published on Queensland Health’s System Performance Reporting (SPR) platform. The first reporting is due by December 2019.

Lessons Learnt

Change can occur through a diverse range of models, however significant enabling factors include Executive Leadership support, effective stakeholder consultation, communication strategies, and consideration of sustainability measures past the end of the funding period.

The following lessons summary is provided from the 2018 Partners in Prevention Forum - healthier drinks in health care panel discussion.

Dominique Ryan, Senior Dietitian, Sunshine Coast Hospital and Health Service

Key message: Laying the groundwork to enable sustainable change

The Sunshine Coast Hospital and Health Service (SCHHS) was interested in pursuing the healthier drinks strategy and saw opportunities to extend partnerships with the University of the Sunshine Coast in the form of student placements, supported by the SCHHS Staff Wellness/Health 4 Life. This project was the second of three placement projects with a central task to develop an implementation plan for Healthy Drinks. Students forged initial relationships with hospital food and drink retail outlets and gathered baseline data in the complex environment. Funding has since been granted for a Healthy Drinks Project Officer who – with the support of ongoing students placements - will continue with the implementation of the project and ensure its sustainability across the different sites within the SCHHS.

Annabelle Stack, Project Officer Healthy Choices, Metro South Hospital and Health Service

Key message: Wide stakeholder engagement can result in productive partnerships

The Healthier drinks project in Metro South Hospital and Health Service (MSHHS) took a broad and comprehensive approach with stakeholder engagement. From consumers to clinical staff, retail and suppliers, auxiliary and foundations, valuable partnerships were formed to drive positive changes in the food and drink supply. A key result was no negative impact on revenue and in fact an overall increase was achieved.

Debbie Carroll, Chief Operating Officer, Wide Bay Hospital and Health Service

Key message: Executive leadership support drives change

As the only HHS not to access funding, Wide Bay Hospital and Health Service (WBHHS) were successful in removing sugary drinks from sale in a short time by gathering support at the Board and Executive Management level, and establishing an expectation that the health service would be a leader in the Healthier drinks space. The transition took a few months and was pre-empted by implementation consultation with staff and consumers, and suppliers/retailers.

Rohan Ballon, Community Nutritionist, South West Hospital and Health Service

Key message: Quality project delivery can embed changes long term

All the hallmarks of good project management can be identified in the Healthier drinks work at South West Hospital and Health Service (SWHHS). A baseline audit revealed a drink supply dominated by unhealthy options but a consumer survey showed an expectation for more healthy options within a health setting. A working group representing all key stakeholder groups worked through a phased approach, supported by Executive Leadership team. Changes were embedded in policy and communication strategies utilised to prevent slippage. The project has ended but the changes remain.

Dr Ayala Rogany, Dietitian - Clinical Leader Obesity, Children's Health Queensland Hospital and Health Service

Key message: Measuring change (evaluation) can prove positive results

Children's Health Queensland (CHQHHS) and West Moreton Hospital and Health Service (WMHHS) partnered with University of Queensland (UQ) to conduct a formal evaluation of healthier drinks implementation across all sites. Working with suppliers, and using pre- and post-audits, the HHSs were able to demonstrate that sales of healthy drinks increased whilst unhealthy drink sales fell, with proven staff and visitor support for the changes.

Key discussion points raised by the audience

  • Some HHSs have found that consumer support for healthy changes is stronger than staff support. Some important strategies for progressing change were identified, including
    • Union consultation
    • Framing of the change as health services leading by example by making a system change – less focus on the individual
    • Promote the positives including increasing healthier choices, and more accessibility and availability (e.g. more free water, 24 hours healthy options through improved vending)
  • Healthy changes to food and drinks is moving with consumer and business trends currently so it is an opportune time to make progress in health services.
  • Key challenges in health settings include staff resistance, fundraising activities, and increasingly, the complexity of retail services which can be set up as hubs with franchise operations.

Further Reading

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Key contact

Deanne Wooden
Senior Public Health Nutritionist
Preventive Health Branch
(07) 3328 9248
Deanne.Wooden@health.qld.gov.au