In Their Words: Mills-Peninsula Medical Center's Kristin Pfenning

Since early 2018, the Food and Nutrition Services Department at the Mills-Peninsula Medical Center in Burlingame, CA has been transitioning its produce from conventional to organic. The hospital’s efforts are part of a broader sustainability initiative undertaken by Sutter Health, the not-for-profit organization of which Mills-Peninsula is an affiliate. The initiative focuses on improving Sutter’s environmental impact in five main areas: energy and emissions, supply chain, facilities, waste, and food.

Sutter’s sustainability program was developed with assistance from Health Care Without Harm, a nonprofit whose Healthy Food in Health Care initiative has been supporting Mills-Peninsula’s transition to organic produce. While Mills-Peninsula is the only Sutter Health facility to begin such a transition, others are currently exploring the option. OPN spoke with Food and Nutrition Services Director Kristin Pfenning to learn more about Mills-Peninsula’s organic shift.

Can you give us a little background on the food and nutrition services department at Mills-Peninsula and the population it serves?

The Mills-Peninsula Food and Nutrition Department feeds an average of 165 patients per day and up to 70 participants in our senior focus day program. We also provide services to staff, volunteers, physicians, and visitors in our cafeteria, along with internal catering services and a physician’s lounge. Annually, we serve 700,000 meals, all of which come from our kitchen here in the hospital. 

How did your organic produce purchasing program come about?

About 4 to 5 years ago, I started to dig into the research around our food supply and learned just how toxic it really is. I personally changed the food I bought to nearly 100 percent organic, grassfed, pasture raised, and wild-caught. I avoid conventionally produced food as much as possible. That’s where it started for me at home. It’s really become something I’m passionate about, and I wanted to bring that to my work environment. When I came on board with Sutter a little over three years ago, I was so excited to learn about their sustainability program as many of the focus areas also align with improving the health of those who visit our facilities.

At Mills-Peninsula, we decided to transition our produce to organic as one of our health-promoting and sustainable initiatives. We began our transition to organic in January of 2018, starting with the dirty dozen, the most pesticide-heavy produce items. All of the items on the dirty dozen list were transitioned to organic over the course of three months. Any items on the dirty dozen list that we were unable to obtain in organic, we removed from our menus until we were able to source them. And from there, we slowly added more organic options like cucumbers and all leafy greens. We have continued to work through the list of produce in order of most pesticide-heavy to least (per the Environmental Working Group) in order to continue our transition. The goal is that at least 90 percent of the produce we purchase will be organic. Currently, about 60 percent of our produce is organic.

One of the challenges is that options can be limited through our prime vendor US Foods. However, we do work very closely with our rep to increase the number of organic and sustainable items available for purchase.

So your demand for organic items influences what US foods carries? 

Yes, it does—but to an extent. For US Foods, they have a requirement. They’ll generally bring in any product; however, you have to commit to ordering a certain number of cases per week. If it is just Mills-Peninsula requesting organic cucumbers, and we know that we’re not going to be able to meet three cases per week, then they are not able to bring that in as a regularly stocked item. So, it’s not to say we can’t get it, but it may not be regularly stocked. In that case, what we’ve tried to do is partner our buying with other health care organizations who also utilize US Foods and who are on a similar organic journey.

Cost is another factor. Organic items generally cost more than conventional, so even if US Foods is able to stock an item, sometimes the cost is too high. We have another produce vendor that we utilize, Bay Cities Produce. We use both US Foods and Bay Cities, looking for the best quality organic items and the fairest price.

Are you able to purchase anything directly from organic farmers?

We’re part of a group purchasing organization (GPO), and so we are generally held to purchasing from a set list of vendors. It’s not to say that we couldn’t set up a contract with an individual family farm, but part of the contractual requirements our hospital has is a certain level of insurance coverage for safety reasons, and oftentimes family farms are not able to afford that insurance coverage. Also, with the GPO, we receive discounts that we would not otherwise obtain, so it is advantageous for us to purchase through our GPO.

Do you have any advice for organic farmers interested in selling their produce to hospitals?

I would encourage them to reach out to some of these food companies, such as Bay Cities and US Foods, and see what they might be able to coordinate.

CCOF (California Certified Organic Farmers) has some initiatives within the state of California aimed at increasing the percentage of land dedicated to organic agriculture, and they are also trying to identify opportunities to help family farms be able to get into some of these large distributors. That may be another mechanism—farmers could coordinate with CCOF to see if they might be able to provide support. 

Mills-Peninsula works very closely with their reps to increase the number of organic and sustainable items available for purchase

Have you gotten any feedback from patients or customers about the presence of organic food at Mills-Peninsula? Have they noticed the change?

Yes, they have. We have patients who, before we started the transition, would ask for organic foods or would ask if what’s on our menu was organic. And it’s really exciting now to be able to say much of our produce is organic. It’s been very well received by our patients.

Initially, when we made the dirty dozen transition and then after it expanded, we posted signage in our physician’s lounge and in our cafeteria. I wouldn’t say there’s been as much of a demand for organic food from our cafeteria as there was from our patients, but it’s been well received. We’ve really tried to be cautious around raising our prices, and so I think that has been one of the things our paying customers have been most appreciative of.

From your perspective as both a registered dietician and a food service director, what role does organic produce play in health care and health in general? 

After learning about the way these toxins and chemicals in our environment wreak havoc on our bodies, it’s become very important for me to eliminate them not only from my personal environment but also from the environment of the patients that we care for and the customers that we serve every day.

Historically, for food service institutions, it’s been about the bottom line and trying to purchase food as economically as possible. I think we have to be fiscally responsible but also do the right thing for our patients and customers and our communities, and so we must find the right balance between the two. There is a cost to making sustainability improvements—and the cost is ultimately worth it. I’m proud to work for an organization that recognizes this. And so I am really excited! I’m excited about where we’re currently at, but then also looking forward a few years down the road, I expect to see other health care and food service institutions making this same transition to organic, sustainable food.