Some 'best practice' ideas from Dartmouth-Hitchcock

By Terry Johnson, HEAL NH Director
Published in the New Hampshire Business Review, April 6-19

Dartmouth-Hitchcock Medical Center has a long history of putting healthy policies in place with its employees, patients and community in mind. But the move to stop selling sugar- sweetened beverages – including soda and sports drinks – caused considerable debate on and off the Lebanon campus earlier this year.

"We knew that some employees might not like this new policy at first, but after seeing the data, we knew it was just the right thing to do," said Deborah Keane, director of food and nutrition services and a member of the Healthy Living Committee at Dartmouth-Hitchcock.

"Evidence shows a direct correlation between sugar-sweetened beverages, obesity and a number of diseases, such as diabetes and hypertension," she explained. "Our goal is to change the environment so it is easier to consume healthier foods and beverages. Research shows that this will lead to long-term changes in diet, and a healthier workforce and community in the long run."

Vending machines and outside vendors – Au Bon Pain, Sbarro and Cravin's Deli – will not sell sugar-sweetened beverages, but the policy does not ban these types of beverages from the campus, and employees can bring them to work if they choose. Diet soda will remain available.

Over the years, Dartmouth-Hitchcock has not shied away from initiatives aligned with its vision of "achieving the healthiest population possible."

On July 4, 2008, Dartmouth-Hitchcock became a smoke-free campus, before it was the norm. A year later, deep-fried foods were removed from its menu. On Jan. 1, 2012, sales of sugar-sweetened beverages were stopped.

"We can see that people make healthier choices when those items are made available," said Keane. "Our most popular menu item in the cafeteria was fried chicken fingers, with over 400 orders per week. We replaced it with grilled salmon, and it has become just as popular. During the first year we estimate 21 million fewer fat calories were consumed, equating to a potential loss of 6,000 pounds."

While it has only been about three months since the healthy beverage initiative began, Keane said she has noticed that employees who would typically drink soda are now drinking more water and milk. In fact, sales of plain water increased over 30 percent and sales of milk increased approximately 15 percent since the elimination of sugar-sweetened beverages. While some employees may feel inconvenienced by the change, Dartmouth-Hitchcock's leadership remains steadfast in its belief in the initiative, despite employee questions, vendor negotiations and an initial decrease in overall cold beverage sales.

Dartmouth-Hitchcock officials recognized a successful workplace wellness initiative needs a plan to gain buy-in from staff and stakeholders.

If your business is considering implementing a new workplace wellness initiative, here are a few "best practices" from Dartmouth- Hitchcock to help communicate any new initiatives or policy changes to better engage your employees:

  • Engage leadership. Senior management is a key stakeholder group within any organization and is critical to the success of the policy because it bears responsibility for implementing and enforcing the policy's provisions.
  • Educate staff. Provide information to staff on the health benefits associated with the ini- tiative and the degree to which these changes play a unique role in improving lifestyle, increasing productivity and decreasing health costs.
  • Implement an incentive strategy. Provide incentives such as days off or cost savings toemployees who make healthier choices. (For example, Dartmouth-Hitchcock decreased the price on healthier food and beverage options, while slightly increasing those of less healthy alternatives.)
  • Frame your policy favorably by emphasizing healthier options rather than restricting choices – focus on messages around creating a healthier work environment rather than a workplace ban.
  • Display educational signs in areas where employees congregate or, with healthier food/ beverage initiatives, near points of sale.
  • Kick off your initiative with an informational event and/or health-related event to demonstrate your commitment to a healthy environment.

The Centers for Disease Control and Prevention offers excellent resources for environmental approaches to improve food, physical activity, breastfeeding and tobacco-free environments in hospitals at Included are a Healthy Hospital Choices report and a compilation of case studies from around the country that can serve as models for New Hampshire's hospitals.

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