Abstract

Introduction: Due to reduction in cardiovascular risk, healthy, plant-based foods, as opposed to animal-derived products should be promoted to patients. We created a hospital initiative on the cardiac floors to educate the multidisciplinary staff to serve as advocates for healthy eating. Methods: Housestaff participated in education sessions on the benefits of plant-predominant meals and patient counseling. More plant-predominant options were added to the menu and several unhealthy items were eliminated. Food orders were assessed pre-intervention (February 2020) and post-staged interventions (October 2020 and April 2022). Food choices were assessed using the healthful and unhealthful diet index. Press Ganey scores were obtained and housestaff comfort with diet counseling was also assessed. Results: Resident perception of their own knowledge went from “poor” to “good” post-intervention. Confidence in talking to patients about plant-based diets went from “not confident at all” to “fairly confident". After analysis of diet orders, a 52% decrease was noted in animal-based products (chicken, beef, pork and turkey), 35% decrease in unhealthful food items (refined grains, processed foods, potatoes and sweetened beverages), and 25% decrease in plant-predominant food items (whole grains, fruits, vegetables, nuts, salads, legumes and fish), but this time period occurred in the setting of high COVID-19 rates. A subsequent analysis of a single cardiac unit after the COVID-19 surges and after select unhealthy items were removed from the menu showed notable improvements in each parameter when adjusted for discharges; a 2% increase in plant-based, 37% decrease in animal based and 4% decrease in unhealthy items. Press Ganey ratings for the quality of food increased post-initiative by at least 27%. Conclusions: This quality initiative was a local pilot to increase our understanding of interventions that may have a meaningful impact on healthy eating for patients. Interpretation of results is limited due to the COVID-19 pandemic, which may have impacted food choices of admitted patients. Although further research is needed, housestaff engagement may be a promising mechanism to educate patients and encourage food and nutrition changes in a health system.

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