Background To understand, monitor and compare the scope of food waste in hospital foodservices, it is essential to measure food waste using a standardised method. The aims of this systematic review were to: (i) describe and critique the methodological features of waste audits used in hospital foodservice settings that measure aggregate food and food‐related waste and (ii) develop a consensus tool for conducting a food waste audit in a hospital foodservice setting. Methods Seven electronic databases were searched for peer reviewed literature, and 17 Google Advanced searches located grey literature that described food waste audit methods previously used or developed for hospital foodservices. Study selection and quality assessment occurred in duplicate. Data describing the audit method, its feasibility, and strengths and limitations were extracted and synthesised to develop a consensus tool. Results Eight peer reviewed and nine grey literature documents describing a variety of food waste audit methods were found. The most common practices were 2‐week data collection (n = 5), foodservice staff collecting data (n = 6), measuring food waste only (n = 11), measuring food waste at main meals (n = 5) and using electronic scales to measure waste (n = 12). A consensus tool was developed that proposes a method for preparing, conducting and analysing data from a food waste audit. Conclusions This review used published evidence to develop the first ever food waste audit consensus tool for hospital foodservices to use and measure food and food‐related waste. Future research is needed to apply and test this tool in practice.

Aim This review explored peer‐reviewed and grey literature to describe the types and characteristics of food or food‐related waste management strategies used in hospital food service settings; their financial, environmental and staffing outcomes; and the barriers and enablers associated with their implementation. Methods Six electronic databases, 17 Google Advanced searches, and 19 targeted websites were searched for peer‐reviewed and grey literature. Literature reporting the financial, environmental, or staffing outcomes of food or food‐related waste management strategies that reused, recovered energy from, or recycled waste instead of sending it to landfill were eligible. Document screening and review were completed in duplicate, and included peer‐reviewed literature were assessed for quality using the Mixed Methods Appraisal Tool. Data were synthesised narratively. Results Four peer‐reviewed and 81 grey literature records reported 85 strategies. When grouped from most to least favourable according to the food recovery hierarchy they managed waste by: donating surplus food (n = 21); feeding animals (n = 2); industrial use (n = 11); composting (n = 34) and other (n = 17). These approaches had the capacity to reduce waste hauling fees (n = 14), reduce staff handling of waste (n = 3), and decrease the amount of waste sent to landfill (n = 85). Barriers included contamination of waste streams, while enablers included leadership and time‐neutral changes. Conclusion This review summarises the waste management strategies used by hospitals worldwide that divert food and food‐related waste from landfill, their outcomes, and position in the food recovery hierarchy to enable hospital food services to implement appropriate practice and policy changes to decrease their environmental footprint.

This study contributes to the current body of research in this area by examining the most current data, a more robust sample, and a methodology that allows analysis of actual rather than extrapolated last-year-of-life expenses. The analysis has shown current trends in decedent/survivor costs, their relationship to each other, and the changes in this relationship over time. In addition, the finding that the relationship has changed to varying degrees by age groups provides the impetus for including age, gender, and decedent/survivor refinements into the current Medicare projection methodology.

BackgroundDesigning a food waste audit tool for novel hospital foodservice practice does not guarantee uptake. Intended users must be consulted to understand the tool’s feasibility and face validity. This study aimed to identify the perspectives of staff involved in the operation of hospital foodservices on (1) how an evidenced based consensus pathway food waste audit tool is perceived to translate into practice, and (2) to determine the factors that influence the completion of food and food-related waste audits within this setting.Materials and methodsPurposeful sampling was used to recruit staff with knowledge on the operation/governance of foodservices within hospitals in Victoria, Australia. Semi-structured interviews (n = 20) were conducted via Zoom to explore barriers and enablers to completing food and food-related waste audits and a previously published food waste audit tool. NVivo was used for inductive thematic analysis.ResultsThree factors determined the completion of food and food-related waste audits in hospital foodservices, and each factor could be a barrier or an enabler; (1) capacity: the availability of time, labour and materials to complete an audit (2) change: staff resistance to audit procedures and how to gain their buy-in (3) processes, governance, and leadership: the opportunity for high level support, policy and structure to encourage waste audits if present. The consensus tool appeared to have face validity. Planning audit operations, conducting stakeholder meetings, providing education/training to foodservice team members, and facilitating communication between managers and staff were described to support consensus tool use and audit completion.ConclusionThe consensus tool can be used to support hospital foodservices to complete food and food-related waste audits, although it may need to be customised to be fit for purpose. Optimising the capacity, change management and processes, governance and leadership of the foodservice department may improve the experience and success of a food and food-related waste audit.