Hunter Brain Injury Service (HBIS) is a community based rehabilitation service for adults with acquired brain injury, located in Newcastle, New South Wales. The Hunter New England Local Health District (HNELHD) developed a plan to be carbon and waste neutral by 2030, using the principles of a circular economy to tackle the issue of food waste. In support of this plan, HBIS has successfully implemented a closed loop, patient-led solution to stop food waste from reaching landfill.

The Problem:

Compared to large acute health services in the district, HBIS has a relatively low level of waste production. This is due to the fact that the team at HBIS is mainly composed of allied health professionals, who use minimal medical consumable products and operate on a model of care that is focused on community reintegration and social participation for patients. At the beginning of the project, HBIS identified that food waste was the main component of general waste at the service and there were no commercial food organics collection available. In response to this, the team sought to implement a patient-led circular solution to manage food waste onsite.

Goals:

• HNELHD is aiming to be carbon waste neutral by 2030
• HBIS is committed to diverting and minimising food waste from general waste
• Improve patient outcomes by 

  • Embedding patient-led sustainable practice into brain injury rehabilitation;

  • Creating a culturally safe space for patients and families to recognise the value of
    Caring for Country on health and wellbeing;

  • Improving opportunities for incidental physical activity, cognitive stimulation and social
    interaction;

  • Optimising nutrition literacy and improve dietary habits;

  • Offering opportunities for pre-vocational skill development;

  • Combatting poor engagement in centre based indoor therapy programs

The Process:

Two key milestones initiated this project in 2019. Firstly, an HBIS consumer engagement group identified that access to meaningful and culturally safe outdoor leisure activities could help reduce physical inactivity and boredom between therapy appointments. Secondly, HNELHD encouraged staff to become 'Sustainability Champions' and brought focus to achieving the sustainability goals set out in the district's sustainability strategy. The program was then implemented in 2020.

• A therapy garden and bush tucker yarning circle were built on site with a small scale compost system and worm farm integrated into the design.
• HBIS provided patients and staff with a culturally safe space to sit and converse
• Process for diverting staff and patient food waste from the kitchen from general waste to the onsite compost system and worm farm were developed and embedded into the service model
• A weekly garden group was formed for patients residing in the transitional living unit, where they participated in a list of activities that taught them transferable skills for reintegration into home life. This included depositing food waste from the kitchen into the compost bin and worm farm each day.
• The compost and worm castings were then fed into the garden beds to optimise conditions for the prolific growth and harvesting of the various edible plants in the therapy garden.
• To further mitigate food waste, the meal planning process at HBIS was reviewed, which replaced the food that was previously procured from major supermarkets with the seasonal harvest from the garden. This system has reduced food costs and minimised food spoilage associated with over-purchasing.

Outcome:

Since the strategy was implemented, HBIS has achieved significant environmental and financial benefits through the program. Onsite composting and worm farming have diverted 120kg of food waste from landfill per year, and reduced HBIS' overall carbon emissions. Moreover, harvesting fresh produce from the garden has decreased the average spend on patient food by 49%. Patient surveys have also highlighted that improved nutrition literacy and enhanced connection to food systems have been observed in HBIS patients. HBIS has successfully diversified meal preparation skills in patients and increased their intake of nutritious unprocessed foods, giving them greater opportunities to practice real world cognitive and social communication skills while improving dietary intake.

Patient surveys reported that 87.5% of patients who participated in the program, were eager to use their new knowledge of sustainable food gardening and food preparation upon discharge of the service.

In 2022, the project was awarded the Sustainability and Environmental Health Award at the annual HNELHD Excellence Awards.

This full case study is available to GGHH members via GGHH Connect.

Congratulations Hunter Brain Injury Service! Thank you for your sustainable healthcare leadership!